Eviction Services

from the

Law Office of Mark B. Tackitt

Eviction Questionnaire

You can print this form, or cut and paste it to a document and email it to your attorney.

Manager Information (Leave blank if owner is the manager)

Owner Information

Status of Owner

How does the owner hold title to the subject property?

___ As an Individual

___ As a Partnership

___ As a Corporation

___ Other (Describe)

Subject Property

  1. Property Address _______________________________________________________________
  2. Unit Number ___________________________________________________________________
  3. Property Description (apartment, single family residence, rented condominium, et cetera) _____________________________________________________________________________


  1. Full names of all tenants who leased the property
  2. Full names of all other adult persons in possession of the premises whether or not they are tenants

The Rental Agreement

  1. Date of the Agreement
  2. Period (month to month tenancy, yearly, et cetera)
  3. Rental Amount $______________ Per ________________ (Month, Week, et cetera)
  4. Who signed for the Owner (Owner, Former Owner, Agent, et cetera)?
  5. Do you possess the original or a copy of the agreement? If so, indicate whether it is the original or a copy.

Modification(s) of the Rental Agreement

  1. Has the agreement been modified? Yes or no.
  2. Date of notice of modification:
  3. Method of service of modification notice: (Personal, by mail, et cetera)
  4. Which term was modified? (Rental Amount, Due Date, et cetera)
  5. Date when the modification took effect:
  6. Do you possess an original or a copy of the modification notice? If so, indicate whether is it the origianl or a copy.

Reason for Eviction

___ Failure to Pay Rent

___ Expiration of Term of Lease

___ Breach of Term of Lease (failure to pay water/sewer/garbage; excessive persons; unauthorized pets; etc.)

___ Owner or member of immediate family intends to reoccupy

___ Drug Nuisance (Please provide copy of notice sent by the City, County, or State demanding that the owner abate the drug nuisance.)

___ Waste

___ Excessive notices served upon tenant residing in Seattle (four 3-day notices to pay rent or vacate, three 10-day notices to comply with terms of contract, et cetera)

___ Other (Describe)

Rent currently due

$___________ From __________ 199__ To __________ 199__

$___________ From __________ 199__ To __________ 199__

$___________ From __________ 199__ To __________ 199__

$___________ From __________ 199__ To __________ 199__

$___________ From __________ 199__ To __________ 199__

$___________ From __________ 199__ To __________ 199__

$___________ From __________ 199__ To __________ 199__

Total rent now due and owing: $___________

Previous Eviction Notices

  1. Have you already served the eviction notice? Yes or no.
  2. Type of Notice served? 3 day pay, 10 day comply, 20 or 60 day termination.
  3. Method of Service

___ handed to tenant

___ handed to someone else at the premises

___ post or affix to door

___ by mail

  1. Who served the notice?
  2. Do you possess a copy of the notice?
  3. Have you completed the Declaration of Service of Notice? (Go to Declaration)

Tenant Complaints/Potential Defenses

  1. Have the tenants made any complaints to you, to any other person, or to any governmental agency about the conditions of the property? If yes, describe.
  2. For each complaint, describe your efforts (if any) to remedy the complaint.
  3. Has the tenant in the last twelve months withheld portions of the rent for repairs or replacement of any items in the premises?
  4. Has the tenant sent you any letters in the past twelve months? If so, copy and send. notices?


Law Office of Mark B. Tackitt
P.O. Box 46331
Seattle, Washington, 98146

This page last edited 2 August 2000.