Free Cover Sheet - Missouri

In the


For File Stamp Only



CIRCUIT COURT
Of St. Louis County, Missouri
This Small Claims Cover Sheet and the information contained herein neither replaces nor supplements the filing and service of pleadings or other papers as required by law, except as provided by local rules of court. This form is required by the Clerk of this Court for the purpose of initiating case processing. (See instructions below.)

_____________________ Case Number VC _____________________ Division





Small Claims Cover Sheet
PLAINTIFF(S) DEFENDANT(S)

First Plaintiff's: Address Telephone

First Defendant's: Address Telephone

Pending Actions Have you, as a Plaintiff, previously filed a Small Claims action against the above defendant(s)? ______Yes ______No Did the prior cases involve the same issues as this case? ______Yes ______No Prior Litigation Have you, as a Plaintiff, filed any Small Claims actions during the current calendar year in this county or any other county within the State of Missouri? ______Yes ______No If so, how many?

Pro Se Party/Attorney (PLEASE PRINT) Address I hereby certify that the above information is true and accurate:

City

State

Zip Code

Signature of Pro Se Party/Attorney

Date

Bar Number

Phone Number

Fax Number

CCAC174

03/07