Appendix D: Property Status Certification Affidavit
STATE OF INDIANA	) 	IN THE ____________________COURT
	) SS:
COUNTY OF______________	)
		CASE NUMBER:

___________________________________________	
Plaintiff(s)
			vs.

___________________________________________
Defendant(s)
PROPERTY STATUS CERTIFICATION AFFIDAVIT
I _________________________ as the owner/property manager of the real estate commonly known as  _____________________________________________________________________________,
(Address)
which is the subject matter of this case affirms the property is a:
□ Covered property
a.	I have reviewed the CARES Act on evictions for non-payment of rent from federally- subsidized housing and federally-backed mortgages.
b.	I am not filing this claim prior to the expiration of the 30-day notice sent to the tenant.
c.	I have received funds under the Act and sent a 30-day notice to vacate that is attached to this Notice of Claim for Possession of Real Estate.
OR
□ Non-covered property
a.	The property associated with Notice of Claim for Possession of Real Estate is a not a federally-subsidized apartment, and is not supported by HUD, USDA or the Treasury (Low Income Housing Tax Credit).  Further, if the home is a single-family dwelling, I verify that the property is not backed by a federally financed mortgage through FHA, Fannie Mae, and Freddie Mac mortgage.

I affirm, under the penalties for perjury, that the foregoing representation is true to the best of my knowledge and belief.
__________	_____________________________
    Date	 Landlord/Attorney for Landlord

Certificate of Service
I hereby certify that a copy of this document was sent to the parties or their counsel by ______________________ (US Mail, E-Service, Sheriff, other manner allowed by IN Trial Rules).

______________				_____________________________________________
Date								Name