Joseph E. Smith Clerk of the Circuit Court St. Lucie County, Florida small claims division 250 N.W. Country Club Drive Port Saint Lucie, Florida 34986 (772) 785-5880 In the County Court, Nineteenth Judicial Circuit, in and for County of St. Lucie, State of Florida ­ Civil Division Case No. PLAINTIFF, VS DEFENDANT. ________________________________/ STATEMENT OF CLAIM FOR REPLEVIN (FOR RETURN OF PERSONAL PROPERTY/WEAPON FROM GOVERNMENT ENTITY) Plaintiff(s) sues the Defendant(s) and alleges: 1. 2. This is an action to recover possession of personal property. The description of the property is: [list property]__________________________________ _________________________________________________________________________ _________________________________________________________________________ To the best of plaintiff's knowledge, information and belief, the value of the property is: $_____________ and its location is: ___________________________________________ _________________________________________________________________________ Plaintiff is the owner of the claimed property or is entitled to possession of it by virtue of the following source of title, or right of possession: ________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ (if interest is based on a written instrument a copy is attached) 3. 4. 5. The property cannot be released by the defendant without a court order, or the property is wrongfully detained by the defendant who obtained possession by:______________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ To Plaintiff's best knowledge, information and belief, the defendant detains property because:__________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ 6. American LegalNet, Inc. www.FormsWorkFlow.com 7. The property has not been taken for any tax, assessment or fine pursuant to law, nor has it been taken under an execution or attachment against plaintiff's property, or if so taken, it is by law exempt from such taking by the following reference to the exemption law relied upon:____________________________________________________________________ _________________________________________________________________________ Written demand for return of the property was provided to Defendant and [if Defendant is not a municipality] also to the Department of Financial Services at least 90 days prior to the filing of this Complaint. Section 768.28(6)(a), Florida Statutes. A copy of the demand is attached hereto. The property is not contraband, was not the fruit of criminal activity, and is not being held for some evidentiary purposes The property came into possession of Defendant on or about ________________________ (date) 8. 9. 10. 11. Plaintiff has the legal right to possess the property and is not subject to any legal prohibition against such possession. Pursuant to section 92.525, Florida Statutes, under penalties of perjury, I declare that I have read the foregoing Statement of Claim and the facts stated in it are true. Signature: Print Name: Address: __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ Phone: __________________________________________ Revised 1/1/2014 American LegalNet, Inc. www.FormsWorkFlow.com