(Revised 7/05) File Stamp Date Case Number ______ Prepared by: Filer's name, SC# Filer's address Filer's phone number {Filer's fax phone number} {Filer's e-mail address} Attorney for Plaintiff In The District Court of ______ County, Kansas Plaintiff's name vs. Defendant's name Defendant's address Pursuant to Chapter 61 of Kansas Statutes Annotated PETITION (recovery of money) The plaintiff states the following claim(s): 1. The defendant(s) is indebted to the plaintiff in the amount of $______. WHEREFORE, the plaintiff demands judgment against the defendant(s) for: principal amount interest before judgment interest after judgment and costs. $______, ______% per year from __________________, _______, ______% per year, _________________________________ Plaintiff or Plaintiff Attorney Signature SC# {If applicable, include the following: This is a communication from a debt collector. This is an attempt to collect a debt and any information obtained will be used for that purpose.} Defendant Plaintiff Case No. ______ American LegalNet, Inc. www.USCourtForms.com