AOC-180 Rev. 12-01 Page 1 of 1
Summons Type: SC
01/8/2007 03:19 pm
Ver. 1.01
Case No.
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Court County
District Small Claims
Commonwealth of Kentucky Court of Justice KRS 24A.280
SMALL CLAIMS SUMMONS
Individual Other
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PLAINTIFF
VS.
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Individual
Other
DEFENDANT
THE COMMONWEALTH OF KENTUCKY To the above-named Defendant(s): You are hereby notified a legal action has been filed against you in this Court demanding relief as shown on the complaint delivered to you with this Summons. You are summoned to appear before this Court on ______________, ______, at _________ [ ] a.m./ [ ] p.m., at the following location: __________________________________________ _____________________________________________________________________________________. Failure to appear on the date indicated may result in a judgment by default against you for the relief demanded in the attached complaint. The name(s) and address(es) of the party or parties demanding such relief against you or his/her (their) attorney(s) is/are shown on the complaint delivered to you with this Summons. Date: ___________________, 2_____. _______________________________________ Clerk By:_____________________________________ D.C.
PROOF OF SERVICE This summons was served by delivering a true copy of this summons and the complaint (or other initiating document) to: _____________________________________________________________________
________________________________________________________________________________ ________________________________________________________________________________
This _____ day of ______________, 2______. Served by: ________________________________
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