REQUEST FOR WRIT OF EXECUTION RESTITUTION OF POSSESSION

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					                                                                                                                                                                    (Information must be legible)
       JACKSON COUNTY CIRCUIT COURT
            415 EAST 12TH STREET                                   REQUEST FOR WRIT OF EXECUTION
         KANSAS CITY, MISSOURI 64106                                                                                                                                CASE NUMBER:
                (816) 881-6465                                       RESTITUTION OF POSSESSION
               308 W. KANSAS
                                                                    LANDLORD-TENANT CASE ONLY
        INDEPENDENCE, MISSOURI 64050
                (816) 881-4490                                 AT KANSAS CITY                                 AT INDEPENDENCE                                       EXECUTION:


                                                    IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI
 STYLE OF CASE:                                                             DATE OF JUDGMENT:                                                                        DEBTOR INFORMATION
                                                                                                                                             Name:

                                                                            RETURNABLE:                                                      Street Address
                                           PLAINTIFF
                                                                                10 DAYS (Chapter 441 Case-Drug or Violence)
                      VS.                                                                                                                    City                                         State           ZIP
                                                                                15 DAYS (Chapter 534 Unlawful Detainer)
                                                                                15 DAYS (Chapter 535 Rent And Possession)


                                                                            Return Date: ______________________________
                                           DEFENDANT
 PLEASE ISSUE:                                   PROPERTY ADDRESS                                (MUST COMPLETE)

                                                      Street Address
     EXECUTION /RESTITUTION
                                                      City                                                     State
                                                                                                                                                                         (TIME STAMP)
 Instructions For Service



 (MUST COMPLETE)
     A judgment was entered on the above referenced date that is now a final judgment and remains unsatisfied
     Defendant(s) remains in possession; and
     There has been no appeal bond filed; and
     No new agreement, either oral or written, has been made with the Defendant(s) that allows the Defendant(s) to be in possession of the premises; and
     Request for execution delivering possession of the premises to Plaintiff is requested.
     I certify that the above information is correct to the best of my knowledge, information and belief and that I have exercised due diligence to verify that the information is true.

 REQUESTED BY: (SIGNATURE)                                                           ATTORNEY FOR:                                                                         DATE:


 ADDRESS:                                                                                                 BAR #:                                                PHONE:




                                                              WRIT OF EXECUTION/RESTITUTION OF POSSESSION
 THE STATE OF MISSOURI TO THE SHERIFF OF ANY COUNTY IN THE STATE OF MISSOURI
 Whereas a judgment granting immediate possession of the property to the Plaintiff and for execution and restitution to issue has been entered by this Court against the above
 Defendant/Judgment Debtor on the date stated above, and Whereas the Defendant/Judgment Debtor remains in possession of the property, and Whereas no appeal bond or bond for trial
 de novo has been entered,
 NOW, THEREFORE, You are commanded to put the Judgment Creditor into immediate possession of the said premises and to deliver possession to the Judgment Creditor, and that you
 return this writ within
     10 days from the date hereof. (Immediate Possession Pursuant To Chapter 441)                  15 days from the date hereof. (Unlawful Detainer/Rent And Possession)
 Date                                        COURT ADMINISTRATOR’S OFFICE-DEPARTMENT OF CIVIL RECORDS-JACKSON COUNTY, MO

                                                                                                                             BY_____________________________________________
                                                                                                                                       Deputy Court Administrator
                                                                                              RESTITUTION RETURN
 I certify that I have executed this restitution by overseeing the removal of all personal property from the premises to the curb and restored possession of the property to plaintiff.

 Evicted From:

 Date:                                                                  Time Started:                                                          Time Completed:
 Comments:


 I certify that this restitution was not executed for the following reason:
      Voluntarily Moved               Incorrect Address              Stay Order Cancelled By Pltf/Atty Pltf/Atty Never Returned Call                                                              Other
 DATE:                                           COURT ADMINISTRATOR’S OFFICE-DEPARTMENT OF CIVIL PROCESSJACKSON COUNTY, MO

                                                                                                                             BY_____________________________________________
                                                                                                                                       Deputy Court Administrator
 NOTES:



CIRCT 1695-B       10/2009
           All shaded areas must be completed or your request will be returned unprocessed. Please submit one original and three copies.