Free Form 5 - Iowa

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4

Ch 3, p.4 Form 3.5: Counterclaim.
September 2004

SMALL CLAIMS FORMS

September 2004

IN THE DISTRICT COURT OF IOWA IN AND FOR ______________________ COUNTY, IOWA Plaintiff(s) (Name) (Address) (Name) (Address) vs. Defendant(s) (Name) (Address) (Name) (Address) TO: ___________________________, PLAINTIFF(S) YOU ARE HEREBY NOTIFIED that ____________________________________________, defendant(s), as counterclaimant(s), demand(s) from you the amount of $ __________ based on _______________________________ _____________________________________________________________________________________________ (state briefly the basis for the demand). __________________________________________________ __________________________________________________ Defendant(s) - Counterclaimant(s) COUNTERCLAIM Small Claim No. ________________ Date Filed _____________________

2002]

[Court Order December 11, 1975, received for publication February 28, 1984; November 9, 2001, effective February 15,