Free    Small Claims Form - Ohio


File Size: 17.1 kB
Pages: 1
File Format: PDF
State: Ohio
Category: Court Forms - Local
Word Count: 179 Words, 1,350 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.bedfordmuni.org/documents/SmallClaimsForm.pdf

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BEDFORD MUNICIPAL COURT
165 Center Road Bedford, Ohio 44146-2898 (440) 232-3420
SMALLS CLAIMS COMPLAINT ­ Case No: Date: Municipality: 04

________________________________________________________________________
Full Name Plaintiff Street Address City State Zip

Plaintiff -vs-

________________________________________________________________________
Full Name Defendant Street Address City State Zip

Defendant

TO THE CLERK Please take notice that a claim is hereby filed against the above Defendant(s) and request that he/she/they be summoned to appear in Court to answer same. Statement of Claim

Wherefore the Plaintiff prays for judgment against Defendant(s) in the sum of _____________ plus interest from ____________ (date), at a rate of ______% per annum and costs herein. STATE OF OHIO COUNTY OF CUYAHOGA ) ) SS:

AFFIDAVIT OF COMPLAINANT'S CLAIM

_______________________(Plaintiff), being first duly sworn, on oath states that he/she/they is/are the Plaintiff in the above entitled case, that the above cause is for payment of money, that the nature of the Plaintiff's demand is as stated above. Defendant(s) is/are not now in the military or naval service of the United States. _______________________________ (Plaintiff's signature) SUBSCRIBED AND SWORN to before me on ____________(date)

______________________________ Deputy Clerk