IN THE JUSTICE OF THE PEACE COURT OF THE STATE OF DELAWARE, IN AND FOR COUNTY COURT NO COURT ADDRESS CIVIL ACTION NO VS. PLAINTIFF(S) DEFENDANT(S) 1) Name Address 1) Name Address System ID# System ID# Phone Phone PLAINTIFF(S) DEFENDANT(S) Phone 2) Name Address Phone 2) Name Address System ID# System ID# Phone Phone Plaintiff's Attorney or Agent, if any: Defendant's Attorney or Agent, if any: Address Address System ID# System ID# (bar#) Phone (bar#) Phone Check One Individual Corporation or other Artificial entity (see Supreme Court Rule 57) Type of Service: (Check One) Court Service Special Process Server Type of Action: Debt Replevin Deficiency Judgment Check One Individual Corporation or other Artificial entity (see Supreme Court Rule 57) Alternate Address (Physical or Mailing) 1. Trespass Summary Possession (Landlord Tenant) COMPLAINTConcise Statement of Facts: (Who, What, When, Where, How?) 2. Relief Sought: $ Amount of money claimed. (Not including interest) $ Pre Judgment Interest at or % legal rate . % contractual rate $ Post Judgment Interest at the legal rate OR contractual rate of _% $ Court Costs. $ Other Possession Jury Trial Demanded (Possession only) Yes No Return of personal property or Total value (Attach list of property stating description, number $ and value of items on 8 ½" x 11" paper TO: THE COURT OF THE JUSTICES OF THE PEACE Please docket the above-captioned case and issue a Summons to the above-named Defendant(s) to appear before you so there may be a trial on this case and judgment for the Plaintiff(s), together with interest and costs of this proceeding: or, for an Attachment in Lieu of Summons, please issue same and direct the Constable to execute the proper process. . Date J.P. Civ. Form No. I (Rev 01/05/2007) Plaintiff or Plaintiff's Attorney Doc. No.02-13-95-05-01 American LegalNet, Inc. www.FormsWorkflow.com