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File No
STATE OF NORTH CAROLINA 24CV005358-310
In The General Court Of Justice
County
Name And Address Of Plajntiff
SERVICEMEMBERS CIVIL RELIEF ACT
VERSUS DECLARATION
Name And Address Of
G.S. Ch. 127B Art. 4; 50 U.S.C. 3901 to 4043
NOTE: Though this form may be used in a Chapter 45 Foreclosure action, it is not a substitute for the certification that may be required by G.S. 45-21.12A
DECLARATION
the undersigned Declarant, under penalty of perjury declare the following to be true:
1.. As of the current date:: (check one of the following)
have personal knowledge that the defendant named above is in military service
a.
have personal knowledge that the defendant named above is not in military service *
b. |
Cc. am unable to determine whether the defendant named above is in military service *
|
2. As of the current date, | have have not received a copy of a military order from the defendant named above relating
to State active duty as member of the North Carolina National Guard or service similar to State active duty as é member of the
a
National Guard of another state. See G.S. 127B-27 and G.S. 127B-28(b)
3. Clused [fdid not use the Servicemembers Civil Relief Act Website https://scra.dmdc.osd.mil/) to determine the
defendant's federal military service
(J
The results from my use of that website are attached
(NOTE:: The Servicemembers Civil Relief Act Website is a website maintained by the Department of Defense (DoD). If DoD security certificates
are not installed on your computer, you may experience security alerts from your intemet browser when you attempt to access the website.
Members of the North Carolina National Guard under an order of the Govemor of this State and members of the National Guard of another state
under an order of the governor of that state will not appear in the SCRA Website database.)
4. The following facts support my statement as to the defendant's military service:: (State how you know the defendant is or is not in the
military. Be specific.)
PRE MOTE FILED
DATE: June 25,. 2024
TIME: 2:12:44 PM
DURHAM COUNTY
CLERK OF SUPERIOR COURT
BY: Lunsford Jermaine
*NOTE: The term 'military service" includes the following: active duty service as a member of the United States Army, Navy, Air Force, Marine Corps
Space Force, or Coast Guard; service as éa member of the National Guard under a cail to active service authorized by the President or the
Secretary of Defense for a period of more than 30 consecutive days for purposes of responding to a national emergency; active service as
a commissioned officer of the Public Health Service or of the National Oceanic and Atmospheric Administration; any period of service during
which a servicemember is absent from duty on account of sickness, wounds, leave, or other lawful cause. 50 U.S.C. 3911(2). The term "military
service" also includes the following: State active duty as ca member of the North Carolina National Guard under an order of the Governor
pursuant to Chapter 127A of the General Statutes for a period of more than 30 consecutive days; service as a member of the National Guard of
another state who resides in North Carolina and is under an order of the govemor of that state that is similar to State active duty, for a period of
more than 30 consecutive days. G.S. 127B-27(3) and G.S. 127B-27(4)
I declare (or certify, verify, or state) under penaity of perjury that the foregoing is true and correct.
Date Of clara f Declarant (type
Bo}San iD Khadet gvte
Signat print)
-62
NOTE TO COURT: Do not proceed to enterjudgment in a non riminal case in which the defendant has not made an app nce until a
Servicemembers Civil Relief Act affidavit or declaration (whether on this form or not) has been filed, and if it appears that
the defendant is in military service, do not proceed to enter judgment until such time that you have appointed an attorney
to represent him or her.
(Over)
AOC-G-250 Rev. 4/24
© 2024 Administrative Office of the Courts
Information About Servicemembers Civil Relief Act Affidavits And Declarations
1 Plaintiff to file affidavit/declaration
In any civil action or proceeding, including any child custody proceeding, in which the defendant
does not make an appearance, the court, before entering judgment for the plaintiff, shall require the
plaintiff to-file with the court-an affidavit-_: . +
(A) stating whether or not the defendant is in military service and showing necessary facts to
support the affidavit, or :
(B) if the plaintiff is unable to determine whether or not the defendant ts in military service,
stating that the plaintiff is unable to determine whether or not the defendant ts in military
Service 1
50 USC 3931(b)(1)
2 Appointment of attorney to represent defendant tn military service
If in a civil action or proceeding in which the defendant.does not make an appearance it appears
that the defendant !s inmilitary service, the court may not enter a judgment until after the court
appoints an attorney toirepresent the defendant f an attorney appointed to represent a service
member cannot locate the service member, actions by the attorney in the case shall not waive any
defense of the service member or otherwise bind the service member 50 USC 3931(b)(2)
State funds are not available to pay attorneys appointed pursuant to the Servicemembers Civil
Relief Act To comply with the federal Violence Against Women Act and tn consideration of
GS 50B-2(a), 50C-2(b), and 50D-2(b), plaintiffs in Chapter 50B, Chapter 50C, and Chapter
50D proceedings should not be required to"pay the costs of attorneys appointed pursuant to the
Servicemembers Civil Relief Act Plaintiffs in other types of actions and proceedings may be
required to pay the costs of attorneys appointed pursuant to the Servicemembers Civil Relief Act
The allowance or disallowance of the ordering of costs will require a case-specific analysis
3 Defendant's military status not ascertained by affidavit/declaration
Ifbased upon the affidavits filed in such an action, the court is unable to determine whether the
defendant Is in military service, the court, before entering judgment, may require the plaintiff to file
a bond in an amount the court If the defendant ts later found to be in military service,
approved by
the bond shall be available to indemnify the defendant against any loss or damage the defendant
may suffer by reason of any judgment for the plaintiff against the defendant, should the judgment be
set aside in whole or in part The bond shall remain in effect until expiration of the time for appeal
and setting aside of a judgment under applicable Federal or State law or regulation or under any
applicable ordinance of a political subdivision of a State The court may issue such orders or enter
such judgments as the jcourt determines necessary to protect the rights of the defendant under.this
Act 50U SC 3931(b)(3)
4 Satisfaction of requirement for affidavit/declaration
The requirement for an affidavit above may be satisfied by a statement, declaration, verification, or
certificate"'in writing, subscribed and certified or declared to be true under penalty of perjury
50USC 3931(b)4) The presiding judicial official will determine whether the submitted affidavit ts
sufficient
5 Penalty for making or. using false affidavitideclaration
A person who makes or uses an affidavit permitted under 50 U US C 3931(b) (ora statement
declaration, verification, or certificate as authorized under 50 UUSC 3931(b)(4)) knowing It to be
false, shall be fined as provided tn title 18, United States Code, or imprisoned for not more than one
year, or both 50 USC 3931(c)
AOC G 250 Side Two Rev 4/24 t
© 2024 Administrative Office of the Courts
:
Preview
File No STATE OF NORTH CAROLINA 24CV005358-310 In The General Court Of Justice County Name And Address Of Plajntiff SERVICEMEMBERS CIVIL RELIEF ACT VERSUS DECLARATION Name And Address Of G.S. Ch. 127B Art. 4; 50 U.S.C. 3901 to 4043 NOTE: Though this form may be used in a Chapter 45 Foreclosure action, it is not a substitute for the certification that may be required by G.S. 45-21.12A DECLARATION the undersigned Declarant, under penalty of perjury declare the following to be true: 1.. As of the current date:: (check one of the following) have personal knowledge that the defendant named above is in military service a. have personal knowledge that the defendant named above is not in military service * b. | Cc. am unable to determine whether the defendant named above is in military service * | 2. As of the current date, | have have not received a copy of a military order from the defendant named above relating to State active duty as member of the North Carolina National Guard or service similar to State active duty as é member of the a National Guard of another state. See G.S. 127B-27 and G.S. 127B-28(b) 3. Clused [fdid not use the Servicemembers Civil Relief Act Website https://scra.dmdc.osd.mil/) to determine the defendant's federal military service (J The results from my use of that website are attached (NOTE:: The Servicemembers Civil Relief Act Website is a website maintained by the Department of Defense (DoD). If DoD security certificates are not installed on your computer, you may experience security alerts from your intemet browser when you attempt to access the website. Members of the North Carolina National Guard under an order of the Govemor of this State and members of the National Guard of another state under an order of the governor of that state will not appear in the SCRA Website database.) 4. The following facts support my statement as to the defendant's military service:: (State how you know the defendant is or is not in the military. Be specific.) PRE MOTE FILED DATE: June 25,. 2024 TIME: 2:12:44 PM DURHAM COUNTY CLERK OF SUPERIOR COURT BY: Lunsford Jermaine *NOTE: The term 'military service" includes the following: active duty service as a member of the United States Army, Navy, Air Force, Marine Corps Space Force, or Coast Guard; service as éa member of the National Guard under a cail to active service authorized by the President or the Secretary of Defense for a period of more than 30 consecutive days for purposes of responding to a national emergency; active service as a commissioned officer of the Public Health Service or of the National Oceanic and Atmospheric Administration; any period of service during which a servicemember is absent from duty on account of sickness, wounds, leave, or other lawful cause. 50 U.S.C. 3911(2). The term "military service" also includes the following: State active duty as ca member of the North Carolina National Guard under an order of the Governor pursuant to Chapter 127A of the General Statutes for a period of more than 30 consecutive days; service as a member of the National Guard of another state who resides in North Carolina and is under an order of the govemor of that state that is similar to State active duty, for a period of more than 30 consecutive days. G.S. 127B-27(3) and G.S. 127B-27(4) I declare (or certify, verify, or state) under penaity of perjury that the foregoing is true and correct. Date Of clara f Declarant (type Bo}San iD Khadet gvte Signat print) -62 NOTE TO COURT: Do not proceed to enterjudgment in a non riminal case in which the defendant has not made an app nce until a Servicemembers Civil Relief Act affidavit or declaration (whether on this form or not) has been filed, and if it appears that the defendant is in military service, do not proceed to enter judgment until such time that you have appointed an attorney to represent him or her. (Over) AOC-G-250 Rev. 4/24 © 2024 Administrative Office of the Courts Information About Servicemembers Civil Relief Act Affidavits And Declarations 1 Plaintiff to file affidavit/declaration In any civil action or proceeding, including any child custody proceeding, in which the defendant does not make an appearance, the court, before entering judgment for the plaintiff, shall require the plaintiff to-file with the court-an affidavit-_: . + (A) stating whether or not the defendant is in military service and showing necessary facts to support the affidavit, or : (B) if the plaintiff is unable to determine whether or not the defendant ts in military service, stating that the plaintiff is unable to determine whether or not the defendant ts in military Service 1 50 USC 3931(b)(1) 2 Appointment of attorney to represent defendant tn military service If in a civil action or proceeding in which the defendant.does not make an appearance it appears that the defendant !s inmilitary service, the court may not enter a judgment until after the court appoints an attorney toirepresent the defendant f an attorney appointed to represent a service member cannot locate the service member, actions by the attorney in the case shall not waive any defense of the service member or otherwise bind the service member 50 USC 3931(b)(2) State funds are not available to pay attorneys appointed pursuant to the Servicemembers Civil Relief Act To comply with the federal Violence Against Women Act and tn consideration of GS 50B-2(a), 50C-2(b), and 50D-2(b), plaintiffs in Chapter 50B, Chapter 50C, and Chapter 50D proceedings should not be required to"pay the costs of attorneys appointed pursuant to the Servicemembers Civil Relief Act Plaintiffs in other types of actions and proceedings may be required to pay the costs of attorneys appointed pursuant to the Servicemembers Civil Relief Act The allowance or disallowance of the ordering of costs will require a case-specific analysis 3 Defendant's military status not ascertained by affidavit/declaration Ifbased upon the affidavits filed in such an action, the court is unable to determine whether the defendant Is in military service, the court, before entering judgment, may require the plaintiff to file a bond in an amount the court If the defendant ts later found to be in military service, approved by the bond shall be available to indemnify the defendant against any loss or damage the defendant may suffer by reason of any judgment for the plaintiff against the defendant, should the judgment be set aside in whole or in part The bond shall remain in effect until expiration of the time for appeal and setting aside of a judgment under applicable Federal or State law or regulation or under any applicable ordinance of a political subdivision of a State The court may issue such orders or enter such judgments as the jcourt determines necessary to protect the rights of the defendant under.this Act 50U SC 3931(b)(3) 4 Satisfaction of requirement for affidavit/declaration The requirement for an affidavit above may be satisfied by a statement, declaration, verification, or certificate"'in writing, subscribed and certified or declared to be true under penalty of perjury 50USC 3931(b)4) The presiding judicial official will determine whether the submitted affidavit ts sufficient 5 Penalty for making or. using false affidavitideclaration A person who makes or uses an affidavit permitted under 50 U US C 3931(b) (ora statement declaration, verification, or certificate as authorized under 50 UUSC 3931(b)(4)) knowing It to be false, shall be fined as provided tn title 18, United States Code, or imprisoned for not more than one year, or both 50 USC 3931(c) AOC G 250 Side Two Rev 4/24 t © 2024 Administrative Office of the Courts :