Free Small Claims Form - Statement of Claim and Citation - Louisiana

***ALL SHADED AREAS MUST BE COMPLETED.

BATON ROUGE CITY COURT SMALL CLAIMS DIVISION 233 St. Louis St. P. O. Box 3438 Baton Rouge, LA 70821 (225) 389-3017

STATEMENT OF CLAIM AND CITATION
R.S. 13:5200 et seq.
SUIT NUMBER: ______________________________
PLAINTIFF VERSUS DEFENDANT

(By signing this petition, I verify that I have read and understand the Court's publication: "How to Use the Small Claims Division.")

FULL NAME OF PARTY BEING SUED

NAME OF OWNER IF SUING A COMPANY

FULL NAME OF SUING PARTY

STREET ADDRESS OF DEFENDANT

DAYTIME PHONE

CITY, STATE, ZIP CODE

DAYTIME PHONE

STREET ADDRESS OF PLAINTIFF

OTHER ADDRESS FOR DEFENDANT

CITY, STATE, ZIP CODE

CITY, STATE, ZIP CODE

PLAINTIFF CLAIMS THE FOLLOWING RELIEF FROM THE DEFENDANT (Short Statement of Plaintiff's claim and reasons.) If claim is for money, state the date and manner in which indebtedness arose. If claim is for movable property, give description, location, and value. Attach copies of any written supporting documents. Amount sued for $____________________________ plus legal interest and court costs.
I am requesting that this matter be heard by: (Check One) Arbitrator Judge

(If additional space is needed, complete Attachment ­ Page 8.)
NOTICE TO ALL PARTIES: During the pendency of this lawsuit, the Court will contact you at the above address and phone number that you have provided. If either address or phone number should change, you must notify the Court immediately. Your case may be decided by an Arbitrator, who is a licensed attorney, appointed by the Judge. If so appointed, and the parties agree to be bound by his arbitration, his decision will be final and binding. Citation continued on the following page.

SIGNATURE OF PLAINTIFF

FILED:
Deputy Clerk:

If there is an attachment, check here
PLEASE SERVE DEFENDANT/AGENT:

At:
Civil - Statement of Claim & Citation (Interactive Packet) 08-15-08 ORIGINAL (Page 1)

CITATION ­ PAGE 2 La.R.S. 13:5204(b)
BATON ROUGE CITY COURT SMALL CLAIMS DIVISION 233 St. Louis St. P. O. Box 3438 Baton Rouge, LA 70821 (225) 389-3017

* * * ATTENTION * * *
This lawsuit is filed in the Small Claims Division. The ordinary rules of evidence do not apply in the Small Claims Division. If you lose in the Small Claims Division, you have no right to appeal the Court's decision. Your matter will be tried before a Judge, unless both parties request in writing that the matter be heard before an arbitrator. This preference can be made on the first page of the Petition or Answer, whichever applies, in the designated box. The preference for arbitration must be filed with the Clerk of the Small Claims Division no later than ten days from the date on which you receive this notice. Copies of the written preference should be sent to all other parties in this matter. You may have this case transferred to the regular Civil docket. To do so, you must file your answer and written notice of that intent to transfer with the Clerk of City Court within ten (10) days, including weekends, and pay a transfer fee of $50.00. If you are unsure of what to do, you should talk with an attorney about it immediately. If you want to contest this claim, you must decide whether or not you want the case to remain in the Small Claims Division. The advantages of the Small Claims Division are that trial procedures are not strictly enforced and the formal rules of evidence do not apply. The disadvantage is that there is no appeal from the decision upon the case. You do not need a lawyer, but if you wish to retain one, you may do so. Corporations, partnerships and other legal entities may defend themselves through a duly authorized partner, shareholder, officer or employee on any claim not exceeding $3,000.00, if the basis of the suit involves an open account or promissory note. In all other such cases, an attorney is required to represent these entities. If you decide to contest this claim in the Small Claims Division, you must contact the Clerk of the Small Claims Division in writing within ten (10) days, including weekends, of receiving this letter. To do so, use the form which is provided entitled "Defendant's Answer." If you plan to file a reconventional demand (counterclaim) against the Plaintiff in an amount exceeding $3,000.00, you must have the case transferred to the regular Civil Docket and pay the appropriate fee.

Civil - Statement of Claim & Citation (Interactive Packet) 08-15-08

(Page 2)

***ALL SHADED AREAS MUST BE COMPLETED.

BATON ROUGE CITY COURT SMALL CLAIMS DIVISION 233 St. Louis St. P. O. Box 3438 Baton Rouge, LA 70821 (225) 389-3017

STATEMENT OF CLAIM AND CITATION
R.S. 13:5200 et seq.
SUIT NUMBER: ______________________________
PLAINTIFF VERSUS DEFENDANT

(By signing this petition, I verify that I have read and understand the Court's publication: "How to Use the Small Claims Division.")

FULL NAME OF PARTY BEING SUED

NAME OF OWNER IF SUING A COMPANY

FULL NAME OF SUING PARTY

STREET ADDRESS OF DEFENDANT

DAYTIME PHONE

CITY, STATE, ZIP CODE

DAYTIME PHONE

STREET ADDRESS OF PLAINTIFF

OTHER ADDRESS FOR DEFENDANT

CITY, STATE, ZIP CODE

CITY, STATE, ZIP CODE

PLAINTIFF CLAIMS THE FOLLOWING RELIEF FROM THE DEFENDANT (Short Statement of Plaintiff's claim and reasons.) If claim is for money, state the date and manner in which indebtedness arose. If claim is for movable property, give description, location, and value. Attach copies of any written supporting documents. Amount sued for $____________________________ plus legal interest and court costs.
I am requesting that this matter be heard by: (Check One) Arbitrator Judge

(If additional space is needed, complete Attachment ­ Page 8.)
NOTICE TO ALL PARTIES: During the pendency of this lawsuit, the Court will contact you at the above address and phone number that you have provided. If either address or phone number should change, you must notify the Court immediately. Your case may be decided by an Arbitrator, who is a licensed attorney, appointed by the Judge. If so appointed, and the parties agree to be bound by his arbitration, his decision will be final and binding. Citation continued on the following page.

SIGNATURE OF PLAINTIFF

FILED:
Deputy Clerk: A True Copy:

If there is an attachment, check here.
PLEASE SERVE DEFENDANT/AGENT:

At:
Deputy Clerk:
Civil - Statement of Claim & Citation (Interactive Packet) 08-15-08 DEFENDANT'S COPY (Page 3)

CITATION ­ PAGE 2 La.R.S. 13:5204(b)
BATON ROUGE CITY COURT SMALL CLAIMS DIVISION 233 St. Louis St. P. O. Box 3438 Baton Rouge, LA 70821 (225) 389-3017

* * * ATTENTION * * *
This lawsuit is filed in the Small Claims Division. The ordinary rules of evidence do not apply in the Small Claims Division. If you lose in the Small Claims Division, you have no right to appeal the Court's decision. Your matter will be tried before a Judge, unless both parties request in writing that the matter be heard before an arbitrator. This preference can be made on the first page of the Petition or Answer, whichever applies, in the designated box. The preference for arbitration must be filed with the Clerk of the Small Claims Division no later than ten days from the date on which you receive this notice. Copies of the written preference should be sent to all other parties in this matter. You may have this case transferred to the regular Civil docket. To do so, you must file your answer and written notice of that intent to transfer with the Clerk of City Court within ten (10) days, including weekends, and pay a transfer fee of $50.00. If you are unsure of what to do, you should talk with an attorney about it immediately. If you want to contest this claim, you must decide whether or not you want the case to remain in the Small Claims Division. The advantages of the Small Claims Division are that trial procedures are not strictly enforced and the formal rules of evidence do not apply. The disadvantage is that there is no appeal from the decision upon the case. You do not need a lawyer, but if you wish to retain one, you may do so. Corporations, partnerships and other legal entities may defend themselves through a duly authorized partner, shareholder, officer or employee on any claim not exceeding $3,000.00, if the basis of the suit involves an open account or promissory note. In all other such cases, an attorney is required to represent these entities. If you decide to contest this claim in the Small Claims Division, you must contact the Clerk of the Small Claims Division in writing within ten (10) days, including weekends, of receiving this letter. To do so, use the form which is provided entitled "Defendant's Answer." If you plan to file a reconventional demand (counterclaim) against the Plaintiff in an amount exceeding $3,000.00, you must have the case transferred to the regular Civil Docket and pay the appropriate fee.

Civil - Statement of Claim & Citation (Interactive Packet) 08-15-08

Page 4)

***ALL SHADED AREAS MUST BE COMPLETED.

BATON ROUGE CITY COURT SMALL CLAIMS DIVISION 233 St. Louis St. P. O. Box 3438 Baton Rouge, LA 70821 (225) 389-3017

STATEMENT OF CLAIM AND CITATION
R.S. 13:5200 et seq.
SUIT NUMBER: ______________________________
PLAINTIFF VERSUS DEFENDANT

(By signing this petition, I verify that I have read and understand the Court's publication: "How to Use the Small Claims Division.")

FULL NAME OF PARTY BEING SUED

NAME OF OWNER IF SUING A COMPANY

FULL NAME OF SUING PARTY

STREET ADDRESS OF DEFENDANT

DAYTIME PHONE

CITY, STATE, ZIP CODE

DAYTIME PHONE

STREET ADDRESS OF PLAINTIFF

OTHER ADDRESS FOR DEFENDANT

CITY, STATE, ZIP CODE

CITY, STATE, ZIP CODE

PERSONAL I served the original citation and process and certified copy of any accompanying document on the ________ day of ______________, 20_____ on the within named, ______________________________, in the Parish of East Baton Rouge, State of La., by tendering same to or the agent/atty., _________________________________________ ________________________________________________________ in PERSON at ___________________________________________ _______________________________________________________ _______________________________________________________ ________________________________________________________ Deputy City Constable, City of Baton Rouge

DOMICILIARY I served the original citation and process and certified copy of any accompanying document on the ______ day of _________________, 20______ on the within named, _____________________________, at his dwelling, house, or usual place of DOMICILE at _______________________________________________________ _______________________________________________________ by leaving same with ______________________________________ _______________________________________________________, a person of suitable age and discretion residing therein as a member of within named person's domiciliary establishment. _______________________________________________________ Deputy City Constable, City of Baton Rouge DUE AND DILIGENT I received the original citation and process and certified copy of any accompanying document on the ________ day of ______________, 20_______. After diligent search and inquiry, I was unable to find the within named, ________________________________________, at his domicile, or anyone legally authorized to represent him. I, therefore, return original citation and process NOT SERVED on this __________ day of _______________________, 20_______ because ________________________________________________ _______________________________________________________ _______________________________________________________ Deputy City Constable, City of Baton Rouge

Service Fee Mileage TOTAL

$_________________ $_________________ $_________________

Civil - Statement of Claim & Citation (Interactive Packet) 08-15-08 COPY FOR RETURN

(Page 5)

***ALL SHADED AREAS MUST BE COMPLETED.

BATON ROUGE CITY COURT SMALL CLAIMS DIVISION 233 St. Louis St. P. O. Box 3438 Baton Rouge, LA 70821 (225) 389-3017

* * * DEFENDANT'S ANSWER * * *
R.S. 13:5200 et seq.
SUIT NUMBER: ______________________________
PLAINTIFF VERSUS DEFENDANT

(By signing this petition, I verify that I have read and understand the Court's publication: "How to Use the Small Claims Division.")

FULL NAME OF PARTY BEING SUED

NAME OF OWNER IF SUING A COMPANY

FULL NAME OF SUING PARTY

STREET ADDRESS OF DEFENDANT

DAYTIME PHONE

CITY, STATE, ZIP CODE

DAYTIME PHONE

STREET ADDRESS OF PLAINTIFF

OTHER ADDRESS FOR DEFENDANT

CITY, STATE, ZIP CODE

CITY, STATE, ZIP CODE

THIS FORM MAY BE USED TO NOTIFY THE SMALL CLAIMS COURT WHETHER OR NOT YOU INTEND TO CONTEST THE PLAINTIFF'S CLAIM. CHECK THE STATEMENT BELOW THAT APPLIES.
I am requesting that this matter be heard by:

_____ _____ _____

1. I do not owe the Plaintiff any part of what he/she claims; or (Check One) Arbitrator Judge 2. I owe the Plaintiff only part of what he/she claims; or 3. I owe the Plaintiff what he/she claims, and waive any further appearance and/or delays and consent to judgment against me in the amount sought. ______________________________________________________________________________________________________

_________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________
FILL IN THIS SECTION COMPLETELY DATE: __________________________ PHONE NUMBER: ________________ SIGNATURE: ADDRESS: __________________________________ __________________________________ __________________________________
I HEREBY CERTIFY that the above and foregoing Answer has been served upon the opposing party by mailing a copy, first class postage pre-paid, addressed to: _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ On this ___________ day of ____________________________, 20______. _____________________________________________________________ Signed
*** NOTICE TO ALL PARTIES: During the pendency of this lawsuit, the Court will contact you at the address and phone number you have indicated. If either address or phone number should change, please notify the Court immediately.

PLEASE SERVE PLAINTIFF: ____________________________________________ At: _________________________________________ ____________________________________________

Civil - Statement of Claim & Citation (Interactive Packet) 08-15-08

(Page 6)

BATON ROUGE CITY COURT SMALL CLAIMS DIVISION 233 St. Louis Street P. O. Box 3438 Baton Rouge, LA 70821 225-389-3017 _________________________________________________ PLAINTIFF VERSUS _________________________________________________ DEFENDANT SUIT NUMBER: _________________________________

* * * RECONVENTIONAL DEMAND * * *
WHETHER OR NOT YOU BELIEVE YOU OWE THE PLAINTIFF ANYTHING, YOU MAY HAVE A CLAIM OF YOUR OWN AGAINST THE PLAINTIFF. YOU MAY RAISE YOUR CLAIM AS PART OF THIS CASE AND HAVE IT DECIDED AT THE SAME TIME. IF YOUR CLAIM IS FOR AN AMOUNT OVER THE JURISDICTION OF THE SMALL CLAIMS COURT ($3,000.00), YOU MUST SUBMIT A NOTARIZED AFFIDAVIT (SWORN STATEMENT OF THAT CLAIM) AND HAVE THE CASE TRANSFERRED TO THE REGULAR DOCKET OF CITY COURT. CONTACT THE CLERK OF COURT REGARDING COURT COST DEPOSITS AND FOR OTHER INFORMATION. PLAINTIFF OWES ME $___________________ FOR THE FOLLOWING REASON(S): _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________

FILL IN THIS SECTION COMPLETELY

DATE: __________________________ PHONE NUMBER: ________________

SIGNATURE: ADDRESS:

__________________________________ __________________________________ __________________________________

I HEREBY CERTIFY that the above and foregoing Reconventional Demand has been served upon the opposing party by mailing a copy, first class postage pre-paid, addressed to: _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ On this ___________ day of ____________________________, 20______. _____________________________________________________________ Signed

*** NOTICE TO ALL PARTIES: During the pendency of this lawsuit, the Court will contact you at the address and phone number you have indicated. If either address or phone number should change, please notify the Court immediately.

PLEASE SERVE PLAINTIFF: ____________________________________________ At: ________________________________________ ____________________________________________

Civil - Statement of Claim & Citation (Interactive Packet) 08-15-08

(Page 7)

***ALL SHADED AREAS MUST BE COMPLETED.

BATON ROUGE CITY COURT SMALL CLAIMS DIVISION 233 St. Louis St. P. O. Box 3438 Baton Rouge, LA 70821 (225) 389-3017

STATEMENT OF CLAIM AND CITATION (ATTACHMENT)
R.S. 13:5200 et seq.
SUIT NUMBER: ______________________________
PLAINTIFF VERSUS DEFENDANT

(By signing this petition, I verify that I have read and understand the Court's publication: "How to Use the Small Claims Division.")

FULL NAME OF PARTY BEING SUED

NAME OF OWNER IF SUING A COMPANY

FULL NAME OF SUING PARTY

SIGNATURE OF PLAINTIFF

FILED:
Deputy Clerk:

PLEASE SERVE DEFENDANT/AGENT:

At:
Civil - Statement of Claim & Citation (Interactive Packet) 08-15-08 ATTACHMENT (ORIGINAL) (Page 8)

***ALL SHADED AREAS MUST BE COMPLETED.

BATON ROUGE CITY COURT SMALL CLAIMS DIVISION 233 St. Louis St. P. O. Box 3438 Baton Rouge, LA 70821 (225) 389-3017

STATEMENT OF CLAIM AND CITATION (ATTACHMENT)
R.S. 13:5200 et seq.
SUIT NUMBER: ______________________________
PLAINTIFF VERSUS DEFENDANT

(By signing this petition, I verify that I have read and understand the Court's publication: "How to Use the Small Claims Division.")

FULL NAME OF PARTY BEING SUED

NAME OF OWNER IF SUING A COMPANY

FULL NAME OF SUING PARTY

SIGNATURE OF PLAINTIFF

FILED:
Deputy Clerk:

PLEASE SERVE DEFENDANT/AGENT: A True Copy:

At:
Deputy Clerk:
Civil - Statement of Claim & Citation (Interactive Packet) 08-15-08 ATTACHMENT (DEFENDANT'S COPY) (Page 9)