Statement Of Claim Auto Collision No Medical Expenses
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Statement Of Claim Auto Collision No Medical Expenses Form. This is a Florida form and can be use in Orange Local County.
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Tags: Statement Of Claim Auto Collision No Medical Expenses, Florida Local County, Orange
IN THE COUNTY COURT OF THE
NINTH JUDICIAL CIRCUIT OF FLORIDA
ORANGE COUNTY, FLORIDA
Case Number ____________________
Plaintiff(s)
VS
Defendant(s)
STATEMENT OF CLAIM
AUTO COLLISION-NO MEDICAL EXPENSES
The above named plaintiff(s) sue(s) the above named defendant(s) for:
On
or
about
____________________________________________________at
_______________________________________________________________________,
City, ______________________, County, ___________________, State, ____________,
the defendant, __________________________________________ willfully and/or
recklessly and/or negligently drove a motor vehicle owned by ______________________
against the motor vehicle of the plaintiff(s) thereby damaging the same and depreciating
its market value, and causing plaintiff(s) to lose the value of its use during its repair.
And Plaintiff(s) claim(s) $
interest, court costs and attorney fees.
damages not to exceed $5,000.00 exclusive of
______________________________
Plaintiff(s)
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