Free STATE OF NEBRASKA - Nebraska

STATE OF NEBRASKA FORM NO. CC 4:2 12/99 Rev. Sec. 25-2804(4)
IN THE COUNTY COURT OF

COUNTERCLAIM OR SETOFF OF DEFENDANT
(Small Claims Court)

CASE NUMBER

COUNTY, NEBRASKA

Plaintiff VS.

COUNTERCLAIM OR SETOFF OF DEFENDANT

Defendant In the above entitled action I state and claim as my counterclaim or setoff the following sum: , or return of property valued at $ , because:

$

DATE:

DEFENDANT'S SIGNATURE:

ORDER FOR TRANSFER TO CIVIL DOCKET
This case is transferred to the civil docket because the counterclaim or setoff exceeds the jurisdiction of Small Claims Court, as case #____________. Pretrial hearing in this matter is hereby set for _______________________, ________ at _______ ____.M.
DATE: BY THE COURT: Judge/Clerk Magistrate (Seal)

AFFIDAVIT OF SERVICE
I certify that I have delivered a copy of this counterclaim or setoff to the plaintiff by either personal service sheriff/constable mailing a copy to the plaintiff by first class mail: (State full name and address to whom mailed)

DATE AND TIME OF TRIAL: DATE:

DATE COPY DELIVERED TO PLAINTIFF: DEFENDANT'S SIGNATURE:

Note: A copy of the Counterclaim or Setoff of Defendant must be delivered to the plaintiff and the original filed with the court at least two days prior to the time set for hearing.

RETURN
Received this Writ I Hereby Certify that on the Counterclaim/Setoff on by , day of , at , o'clock .M. , I served the within

a true and certified copy thereof with all the endorsements thereon, in the county aforesaid.

SHERIFF Service and return Copy Mileage ____ miles TOTAL $

$