Defendants Claim Page 2

Statement of claim:

, having read the instructions above, assert the following

claim against

, plaintiff:

Demand for judgment:

Based on the claim stated above, judgment is demanded against plaintiff as follows:

1. Payment of $

, plus interest, costs and any damages awarded under

K.S.A. 60-2610 and amendments thereto.

2. Recovery of the following described personal property, plus costs:

This property has an estimated value of $

, hereby swear that, to the best of my knowledge and belief, the

above claim asserted against the plaintiff (including the estimate of value of any property

sought to be recovered) is a just and true statement.

(Signature)

Defendant

Subscribed and sworn to before me on the

day of

, 2

(Signature)

Judge (clerk or notary)

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Parent category: Legal