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Here is the text we could read:

HOUSING COURT 
DEPARTMENT 

MOTION FOR ISSUANCE OF EXECUTION

COUNTY 

DIVISION 

DOCKET NUMBER 

Named parties should be listed exactly as they appear on the Complaint filed.  

CASE NAME 

[In Matter of] 

[v.] 

I,  ________________________________,  the  undersigned,  move  (ask)  this  Court  to  issue  an  execution 

for possession (move-out order) in the above-referenced case. 

The  defendant(s)  still  owe  rent  (or  use  and  occupancy)  in  the  amount  of  $  ______________ 

through ______________.  This  balance  includes  only  unpaid  rent/use  and  occupancy  charges  and  does not 

include court  costs  or  other  claims,  debts,  damages,  or  expenses.  (If  money  is  owed,  you  must 

complete  the worksheet  on  page  2  or  submit other documentation with this motion).

The Court should issue the execution for possession because: (Provide the specific legal reason(s) why the 

Court should allow this motion and issue the execution that you request.)

Subscribed and sworn under the pains and penalties of perjury. 

A copy of this form must be served upon the opposing party(ies). 

PRINTED NAME OF PLAINTIFF OR PLAINTIFF'S ATTORNEY 

BBO # (if applicable) 

XX 
X

SIGNATURE OF PLAINTIFF OR PLAINTIFF'S ATTORNEY 

DATE 

I                          a copy of this motion on __________________________ to __________________________.

The Court rules and orders as follows: 

To be completed by the Housing Court.

So Ordered: ___________________________________________ 

Date: ___________________ 

Last updated 10/2022 

Page 1 of 2 

HOUSING COURT 
DEPARTMENT 

MOTION FOR ISSUANCE OF EXECUTION

DIVISION 

DOCKET NUMBER

ACCOUNT ANNEXED WORKSHEET

        MONTH  

AMOUNT NOT PAID 

Last updated 10/2022 

Page 2 of 2

Motion for Issuance of Execution

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Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from www.mass.gov (2023-03)
Page(s): 2
Fields(s): 60
Average fields per page: 30
Reading Level: Grade 9
LIST Grouping(s): GO-00-00-00-00.

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Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Motion for Issuance of Execution

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02