AOC- 185 Rev. 5-11 Page 1 of 1 Doc. Code: CC COM M O NW E A LT H O F K E lex et justitia Case No. ____________________ District Small Claims Court _______________________ County ______________________ NT U C KY Commonwealth of Kentucky Court of Justice www.courts.ky.gov KRS 24A.290 RT OF JUS TI SMALL CLAIMS COUNTER-CLAIM C Name: ___________________________________________ Address: _________________________________________ _________________________________________ _________________________________________ VS. Name: ___________________________________________ Address: _________________________________________ _________________________________________ _________________________________________ 1. Defendant claims Plaintiff: ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ 2. Defendant claims the following sum from Plaintiff for damages brought about by the above Complaint: $_____________________, (amount not to exceed $2,500.00, exclusive of interest and costs) plus interest in the amount of $______________. 3. Defendant also claims court costs. CO U E PLAINTIFF DEFENDANT Date: ___________________________, 2______. _____________________________________________ Defendant's Signature Instructions: This counter-claim shall be filed with the Clerk and a copy delivered to the Plaintiff at least five (5) days prior to the time of the hearing. American LegalNet, Inc. www.FormsWorkFlow.com