Fill and Sign the Small Claims Court State of Maine Judicial Branch Form

IN THE DISTRICT COURT OF THE ________________________ JUDICIAL DISTRICT OF THE STATE OF ______________________, IN AND FOR THE COUNTY OF __________________________ SMALL CLAIMS DEPARTMENT COMES NOW _____________________________ (Name of Plaintiff), Plaintiff in the above-styled and numbered cause, by and through her attorney, and files this her Complaint against Defendant, _____________________________ (Name of Defendant), and in support thereof would show unto the Court the following matters and facts: 1. Plaintiff is an adult resident citizen of ___________________________________ __________________________________________ (city, county, state). 2. Defendant is an adult resident citizen of _________________________________ ___________________________________________ (city, county, state). 3. On __________________________________ (date), in the County of _________________________ (Name of County), State of _______________________ (Name of State), Plaintiff and Defendant entered into an agreement by which Defendant agreed to hold certain funds belonging to Plaintiff as a deposit for an apartment located at ________________________________________________________________________ _____________________ (street address, city, county, state, zip code). Said deposit was in the amount of $__________________ and was to be returned to Plaintiff if (state relevant conditions or events) ______________________________________________ ________________________________________________________________________ _______________________________________________________________________. 4. (State relevant conditions or events that occurred) _______________________
. : (the failure to maintain the apartment in good repair. Or if and injury to life or property of plaintiff or to the person of an individual on or about the premises caused by the failure of such apartment to be sufficiently safe and free from nuisances. And physical or mental illness of the resident and the failure of such apartment to be sufficiently clean. And free from insects, etc., and if no physical or psychological injury occurred to a member of the person, group or corporation on the premises at (date), that (name of person or group or corporation) (city, state, zip code). 5. On (date), in the county of (name of county), state of (name of state), plaintiff and defendant entered into an agreement by which defendant agreed to furnish to plaintiff or to cause to be furnished to plaintiff certain materials, namely, kitchen and bathroom appliances and fixtures. Said appliances and fixtures, in said agreement were to provide certain convenience and conveniences for resident in the particular unit to be offered as the same unit to resident. 6. Defendant failed to comply with said agreement. 7. Plaintiff has filed, and defendant has acknowledged service of and objection thereto upon, a summons and complaint for recovery of damages based on (name of conditions or events) . 10. Plaintiff states that upon receipt of defendant's written acknowledgment of service of and objection to the summons and complaint, she has failed to make payment pursuant to said agreement contained in said statement of claim. 11. Defendant states that she has had occasion to obtain information as to said condition(s) and/or event(s), and upon receipt of said information has concluded that there has been said condition or event and upon conclusion has determined to defend and hold harmless plaintiff on account of such condition or event. 12. Defendant states that, on receipt of this objection, plaintiff's failure to pay said deposit pursuant to the agreement has rendered the deposit null and void and subject to the interest and penalty set forth in section (state) § 19-1428. 13. Plaintiff states that upon receipt of defendant's written acknowledgment of service of and objection thereto, the above-discussed failure of defendant to make payment of said deposit pursuant to the agreement has rendered the deposit null and void and subject to the interest and penalty set forth in section (state) § 20-1428. 14. Plaintiff states that on receipt of this exception or exception, defendant's written refusal to pay said deposit amounts to a waiver of.