STATE OF INDIANA ) IN THE BOONE SUPERIOR COURT II ) SS: COUNTY OF BOONE ) CAUSE NO. Plaintiff Address Phone / E - mail vs. Defendant Address Phone / E - mail NOTICE OF CLAIM TO DEFENDANT 1.You have been sued by the Plaintiff in the above Court and a copy of the Claim is attached, or included here in. 2.You are to appear in the Boone Superior Court II, Courthouse Small Claims Division, Lebanon, Indiana, for a Preliminary hearing/trial of said Claim on . 3.Parties to this action may appear either in person or by attorney. Special rules apply to corporations. Check with the County Clerk. 4.You should bring to the hearing/trial all documents in your possession or under your control concerning the Claim. 5.If you do not wish to dispute the Claim you may nonetheless appear for the purpose of allowing the Court to establish the method bywhich the Judgment shall be paid. 6.If you are unable to appear at the time or place designated in this notice, you should immediately contact the Court Reporter or Bailiffto notify them of that fact. They can be reached in person by Calling the Court (765)482-6502, 8 A.M. to 4 P.M., Monday through Friday ofeach week. 7.A Default Judgment may be entered against you if you fail to appear for hearing/trial. 8.You may, not later than ten (10 days) following service of this Notice demand a trial by jury, by filing an Affidavit showing there arequestions of fact requiring a trial by jury, and specifying such facts, and that such is intended in good faith. Upon filing such demand andAffidavit, the case be transferred to the Civil Docket. There may be addition Court Costs involved. The case then will lose its status as a SmallClaim. Failure to file demand for trial by jury will result in waiver of trial by jury. Date Clerk, Boone Superior Court II I hereby certify that on the date below stated that I mailed a copy of this Summons and a copy of the Complaint to the Defendant, by Certified mail, requesting a return receipt, at the address furnished by the Plaintiff. Date Clerk, Boone Superior Court II RETURN OF SERVICE OF SUMMONS I hereby certify that I have served the within Summons: (1)By delivering a copy of the Summons and a copy of the Complaint to the Defendant, on the day of , .(2)By leaving a copy of the summons and a copy of the Complaint at the dwelling place of abode of the said Defendant, with person of suitable age and discretion residing therein, namely. Sheriff of County, Indiana BY American LegalNet, Inc. www.FormsWorkFlow.com