Fill and Sign the Small Claims Complaint Kentucky Form

AOC-175 Doc. Code: COM Rev. 7-00 Case No. Page 1 of 3 Court Small Claims Commonwealth of Kentucky Court of Justice County S MALL C LAIMS C OMPLIANT KRS 24A.260 In the Small Claims Division, District Court, of __________________________________ County Assigned Trial Date: Plaintiff Attorney Address (if any) Defendant Attorney Address (if any) ▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬ ▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬ NOTICE TO EACH DEFENDANT - READ CAREFULLY You are being sued in the Small Claims Division of District Court by the Plaintiff(s) shown above. The judge has not made any decision in this case. You are to appear in the court on the date shown on the attached summons to tell your side of the dispute. If you fail to appear in court on the date shown on the attached summons a court judgment can be taken against you for the money or property demanded in the following complaint. This could lead to garnishment of your pay check and/or sale of your home or other belongings (unless protected by law) to satisfy that judgment. If you have questions or need assistance, consult the Small Claims Information pamphlet or call an attorney. ▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬ ▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬ Complaint 1. Plaintiff claims that the defendant________________________________ ___________________________________ 2. Plaintiff claims the following sum from the defendant for damages brought by the above complaint $______________ 3. Plaintiff also claims court costs. _____________________________________________ ___________________________________ Plaintiff's or Attorney's Signature Date of Filing ▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬ ▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬ Clerk____________________________________ Phone Number _______________________ Address__________________________________ ________________________________________ (See Reverse) AOC-175 Doc. Code: COM Rev. 7-00 Page 2 of 2 Small Claims Affidavit: This affidavit is not applicable to claims brought by city, county or urban county governments. KRS 24A.250: (1) No party shall file more than twenty-five claims in any one calendar year in the Small Claims Division of any district court in the Commonwealth. Any business engaged in trade or commerce shall be entitled to the maximum number of claims allowed under this section for each established location in the district that has been engaged in trade or commerce for at least six months. * * * * * * * * * * * * (4) The limitation on the number of claims and the other requirements of this section shall not apply to claims brought by city, county or urban county governments. I swear (or affirm) that I have not brought more than the maximum number of claims allowed under KRS 24A.250. ___________________________________________ (Name and Date) Subscribed and sworn to before me this____________day of____________________________, ________. ___________________________________________ (Signature) ___________________________________________ (Title) ▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬ ▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬ WARNING REGARDING JURY TRIAL (KRS 24A.320, 29A.270): There are no jury trials in small claims court. If the amount in controversy exceeds $250, you may have a jury trial by going into regular district court, but remember that the simplified and informal procedures used in small claims court will not be followed in district court. To the plaintiff: If you want a jury trial you must file your claim in district court instead of small claims court. To the defendant: If you want a jury trial you must notify the court clerk in writing at least seven days before the time set for trial and the case will then be transferred to district court.