SMALL CLAIMS 1
STANDARD FORMS OF PLEADINGS FOR SMALL CLAIMS ACTIONS
[Pursuant to Iowa Code section 631.15]
June 1998
IN THE DISTRICT COURT OF IOWA
IN AND FOR ____________________ COUNTY, IOWA
Plaintiff(s)
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
vs. ORIGINAL NOTICE
(Action for money judgment.)
Defendant(s) Small Claim No. __________
___________________________ Date Filed _______________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
TO THE ABOVE-NAME DEFENDANT(S):
YOU ARE HEREBY NOTIFIED that the plaintiff(s) demand(s) from you the
amount of $___________ based on _________________ (state briefly the basis for the demand).
UNLESS YOU APPEAR by completing and filing the attached appearance and
answer form with the clerk of the court at ____________________________________________
(exact address) in _______________________________________________________________
(city), Iowa __________ (zip code), within 20 days after service of this original notice
upon you, judgment shall be rendered against you upon plaintiff’s claim together with
interest and court costs.
IF YOU DENY THE CLAIM AND APPEAR by filing the attached appearance and
answer within 20 days after service of this original notice upon you, you will then receive
notification from the clerk’s office of the place and time assigned for hearing.
______________________________
______________________________
Plaintiff(s)
Judgment Entry:
[Court Order December 11, 1975, received for publication February 28, 1984; June 29, 1984; Letter May 12, 1987 (obsolete reference to “town”
stricken)]
SMALL CLAIMS 2
IN THE DISTRICT COURT OF IOWA
IN AND FOR COUNTY ____________________ , IOWA
Plaintiff(s)
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
vs. ORIGINAL NOTICE
(Action for forcible entry and
Defendant(s) detainer.)
___________________________ Small Claim No.__________
(Name) Date Filed _______________
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
TO THE ABOVE-NAMED DEFENDANT(S):
YOU ARE HEREBY NOTIFIED that the above-named plaintiff(s) demand(s) from
you possession of _______________________________________(state exact address of real
property) for the reason that _______________________________ (state basis of demand).
UNLESS YOU APPEAR before the court to contest this matter at
_________________________________________________________________________(exact
address of court) in _____________________(city), Iowa, at ______o’clock __.m. on the _____
day of ____________________, 20_____ , judgment shall be rendered against you for
possession of the property and for court costs.
______________________________
______________________________
Plaintiff(s)
Judgment Entry:
[Court Order December 11, 1975, received for publication February 28, 1984; Letter May 12, 1987 (obsolete reference to “town” stricken)]
SMALL CLAIMS 3
IN THE DISTRICT COURT OF IOWA
IN AND FOR ___________________ COUNTY, IOWA
(Small Claims Division)
Plaintiff(s)
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
vs. ORIGINAL NOTICE
(Action for forcible entry and
Defendant(s) detainer and money judgment)
___________________________ Small Claim No. ____________
(Name) Date Filed _________________
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
TO THE ABOVE-NAMED DEFENDANT(S):
Count I
YOU ARE HEREBY NOTIFIED that the above-named plaintiff(s) demand(s) from
you possession of __________________________________________________________ (state
exact address of real property) for the reason that ______________________________________
______________________________________________________________________________
(state basis of demand).
SMALL CLAIMS 4
Count II
YOU ARE HEREBY NOTIFIED that the plaintiff(s) demand(s) from you the
amount of $ __________ based on _________________________________________________
______________________________________________________________________________
(state briefly the basis for the demand).
UNLESS YOU APPEAR before the court to contest this matter at __________________
_________________ (exact address of the court) in ____________________ (city), Iowa, at
______o’clock __.m. on the ______ day of ____________________, ______, judgment shall
be rendered against you for possession of the property and for a money judgment together with
interest and court costs.
______________________________
______________________________
Plaintiff(s) or Plaintiff(s)’ Attorney
______________________________
______________________________
Address
If you require the assistance of auxiliary aids or services to participate in court because of a disability, immediately call your district ADA
coordinator at 515-286-3394. (If you are hearing impaired, call Relay Iowa TTY at 1-800-735-2942.)
Judgment Entry:
[Court Order May 6, 1998]
SMALL CLAIMS 5
IN THE DISTRICT COURT OF IOWA
IN AND FOR _______________________ COUNTY, IOWA
Plaintiff(s)
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
APPEARANCE AND
ANSWER OF
vs. DEFENDANT
Small Claim No.__________
Defendant(s) Date Filed _______________
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
I HEREBY enter my appearance and deny the claim of plaintiff(s).
______________________________
Defendant
SMALL CLAIMS 6
[Court Order December 11, 1975, received for publication February 28, 1984]
June 1998 6 SMALL CLAIMS
IN THE DISTRICT COURT OF IOWA
IN AND FOR COUNTY _______________________, IOWA
Plaintiff(s)
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
COUNTERCLAIM
vs. Small Claim No.__________
Date Filed_______________
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)
SMALL CLAIMS 7
[Court Order December 11, 1975, received for publication February 28, 1984]
IN THE DISTRICT COURT OF IOWA
IN AND FOR COUNTY _______________________, IOWA
Plaintiff(s)
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
CROSS-CLAIM AGAINST
vs. COPARTY
Small Claim No. ________________
Defendant(s) Date Filed_____________________
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
I (WE), _____________________________________________, as cross-claimant(s), hereby
demand from ________________________________________ (state name(s) of party(ies)
against whom the demand is made) the amount of $__________ based on ______________
(state briefly the basis for the demand).
______________________________
______________________________
Cross-claimant(s)
SMALL CLAIMS 8
[Court Order December 11, 1975, received for publication February 28, 1984]
June 1998 8 SMALL CLAIMS
IN THE DISTRICT COURT OF IOWA
IN AND FOR _____________________ COUNTY, IOWA
Plaintiff(s)
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
vs.
Defendant(s) CROSS-PETITION AGAINST
___________________________ THIRD PARTY
(Name) Small Claim No.________________
___________________________ Date Filed _____________________
(Address)
___________________________
(Name)
___________________________
(Address)
Third Party Defendant(s)
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
TO: _______________________________ , THIRD PARTY DEFENDANT(S):
YOU ARE HEREBY NOTIFIED that, _____________________________________, as
cross-petitioner(s), demand(s) from you the amount of $__________ based on ______________
(state briefly the basis for the demand).
UNLESS YOU APPEAR by completing and filing the attached appearance and
answer form with the clerk of the court at ________________________________(exact address)
in ____________________ (city), Iowa __________(zip code), within 20 days after service of
this original notice upon you, judgment shall be rendered against you upon cross-petitioner’s
claim together with interest and court costs.
IF YOU DENY THE CLAIM AND APPEAR by filing the attached appearance and
SMALL CLAIMS 9
answer within 20 days after service of this original notice upon you, you will then receive
notification from the clerk’s office of the place and time assigned for hearing.
______________________________
______________________________
Cross-petitioner(s)
Judgment Entry:
[Court Order December 11, 1975, received for publication February 28, 1984; June 29,
1984; Letter May 12, 1987 (obsolete reference to “town” stricken)]
SMALL CLAIMS 10
IN THE DISTRICT COURT OF IOWA
IN AND FOR COUNTY _____________________ , IOWA
Plaintiff(s)
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
vs.
Defendant(s) APPEARANCE AND ANSWER OF
___________________________ THIRD PARTY DEFENDANT
(Name) Small Claim No.______________________
___________________________ Date Filed___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
Third Party Defendant(s)
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
I HEREBY enter my appearance and deny the claim of __________________________,
cross-petitioner(s).
______________________________
Third Party Defendant
[Court Order December 11, 1975, received for publication February 28, 1984]
June 1998 10 SMALL CLAIMS
SMALL CLAIMS 11
IN THE DISTRICT COURT OF IOWA
IN AND FOR COUNTY _____________________ , IOWA
Plaintiff(s)
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
vs.
Defendant(s) PETITION OF INTERVENTION
___________________________ Small Claim No.________________
(Name) Date Filed_____________________
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
Intervenor(s)
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
TO THE ABOVE-NAMED PLAINTIFF(S) AND DEFENDANT(S):
I (WE), _____________________________ , being interested in the subject matter of
this litigation now intervene ___________________________(either “adversely to both parties”,
or “allied with plaintiff”, or “allied with defendant”) and demand the amount of $ ___________
from ____________________________________________________(state name(s) of party(ies)
against whom the demand is made) based on _____________________________________(state
briefly the basis for the demand).
______________________________
______________________________
Intervenor(s)
[Court Order December 11, 1975, received for publication February 28, 1984]
December 1998 11 SMALL CLAIMS
SMALL CLAIMS 12
IN THE DISTRICT COURT OF IOWA
IN AND FOR COUNTY____________________ , IOWA
(Small Claims Division)
Plaintiff(s)
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
vs. ORIGINAL NOTICE
(Action of replevin.)
Defendant(s) Small Claim No.________________
___________________________ Date Filed _____________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
TO THE ABOVE-NAMED DEFENDANT(S):
YOU ARE HEREBY NOTIFIED that the above-named plaintiff(s) demand(s)
possession of property described as:
(insert description)
(1) The actual value of the property is $_____________________ (If more than one item
is involved, separate values must be stated for each item.) (May not exceed $4,000 in total
value.)
(continued)
June 1998 12 SMALL CLAIMS
SMALL CLAIMS 13
(2) Plaintiff(s) is (are) entitled to immediate possession because (check one):
Plaintiff(s) own(s) the property;
Plaintiff(s) has (have) a security agreement for the property (copy attached) providing
that plaintiff(s) is (are) entitled to seize possession on default, and that default(s) as
follows has (have) occurred;
(State other grounds).
(3) (a) That the property is not in the possession of the defendant(s) under court order
or judgment; or
(b) That property was taken by the defendant(s) under a court order or judgment but is
improperly held, being exempt from such seizure because: (state basis for exemption).
(4) That to the best belief of the plaintiff(s) the property is being held by the defendant(s)
because: (state facts constituting the defendant’s(s’) alleged reason for detaining the property).
(5) That the plaintiff(s) is (are) entitled to damages for such retention in the amount of
$__________ , based on: (state grounds of alleged damage).
UNLESS YOU APPEAR by completing and filing the attached appearance and
answer form with the clerk of the court at ________________________(exact address) in
___________________(city), Iowa __________(zip code), within 20 days after service of
this original notice upon you, judgment shall be rendered against you upon plaintiff’s(s’)
claim together with interest and court costs.
IF YOU DENY THE CLAIM AND APPEAR by filing the attached appearance and
answer within 20 days after service of this original notice upon you, you will then receive
notification from the clerk’s office of the place and time assigned for hearing.
______________________________
______________________________
Plaintiff(s)
June 1998
December 1998
SMALL CLAIMS 14
STATE OF IOWA
` ss:
COUNTY OF _______________________
I (We),______________________________________________ , do hereby swear or
affirm that the above and foregoing statements are true and correct as I (we) verily believe.
______________________________
(Signature(s) of affiant(s))
Subscribed and sworn to before me by ________________________________________,
on this ______ day of ____________________, 20_____ .
______________________________
Notary Public
[Report March 10, 1987, effective July 1, 1987; Court Order November 25, 1998]
December 1998
SMALL CLAIMS 15
IN THE DISTRICT COURT OF IOWA
IN AND FOR COUNTY____________________ , IOWA
(Small Claims Division)
Plaintiff(s)
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
vs. ORIGINAL NOTICE
(Foreign Corporation or
Defendant(s) Nonresident Defendant)
___________________________ Small Claim No.________________
(Name) Date Filed_____________________
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
TO THE ABOVE -NAMED DEFENDANT(S):
YOU ARE HEREBY NOTIFIED that the plaintiff(s) demand(s) from you the
amount of $__________ based on _____________________________________ (state briefly
the basis for the demand).
UNLESS YOU APPEAR by completing and filing the attached appearance and
answer form with the clerk of the court at _______________________________________(exact
address) in ____________________ (city), Iowa ______(zip code), within 60 days after the
filing of this original notice with the secretary of state of the State of Iowa, judgment shall be
rendered against you upon plaintiff’s(s’) claim together with interest and court costs.
IF YOU DENY THE CLAIM AND APPEAR by filing the attached appearance and
answer within 60 days after the filing of this original notice with the secretary of state of the
State of Iowa, you will then receive notification from the clerk’s office of the place and
time assigned for hearing.
______________________________
______________________________
Plaintiff(s)
Judgment Entry:
[Report September 29, 1987, effective December 1, 1987]
SMALL CLAIMS 16
IN THE DISTRICT COURT OF IOWA
IN AND FOR COUNTY ____________________ , IOWA
(Small Claims Division)
Plaintiff(s)
___________________________
(Name)
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
vs. ORIGINAL NOTICE
(Nonresident Motor Vehicle
Defendant(s) Owner or Operator)
___________________________ Small Claim No.________________
(Name) Date Filed _____________________
___________________________
(Address)
___________________________
(Name)
___________________________
(Address)
TO THE ABOVE-NAMED DEFENDANT(S):
YOU ARE HEREBY NOTIFIED that the plaintiff(s) demand(s) from you the
amount of $___________ based on ________________________________________(state
briefly the basis for the demand).
UNLESS YOU APPEAR by completing and filing the attached appearance and
answer form with the clerk of the court at _______________________________________(exact
address) in ____________________(city), Iowa __________(zip code), within 60 days after the
filing of this original notice with the director of transportation of the State of Iowa, judgment
shall be rendered against you upon plaintiff’s(s’) claim together with interest and court costs.
IF YOU DENY THE CLAIM AND APPEAR by filing the attached appearance and
answer within 60 days after the filing of this original notice with the director of transportation of
the State of Iowa, you will then receive notification from the clerk’s office of the place and time
assigned for hearing.
______________________________
______________________________
Plaintiff(s)
Judgment Entry:
[Report September 29, 1987, effective December 1, 1987]
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