District Court Rules
Schedule: C - Forms in civil proceedings Form: 40B.01 Landlord and tenant claim notice: recovery of possession of premises
S.I. No. 17 of 2014
40B.01
Landlord and tenant claim notice: recovery of possession of premises
Schedule C
O.40B, r. 4
District Court Area of
District No.
Record number:
Between
........ Claimant
........ Respondent
LANDLORD AND TENANT CLAIM NOTICE
This landlord and tenant claim notice is issued at the request of the claimant(s), who makes a claim in the District Court against the respondent for recovery of possession of premises at ........ in the above Court *(area and) district.
Particulars of first claimant:
| Name |  |
| Address | *(in the above Court *(area) and district) |
| Occupation | |
| *Solicitor | |
| Address for service of documents | |
[Repeat particulars for second and any subsequent claimant]
Particulars of first respondent:
| Name | |
| Address | *(in the above Court *(area) and district) |
| *Solicitor (if known) | |
| Occupation (if known) | |
| Address for service of documents (if known) | |
[Repeat particulars for second and any subsequent respondent]
Particulars of premises and tenancy:
| Full address of premises | *(in the above Court *(area) and district) |
| Name of landlord(s) | |
| Name of tenants(s) | |
| Nature of tenancy or arrangement by which respondent is in possession of the premises (specify if in writing) | |
| Is the tenancy required to be registered in the private residential tenancies register maintained under section 127 of the Residential Tenancies Act 2004- | Yes/No |
| Is the tenancy registered in the private residential tenancies register maintained under section 127 of the Residential Tenancies Act 2004- | Yes/No |
| Particulars of registration under section 127 of the Residential Tenancies Act 2004 | |
| Rent | €........ [Specify whether per week/month/year, etc] |
| Is it alleged that the tenancy has been brought to an end, and if so how? | |
| If non-payment of rent is claimed, specify the amount of rent due, and the date up to which that rent was due | €........ up to the ......day of ......20... |
STATEMENT OF CLAIM
[Set out in numbered paragraphs a statement of all material facts on which the claimant relies, including necessary particulars of such fact, which must include the place where and the date when the claim arose, but not the evidence by which those facts are to be proved. Specify in that statement the specific provisions of any enactment that is relied on and the amount or other relief or remedy sought. Examples are provided at the end of this form.]
LIST OF CORRESPONDENCE AND OTHER DOCUMENTS ON WHICH THE CLAIMANT WILL RELY AT TRIAL
| Document | Date | Description |
| 1 | e.g. letting agreement | 1 September 2013 | Letting agreement between the claimant and the respondent |
| 2 | | | |
| Etc | | | |
(A) IF YOU DISPUTE THE CLAIM and wish to defend the proceedings, then you must give, or send by post, to the claimant or claimant’s solicitor at the address for service mentioned above an appearance and defence in Form 42.1, Schedule C of the District Court Rules, not later than 28 days after the service on you of this claim notice, and at the same time file a copy of your appearance with the District Court Clerk at the address below.
(B) IF YOU ADMIT THE CLAIM and without serving an appearance and defence and filing an appearance
*PAY THE AMOUNT of €...... and costs of €....... to the claimant or the claimant's solicitor
*ARRANGE to deliver possession of the premises and pay costs of €....... to the claimant or the claimant's solicitor
within 10 days after the service on you of this claim notice, all further proceedings will be stayed, you need not attend court and you will avoid further costs.
IF YOU DO NOT ACT IN ACCORDANCE WITH (A) OR (B) ABOVE you will be held to have admitted the claim and the claimant may apply for judgment to the District Court and if judgment is given, proceed to execution.
Signed:........
*(Solicitor for) Claimant
To the respondent(s) at the address(es) given above
This claim notice is issued at ........ on the ...... day of ........ 20.... by ........ the District Court Clerk assigned to the above
Court area and district
*Delete where inapplicable
Sample statements of claim
Overholding
1. The claimant is the owner of a rental apartment at Flat A, 1 Main Street, Dublin 4 (the premises).
2. The respondent took possession of the premises as tenant of the claimant on 1 January 2012 under a one year lease dated 1 January 2012 between the claimant and the respondent at a monthly rent of €2.
3. The tenancy expired on 31 December 2012. The claimant did not wish to renew the tenancy as he intended to redevelop the premises.
4. The claimant served a written notice on the respondent on 21 January 2013 requiring him to vacate the premises immediately.
5. The respondent remained and remains in possession of the premises and has refused to deliver possession of the premises. No other person is in possession of any part of the premises. The claimant has not accepted rent from the respondent since 31 December 2012.
6. The claimant claims an order for possession of the premises and damages.
Permissive Occupant: section 82 of the Landlord and Tenant Law Amendment (Ireland) Act 1860
1. The claimant is the owner of premises at Flat A, 1 Main Street, Dublin 4 (the premises).
2. The respondent took possession of the premises as caretaker of the claimant on 1 January 2012 as the claimant planned to live abroad during 2012. The claimant allowed the respondent to occupy the premises rent-free in return for routine maintenance and ensuring the security of the premises.
3. The claimant returned to Ireland on 31 December 2012. The claimant wished to resume occupation of the premises as his principal residence.
4. The claimant served a written notice on the respondent on 1 January 2013 requiring him to vacate and deliver possession of the premises to the claimant immediately.
5. The respondent has refused or omitted to deliver possession of the premises to the claimant. The respondent has remained in possession of the premises.
6. Since 1 January 2013, the respondent has kept possession of the premises from the claimant. No other person is in possession of any part of the premises.
7. The claimant claims an order for possession of the premises and damages.
Recovery of possession for non-payment of rent
1. The claimant is the owner of a rental apartment at Flat A, 1 Main Street, Dublin 4 (the premises).
2. The respondent took possession of the premises as tenant of the claimant on 1 January 2011 under a written lease dated 1 January 2011 between the claimant and the respondent at a yearly rent of €20.
3. Rent was paid for 2011. The sum of €20 of rent, being one full year's rent due up to 31 December 2012 (state amount of rent and the last gale day up to which due) became and is still due to the claimant in respect of the premises.
4. The claimant served repeated notices on the respondent on 1 January 2013,
1 February 2013 and 1 March 2013 requiring him to pay the arrears of rent or to vacate the premises immediately.
5. The respondent has refused or failed to pay the arrears of rent and remained and remains in possession of the premises and has refused to deliver possession of the premises. No other person is in possession of any part of the premises.
6. The claimant claims an order for possession of the premises and damages.
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