IN THE DELAWARE CIRCUIT COURT NO. ____SMALL CLAIMS DIVISION
DELAWARE COUNTY JUSTICE CENTER
3100 S. TILLOTSON AVE., MUNCIE, IN 47302
DELAWARE COUNTY JUSTICE CENTER
3100 S. TILLOTSON AVE., MUNCIE, IN 47302
CAUSE NO. 18C0___-___________________________
Your Name
Plaintiff(s)
Your Address
Address
City/State/Zip
Your Phone Number
Telephone No.
NOTICE OF CLAIM
AGAINST
Person You Filed Against
Defendant #1
Their Address
Address
City/State/Zip
Their Phone Number (if available)
Telephone No.
Defendant #2
Address
City/State/Zip
Telephone No.
YOU ARE NOTIFIED THAT THE PLAINTIFF(S) HAS FILED A SMALL CLAIMS LAWSUIT AGAINST YOU IN THE AMOUNT OF $amount owed/requested, TOGETHER WITH COURT COSTS IN THE AMOUNT OF $_filing fee_. A BRIEF STATEMENT OF THE PLAINTIFF’S CLAIM FOLLOWS:
Signature: your signature
Printed Name: Your Name
YOU ARE ADVISED THAT THE ABOVE CLAIM IS SCHEDULED FOR INITIAL TRIAL ON THE ____DAY OF _________________________, 201__ AT __________ ____.M. IN THE DELAWARE CIRCUIT COURT NO. __ AT THE ABOVE-LISTED ADDRESS. (**See Additional Information Regarding the Initial Trial on the Reverse Side of this Form)
Dated:
Clerk:
THE FOLLOWING MANNER OF SERVICE IS HEREBY DESIGNATED:
As to Defendant #1:
Certified mail:
Personal service:
As to Defendant #2:
Certified mail:
Personal service:
Additional Defendants:
Certified mail:
Personal mail: