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Stipulation (Small Claims) Form. This is a Florida form and can be use in Bay Local County.
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Tags: Stipulation (Small Claims), C, Florida Local County, Bay
IN THE COUNTY COURT
IN AND FOR BAY COUNTY, FLORIDA
Small Claims Division
___________________________
Plaintiff(s)
Case No. ________________
__________________________
Address
___________________________
City, State and Zip Code
-vs____________________________
Defendant(s)
____________________________
Address
____________________________
City, State and Zip Code
STIPULATION
On the _________ day of ___________________, 20_____, the Plaintiff(s) did sue the Defendant(s) in the
above styled cause. Defendant(s) admit the debt owing to Plaintiff(s), to wit: $____________, court cost in the
amount of $_____________ have been incurred by Plaintiff(s).
The total debt, including accrued court costs is $___________. Defendant(s) agree to pay the sum of
$______________ to Plaintiff in the following manner:
$____________ on ________________, and a like sum on the __________ day of each and every succeeding
month thereafter until the sum of $____________ is paid to the Plaintiff.
Upon failure of Defendant(s) to make any agreed payment when due, Plaintiff may file an affidavit so
stating and Final Judgment will then issue for the balance owed Plaintiff by Defendant(s).
____________________________
Plaintiff
____________________________
Defendant
____________________________
Plaintiff
____________________________
Defendant
Sworn to and subscribed before me this ______ day of _____________________, 20_____.
_____________________________
Notary Public
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Form C