SMALL CLAIMS COMPLAINT Complaint No. Plaintiff(s) SMALL CLAIM COMPLAINT Defendant(s) 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____ (Signature of Plaintiff) ; in the State of Illinois. Dated: _________________________________________________________________________________________________ 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 _________________________________________________________________________________________________ American LegalNet, Inc. www.USCourtForms.com