Small Claim Complaint
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Small Claim Complaint Form. This is a Illinois form and can be use in Madison Local County.
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Tags: Small Claim Complaint, Illinois Local County, Madison
SMALL CLAIMS COMPLAINT
Complaint
No.
Plaintiff(s)
Defendant(s)
SMALL CLAIM COMPLAINT
I, the undersigned, claim that the defendant is indebted to the plaintiff in the sum of $
for
and that the plaintiff has demanded payment of said sum; that the defendant refused to pay the same and no part thereof has
been paid, that the defendant resides at
phone no.
; that the plaintiff resides at
phone no.
, 200____
Dated:
; in the State of Illinois.
(Signature of Plaintiff)
_________________________________________________________________________________________________
AFFIDAVIT
on oath states that the allegations in this complaint are true.
Signed and Sworn to before Me
, 200__
(Seal)
(Notary Public)
Copy to:
___Court Copy
___Defendant’s Copy
___ Plaintiff’s Copy
_________________________________________________________________________________________________
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