Form DC 102b

COMPLAINT, 
DAMAGE/HEALTH HAZARD TO PROPERTY

  Use this form if:

 

 
 

 
 

 

  • you want to start eviction proceedings against a tenant who has caused extensive and continuing
    damage or a serious and continuing health hazard to rental property, and

  • you delivered to the tenant within 90 days of discovering the damage or health hazard a demand 
    for possession because of damage or health hazard, and 

  • at least 7 days has passed since the date you delivered the demand for possession.

     complaint.

  A civil action between these parties or other parties arising out of the transaction or occurrence alleged in this  

  There is no other pending or resolved civil action arising out of the same transaction or occurrence alleged in this 

The plaintiff states:
1. 
 
 
 
 
 
2. Attached to this complaint is a copy of the lease or occupancy agreement, if any, under which possession is claimed, 
  and a copy of the notice to quit or demand for possession showing when and how it was served.

    complaint has been previously filed in 
    judge are 
 
    The action 

 Court.  The docket number and assigned 
 .

  is no longer  pending.

  remains 

 

3. The person entitled to possession of the property described in the attached demand for possession is

Name (type or print)

4. The defendant is in possession of the following portion of the property: 

 

 
 5. The plaintiff has a right to possession of the property because the defendant has caused a serious and continuing health
  hazard or extensive and continuing damage to the premises.
  State the exact nature and extent of the hazard or injury, and state the period of time that it has continued. 
 

 .

  6. The tenancy involves regulated housing operated by or under rules of a governmental unit.  The rule or law under
 .
    which the tenancy is ended is 
  7. (If applicable.)  The plaintiff declares that this residential property was kept fit for the use intended and has been kept
    in reasonable repair during the term of the lease.

 

 
8. The defendant has not complied with the demands made and has not moved.
9. The plaintiff requests a judgment of possession and costs.
  The plaintiff requests an immediate order of eviction.
 

NOTE:  If you wish to demand a jury trial, you must file a jury demand (MC 22). 

SUPPLEMENTAL COMPLAINT

  10. Complaint is made and judgment is sought for money damages against the defendant as follows:

C

D

E

F

G H I J

K

 

 

Date

L

 

 

Plaintiff/Attorney signature

DC 102b (12/19) COMPLAINT, DAMAGE/HEALTH HAZARD TO PROPERTY, Landlord - TenantMCL 600.5714,MCR 2.113(C), MCR 4.201(B)Plaintiff name(s), address(es), and telephone no(s).vDefendant name(s), and address(es)Plaintiff’s attorney, bar no., address, and telephone no.ABApproved, SCAO Original - Court1st copy - Tenant2nd copy - Mailing3rd copy - LandlordSTATE OF MICHIGANJUDICIAL DISTRICTCOMPLAINTDAMAGE/HEALTH HAZARD TO PROPERTYLandlord - TenantCASE NO.Court addressCourt telephone no.