SMALL CLAIMS COUNTERCLAIM HAMILTON SUPERIOR COURT 4 One Hamilton County Square, Suite 292 Noblesville, Indiana 46060-2231 Telephone no. (317) 776-9612 (Original Defendants) Counter-Claimant 1 __________________________ Counter-Claimant 2 __________________________ Address Line 1 _______________________________ Address Line 2 _______________________________ City ___________________ State ___ Zip _________ Telephone ___________________________________ If Counter-claimant is represented by an attorney: Attorney ____________________________________ Attorney Number _____________________________ Address Line 1 _______________________________ Address Line 2 _______________________________ City ___________________ State ___ Zip _________ Telephone ___________________________________ Counter-Defendant 2 __________________________ Address Line 1 ________________________________ Address Line 2 ________________________________ City __________________ State ____ Zip__________ Telephone ___________________________________ CAUSE NO. 29D04-__________-SC-___________ Plaintiff requests service by: Sheriff of _____________________ County Certified mail vs. (Original Plaintiffs) Counter-Defendant 1 __________________________ Address Line 1 ________________________________ Address Line 2 ________________________________ City __________________ State ____ Zip__________ Telephone ___________________________________ NOTICE OF COUNTERCLAIM TO THE COUNTERCLAIM DEFENDANT (original Plaintiff) FROM THE CLERK OF THE COURTS: The original Defendant has filed a counterclaim against you. This counterclaim, and your original claim, will be heard in the Hamilton Superior Court No. 4 on the same date, time, and place as your original claim. The Court may enter a default judgment against you on the counterclaim if you fail to appear. The Counterclaim is for: Note, Contract, or Account (copy attached). Other _____________________________________. A brief statement of the nature of the counterclaim against you is as follows:____________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ ________________________________________________________________________________________________. The Counter-Claimant demands judgment against the original Plaintiff for $_________________ plus interest from ____________________________, 201__ (date), at the rate of ___________%, and the court costs of this action. Dated:____________________ ____________________________________________ Signature of Counter-Claimant (or attorney) (attorney must sign if an attorney is representing Counter-Claimant) American LegalNet, Inc. www.FormsWorkFlow.com NOTICE OF MAILING OF COUNTERCLAIM I hereby certify this Notice of Counterclaim was mailed via first class mail on the below date to the Counterclaim Defendant at the address shown on the front, allowing sufficient time for it to be received at least seven (7) days prior to the trial set in this case. Dated: ____________________________, 201__. ________________________________________ Clerk, Hamilton County Courts NOTICE OF RECEIPT OF COUNTERCLAIM I hereby certify that this Notice of Counterclaim was filed leaving insufficient time to guarantee delivery to the Counterclaim Defendant by first class mail at least seven (7) days prior to the trial set in this case. Accordingly, the Notice of Counterclaim was placed in the Court's file to effect personal service in open court. Dated:____________________________, 201__. _______________________________________ Clerk, Hamilton County Courts sc4form.005 (revised March 1, 2010) American LegalNet, Inc. www.FormsWorkFlow.com