IN THE COUNTY COURT OF THE FIFTH JUDICIAL CIRCUIT IN AND FOR HERNANDO COUNTY, FLORIDA CASE NO.: _________________________________ __________________________________________, Plaintiff(s) -VS- __________________________________________, Defendant(s) STATEMENT OF RESPONSIBILITY Before filing this case I have considered the following matters and acknowledge that: 1. This case is being filed in the County Court under the rules cited as Small Claims Rules. These rules shall be construed to implement the simple, speedy and inexpensive trial of action at law in county courts. The conduct of this case will be in accordance with the Rules of Procedure and Laws of Florida which apply to this case. The naming of proper parties is an important element of the case and the responsibility for naming the proper plaintiff(s) and defendant(s) in this case is mine. I am responsible for the furnishing of a correct address or location at which the defendant(s) can be served or given notice of this suit. I assume responsibility as to my right to file this case for myself or for the named plaintiff(s), realizing that if the plaintiff is a corporation, said plaintiff is required to be represented by an attorney, unless the case is a Summary Procedure (Small Claims) case. I do not expect the clerk who receives and files this claim to give me legal advice as to how to prosecute this case and acknowledge that the clerk is not acting as my attorney or legal advisor. I am solely responsible for the collection of any judgment entered in my favor. 2. 3. 4. 5. 6. __________________________________ Date _______________________________________ Signature of Plaintiff(s) _______________________________________ Telephone number SMALL_CLAIMS_STATEMENT_RESPONSIBILITY_12122014 American LegalNet, Inc. www.FormsWorkFlow.com