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K.S.A. 61-2713(c) Small Claims - Defendant's Claim (7/1/05)

IN THE DISTRICT COURT OF , , ) ) ) ) )

JUDICIAL DISTRICT COUNTY, KANSAS

v

Plaintiff, Defendant.

Case No. _________

Proceeding Pursuant to K.S.A. Chapter 61 DEFENDANT'S CLAIM Instructions: 1. As stated in the summons, if you have a claim against the plaintiff which arises out of the transaction or occurrence which is the subject of plaintiff's claim and your claim does not exceed $4,000, you must state your claim in the space provided below. If your claim against the plaintiff exceeds $4,000, you may state your claim in the space provided below. In determining whether or not your claim against the plaintiff exceeds $4,000, do not include interest, costs and any damages under K.S.A. 60-2610 and amendments thereto, but do include the value of any personal property sought to be recovered as determined by your estimate of its value under oath. 2. Be clear and concise in stating your claim. 3. If the value of your claim exceeds $4,000 (not including interest, costs and any damages awarded under K.S.A. 60-2610 and amendments thereto, but including the value of any personal property sought to be recovered, as determined by your estimate of its value under oath), the court must decide whether you may pursue your entire claim or only that portion not exceeding $4,000. 4. If your claim exceeds $4,000 and the court determines that you may not pursue the entire claim at the hearing, you have three alternatives: (1) Make no demand for judgment and reserve the right to pursue your entire claim in a court of competent jurisdiction; (2) make demand for judgment of that portion of your claim which does not exceed $4,000 and reserve the right to bring an action in a court of competent jurisdiction for any amount in excess thereof; or (3) make demand for judgment of that portion of your claim which does not exceed $4,000 and waive your right to recover any excess. 5. When completed, this form must be filed with the judge or the clerk of the court on or before the time stated in the summons for the trial.

Statement of claim:

I, claim against

, having read the instructions above, assert the following , plaintiff:

Demand for judgment: Based on the claim stated above, judgment is demanded against plaintiff as follows: 1. Payment of $ , plus interest, costs and any damages awarded under K.S.A. 60-2610 and amendments thereto. 2. Recovery of the following described personal property, plus costs: This property has an estimated value of $ .

, hereby swear that, to the best of my knowledge and belief, the I, above claim asserted against the plaintiff (including the estimate of value of any property sought to be recovered) is a just and true statement. (Signature) Defendant Subscribed and sworn to before me on the day of ,2 .

(Signature) Judge (clerk or notary)