***ALL SHADED AREAS MUST BE COMPLETED. BATON ROUGE CITY COURT SMALL CLAIMS DIVISION 233 St. Louis St. P. O. Box 3438 Baton Rouge, LA 70821 (225) 389-3017 STATEMENT OF CLAIM AND CITATION R.S. 13:5200 et seq. SUIT NUMBER: ______________________________ PLAINTIFF VERSUS DEFENDANT (By signing this petition, I verify that I have read and understand the Court's publication: "How to Use the Small Claims Division.") FULL NAME OF PARTY BEING SUED NAME OF OWNER IF SUING A COMPANY FULL NAME OF SUING PARTY STREET ADDRESS OF DEFENDANT DAYTIME PHONE CITY, STATE, ZIP CODE DAYTIME PHONE STREET ADDRESS OF PLAINTIFF OTHER ADDRESS FOR DEFENDANT CITY, STATE, ZIP CODE CITY, STATE, ZIP CODE PLAINTIFF CLAIMS THE FOLLOWING RELIEF FROM THE DEFENDANT (Short Statement of Plaintiff's claim and reasons.) If claim is for money, state the date and manner in which indebtedness arose. If claim is for movable property, give description, location, and value. Attach copies of any written supporting documents. Amount sued for $____________________________ plus legal interest and court costs. I am requesting that this matter be heard by: (Check One) Arbitrator Judge (If additional space is needed, complete Attachment ­ Page 8.) NOTICE TO ALL PARTIES: During the pendency of this lawsuit, the Court will contact you at the above address and phone number that you have provided. If either address or phone number should change, you must notify the Court immediately. Your case may be decided by an Arbitrator, who is a licensed attorney, appointed by the Judge. If so appointed, and the parties agree to be bound by his arbitration, his decision will be final and binding. Citation continued on back. SIGNATURE OF PLAINTIFF FILED: Deputy Clerk: If there is an attachment, check here. PLEASE SERVE DEFENDANT/AGENT: At: Civil ­ Statement of Claim & Citation (Interactive Packet-WORD) 09-23-14 (Page 1) ORIGINAL American LegalNet, Inc. www.FormsWorkFlow.com CITATION ­ PAGE 2 La.R.S. 13:5204(b) BATON ROUGE CITY COURT SMALL CLAIMS DIVISION 233 St. Louis St. P. O. Box 3438 Baton Rouge, LA 70821 (225) 389-3017 * * * ATTENTION * * * This lawsuit is filed in the Small Claims Division. The ordinary rules of evidence do not apply in the Small Claims Division. If you lose in the Small Claims Division, you have no right to appeal the Court's decision. Your matter will be tried before a Judge, unless both parties request in writing that the matter be heard before an arbitrator. This preference can be made on the first page of the Claim or Answer, whichever applies, in the designated box. The preference for arbitration must be filed with the Clerk of the Small Claims Division no later than ten days from the date on which you receive this notice. Copies of the written preference should be sent to all other parties in this matter. You may have this case transferred to the regular Civil docket. To do so, you must file a written notice of that intent to transfer with the Clerk of the Small Claims Division within ten (10) days, including weekends, of receiving this notice, and pay a transfer fee of $50.00. If you are unsure of what to do, you should talk with an attorney about it immediately. If you want to contest this claim, you must decide whether or not you want the case to remain in the Small Claims Division. The advantages of the Small Claims Division are that trial procedures are not strictly enforced and the formal rules of evidence do not apply. The disadvantage is that there is no appeal from the decision upon the case. You do not need a lawyer, but if you wish to retain one, you may do so. Corporations, partnerships and other legal entities may defend themselves through a duly authorized partner, shareholder, officer or employee on any claim not exceeding $5,000.00, if the basis of the suit involves an open account or promissory note. In all other such cases, an attorney is required to represent these entities. If you decide to contest this claim in the Small Claims Division, you must contact the Clerk of the Small Claims Division in writing within ten (10) days, including weekends, of receiving this notice. (Note: If you are a defendant, served through the Secretary of State, and wish to contest this claim, you must contact the Clerk of the Small Claims Division in writing within fifteen (15) days, including weekends, of receiving this notice. If you are a defendant, served via long-arm, and wish to contest this claim, you must contact the Clerk of the Small Claims Division in writing within thirty (30) days, including weekends, of receiving this notice). To do so, use the form which is provided entitled "Defendant's Answer." If you plan to file a reconventional demand (counterclaim) against the Plaintiff in an amount exceeding $5,000.00, you must have the case transferred to the regular Civil Docket and pay the appropriate fee. Civil ­ Statement of Claim & Citation (Interactive Packet-WORD) 09-23-14 (Page 2) American LegalNet, Inc. www.FormsWorkFlow.com ***ALL SHADED AREAS MUST BE COMPLETED. BATON ROUGE CITY COURT SMALL CLAIMS DIVISION 233 St. Louis St. P. O. Box 3438 Baton Rouge, LA 70821 (225) 389-3017 STATEMENT OF CLAIM AND CITATION R.S. 13:5200 et seq. SUIT NUMBER: ______________________________ PLAINTIFF VERSUS DEFENDANT (By signing this petition, I verify that I have read and understand the Court's publication: "How to Use the Small Claims Division.") FULL NAME OF PARTY BEING SUED NAME OF OWNER IF SUING A COMPANY FULL NAME OF SUING PARTY STREET ADDRESS OF DEFENDANT DAYTIME PHONE CITY, STATE, ZIP CODE DAYTIME PHONE STREET ADDRESS OF PLAINTIFF OTHER ADDRESS FOR DEFENDANT CITY, STATE, ZIP CODE CITY, STATE, ZIP CODE PLAINTIFF CLAIMS THE FOLLOWING RELIEF FROM THE DEFENDANT (Short Statement of Plaintiff's claim and reasons.) If claim is for money, state the date and manner in which indebtedness arose. If claim is for movable property, give description, location, and value. Attach copies of any written supporting documents. Amount sued for $____________________________ plus legal interest and court costs. I am requesting that this matter be heard by: (Check One) Arbitrator Judge (If additional space is needed, complete Attachment ­ Page 8.) NOTICE TO ALL PARTIES: During the pendency of this lawsuit, the Court will contact you at the above address and phone number that you have provided. If either address or phone number should change, you must notify the Court immediately. Your case may be decided by an Arbitrator, who is a licensed att