Small Claims - State Of Wisconsin Circuit Court Milwaukee County
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1
2STATE OF WISCONSIN
CIRCUIT COURT
MILWAUKEE COUNTY
SMALL CLAIMS
,
Plaintiff,
PLAINTIFF ITEMIZATION OF DAMAGES-EVICTION
vs.
Case No.
,
Defendant(s).
As and for an Itemization of Damages, the below undersigned individual states as follows:
I am (Plaintiff) (Authorized Agent for Plaintiff) (Attorney for Plaintiff) [STRIKE TWO]. The following selected elements of
damages are being sought by Plaintiff.
Select Elements
Being Claimed
☐
Plaintiff is seeking BASE RENT damages in the total amount of: $
, calculated as follows:
Month of:
Unpaid Rent:
Month of:
Unpaid Rent:
Month of:
Unpaid Rent:
Month of:
Unpaid Rent:
Additional Months:
☐
Plaintiff is seeking LATE FEE damages in the total amount of: $
, calculated as follows:
Month of:
Unpaid Late Fee:
Month of:
Unpaid Late Fee:
Month of:
Unpaid Late Fee:
Month of:
Unpaid Late Fee:
Additional Months:
☐
Plaintiff is seeking UTILITY FEE damages in the total amount of: $
, calculated as follows:
Copy of bill attached ☐Yes ☐No
Period of:
Unpaid Utility Fee:
Copy of bill attached ☐Yes ☐No
Period of:
Unpaid Utility Fee:
Copy of bill attached ☐Yes ☐No
Period of:
Unpaid Utility Fee:
Copy of bill attached ☐Yes ☐No
Period of:
Unpaid Utility Fee:
Additional Months:
☐
Plaintiff is seeking NON-STANDARD FEE damages in the total amount of: $
, calculated as follows:
I have attached a copy of the lease on which I have highlighted the applicable non-standard provisions.
Service/fee (describe):
Fee: $
Service/fee (describe):
Fee: $
Service/fee (describe):
Fee: $
Service/fee (describe):
Fee: $
Service/fee (describe):
Fee: $
Service/fee (describe):
Fee: $
☐
Plaintiff is seeking PROPERTY damages in the total amount of: $
, which are calculated as follows:
☐ CARPET Describe Damage:
Year carpet installed:
Cost of original installation:
Current Repair Cost:
A copy of the receipt from the original installation is attached ☐Yes ☐No
Photographs of the damage are available ☐Yes ☐No
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