1

2 [NOTE TO USER: ALL INSTRUCTIONS IN BETWEEN BRACKETS – [ . . . ] – ARE

3 INCLUDED TO ASSIST YOU IN PREPARING YOUR DOCUMENT ONLY. INSERT THE

INFORMATION PER THE INSTRUCTION, THEN DELETE THE BRACKETED
4
INSTRUCTION OUT OF YOUR FINAL DOCUMENT.]
5

6 [INSERT DOCUMENT CODE (IF IN DISTRICT COURT)]

7 [INSERT NAME]

8 [INSERT ADDRESS]
[INSERT CITY, STATE ZIP CODE]
9
[INSERT TELEPHONE NUMBER]
10
[INSERT E-MAIL ADDRESS]
11

12 Plaintiff/ Defendant, In Proper Person

13 [CHECK APPROPRIATE BOX ABOVE OR INSERT SOME OTHER PARTY

DESIGNATION]]
14

15

16

17
[INSERT COURT NAME]
18

19
CLARK COUNTY, NEVADA
20

21

22 [INSERT PLAINTIFF NAME(S)]

Case No.: [INSERT CASE #]
23
Plaintiff(s), Dept. No.: [INSERT DEPT. #]
24

25 vs.

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3 [INSERT DEFENDANT NAME(S)]

4
Defendant(s).
5

7 [INSERT TITLE OF DOCUMENT]

8 Date of Hearing: [INSERT DATE IF APPLICABLE OR "N/A"]

Time of Hearing: [INSERT TIME IF APPLICABLE OR "N/A"]
9

10 [BEGIN THE TEXT OF YOUR DOCUMENTS HERE]

11 DATED this ______ day of _________________________, 20___.

12
Pursuant to NRS 53.045, I declare under penalty of
13 perjury that the foregoing is true and correct.
14

15 _____________________________________________ (signature)

16 [INSERT NAME]
[INSERT ADDRESS]
17
[INSERT CITY, STATE, ZIP CODE]
18
[INSERT TELEPHONE NUMBER]
19 [INSERT E-MAIL ADDRESS]

20 Plaintiff/ Defendant, In Proper Person [CHECK

APPROPRIATE BOX OR INSERT SOME OTHER
21
PARTY DESIGNATION]
22

23

24

25

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2 [USE THE FOLLOWING ONLY IF APPROPRIATE FOR YOUR SERVICE OF YOUR TYPE

3 OF DOCUMENT.]

4 CERTIFICATE OF MAILING

5 I HEREBY CERTIFY that on the ______ day of _________________________, 20___,

6 I placed a true and correct copy of the foregoing [INSERT TITLE OF DOCUMENT] in the

7 United States Mail, with first-class postage prepaid, addressed to the following:

8 [INSERT THE NAME(S) AND ADDRESS(ES) OF THE

9 ATTORNEYS FOR EACH OF THE PARTIES IN THE CASE,

OR TO THE PARTIES DIRECTLY IF UNREPRESENTED]
10

11
DATED this ______ day of _________________________, 20___.
12
Pursuant to NRS 53.045, I declare under penalty of
13
perjury that the foregoing is true and correct.
14

15 _____________________________________________ (signature)

16 [INSERT NAME]

17

18

19

20

21

22

23

24

25

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