Full Name of Party Filing Document Mailing Address (Street or Post Office Box) City, State and Zip Code Telephone Email Address (if any) IN THE DISTRICT COURT FOR THE JUDICIAL DISTRICT FOR THE STATE OF IDAHO, IN AND FOR THE COUNTY OF SMALL CLAIMS DEPARTMENT Case No. , Plaintiff(s), vs. CLAIM $ $ $ $ $ $ Claim Filing Fee Service Fee Another Notice Total , Defendant(s). Plaintiff's Name Address City State Zip Phone Plaintiff's Name Address City State Zip Phone Defendant's Name Address City State Zip Phone Defendant's Name Address City State Zip Phone (If you are seeking a judgment for money, fill out this portion.) AMOUNT OF CLAIM: DATE CLAIM AROSE: CLAIM CAO SC 1-2 07/01/2016 (not including filing and service fees) (month and year) PAGE 1 American LegalNet, Inc. www.FormsWorkFlow.com BASIS FOR YOUR CLAIM: If you are seeking a judgment for the return of personal property, fill out this portion. PERSONAL PROPERTY: I am the owner, or I am entitled to possess, the following personal property, which is being held by the defendant (specifically describe the property): VALUE OF THE PROPERTY: $ Service of process by certified mail requested: Yes No BY SIGNING THIS CLAIM, THE PLAINTIFF VERIFIES THAT (1) the Plaintiff is the true owner of the claim, (2) the Defendant resides in Defendant resides outside Idaho and the claim arose in and (3) the information above is true and correct to the Plaintiff's best knowledge. County, or the County, CERTIFICATION UNDER PENALTY OF PERJURY I certify under penalty of perjury pursuant to the law of the State of Idaho that the foregoing is true and correct. Date: Plaintiff's Signature Typed/printed name Favor de avisarnos antes de la audencia si usted necesitara un interprete en la corte. CLAIM CAO SC 1-2 07/01/2016 PAGE 2 American LegalNet, Inc. www.FormsWorkFlow.com