Small Claims Court _________________________ County, Colorado Court Address: PLAINTIFF(S): ______________________________________________ Address: ____________________________________________________ City/State/Zip: ________________________________________________ Phone: Home _______________________ Work ___________________ v. DEFENDANT(S): _____________________________________________ COURT USE ONLY Case Number: Address: ____________________________________________________ City/State/Zip: ________________________________________________ Phone: Home _______________________ Work ___________________ Division Courtroom REQUEST TO SET ASIDE ‰DISMISSAL ‰DEFAULT JUDGMENT Under penalties of perjury, I declare that these statements are true and correct. 1. I/We____________________________, am the ‰Plaintiff(s) ‰Defendant(s) in above captioned case. 2. My claim against the ‰Plaintiff(s) ‰Defendant(s) was/were dismissed on (date). 3. OR The ‰Plaintiff(s) ‰Defendant(s) Judgment was/were entered against me on (date). I/We did not appear in Court on the ‰date of the trial or the ‰date of the entry of judgment because: _________________________________________________________________________________________________ _________________________________________________________________________________________________ 4. I/We believe I/We can provide the following facts to prove my/our case or to establish my/our defense: _______________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Date: _________________________________ ______________________________________ Signature ______________________________________ Signature ORDER The Court upon review of Request to Set Aside ‰Dismissal ‰Default Judgment, ORDERS the following: ‰Request DENIED ‰Request GRANTED ‰Request to be heard by the Court on (date). If after the request is heard and the Court finds that the request for dismissal/default judgment should be set aside, the Court ‰will proceed immediately to trial at the conclusion of the hearing. ‰will re-schedule the trial for another date. The parties are advised to bring with them on the said date all evidence and witnesses necessary for the Court Trial. Date: _________________________________ ___________________________________________ ‰Judge ‰Magistrate CERTIFICATE OF MAILING I hereby certify that on (date) __________________________, I mailed a true and correct copy of the REQUEST TO SET ASIDE DISMISSAL/DEFAULT JUDGMENT, by placing it in the United States Mail, postage pre-paid to the parties at the addresses listed above. ___________________________________________ Clerk of the Court/Deputy Clerk JDF 253 R2/11 REQUEST TO SET ASIDE DISMISSAL/ DEFAULT JUDGMENT American LegalNet, Inc. www.FormsWorkFlow.com