Amended Notice Of Small Claim Form - Henry County, Indiana

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AMENDED
NOTICE OF SMALL CLAIM
PLAINTIFF
Name:
Henry Circuit Court No. 3
Street:
1215 Race Street
City/St/Zip:
New Castle IN 47362
Phone:
(765) 521-2664 or 521-2554
DEFENDANT
CAUSE NO.
Name:
__________________________
Street:
__________________________
City/St/Zip:
__________________________
Phone:
__________________________
TO THE CLERK: Please summons the defendant (s) to appear in Court to answer this claim.
STATEMENT OF CLAIM: _____________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Wherefore Plaintiff asks judgment against the Defendant for $__________, plus interest (if applicable) from
_______________________ at the rate of ___________% and the costs herein.
THIS COMMUNICATION IS FROM A DEBT COLLECTOR. THIS IS AN ATTEMPT TO COLLECT A DEBT
AND ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE.
Date:_______________
_____________________________________
Plaintiff
NOTICE TO APPEAR
Defendant: ______________________________
Defendant: ____________________________
Street: __________________________________
Street: ________________________________
City, State, Zip: ___________________________
City, State, Zip: _________________________
The Plaintiff asks judgment in this Court against you for the sum above stated. You are to appear in the
Henry Circuit Court No. 3 for a trial upon the Plaintiff’s claim on the
day of______________20__, at
____________. You may appear for the trial in person or you may appear with your attorney. You should bring
to the trial, all documents in your possession or under your control, which relate to the Plaintiff’s claim. If you do
not wish to dispute the Plaintiff’s claim, you may appear at the time stated, for the purpose of assisting the Court
in establishing the method by which you will be directed to pay the judgment. If you do not appear for the trial at
the time, on the date stated, a default judgment may be entered against you for the amount asked by the
Plaintiff. You may request a jury trial. You will waive your right to a jury trial, unless requested within ten (10)
days after receipt of the notice of claim. If your jury trial request is granted, you must pay within the (10) days
the additional amount required by statute to transfer to the plenary docket or your request will be deemed
waived. Once a jury trial request has been granted, it may not be withdrawn without the consent of the other
party. Please read the attached instruction sheet.
_________________________________________
CLERK, HENRY COUNTY

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