Free CIVILCOMPLAINT-WORTHLESS CHECK (SCA-M337) - West Virginia

IN THE MAGISTRATE COURT OF
Name, Address & Phone Number of Plaintiff: Case No.

COUNTY, WEST VIRGINIA

v. Name, Address & Phone Number of Defendant

--- fold here ---

--- fold here --WORTHLESS CHECK: CIVIL COMPLAINT

The above-named plaintiff or of the defendant(s)]:

, on behalf of the plaintiff acting in the capacity , alleges the following as true and accurate [give a clear and simple statement of the claim against

and requests the following relief from the court (check all that apply) $ $ $ and the following additional relief: [the face amount of the check less any money received as partial payment of the debt of the check]; [for damages] [NOTICE: the amount claimed for damages may only be $500 or the face value of the check, whichever is less]; [reasonable court costs];

Signature Date NOTICE: A plaintiff may NOT file both a worthless-check civil complaint and a worthless check criminal complaint for the same worthless check(s) [§ 55-16-1(g)]. If a plaintiff does this, the court will dismiss whichever complaint was most recently filed. NOTICE: Any party in a civil action seeking over $20.00 or possession of real estate has the right to elect that the case be tried by a jury. You must give written notice to the magistrate court either 20 days from when the first timely answer to the complaint is made. If you do not notify the magistrate court within the appropriate time period, you give up your right to a jury trial. The jury fee will be assessed against the losing party if the case is tried by a jury or may be prorated between the parties if the case is settled before trial. (OPTIONAL) NOTICE OF ELECTION: As plaintiff in the above action, I wish to have a jury trial.

Signature Date NOTICE: Any person involved in court proceedings who has a disability and needs reasonable accommodation should inform the court sufficiently in advance so that arrangements can be made if possible.
W. Va. Code §§ 50-4-1, 50-5-8(a); 55-16-1; Mag. Ct. Civ. Rules 2, 6A Return Defendant File Plaintiff

SCA-M-337 / 6-00