IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR JACKSON COUNTY SMALL CLAIMS DEPARTMENT (Please type or print legibly) Plaintiff(s): 1.) _____________________________ CASE NUMBER: _____________SM 2.) _____________________________ NOTICE OF DEFENDANT’S ELECTION vs. Defendant(s): 1.) _____________________________ 2.) _____________________________ PART I: Claim received: On (date)___________________ I was served a notice of claim under ORS 46.445 where the above-named plaintiff made a claim against me in the above-entitled court:  In the amount of $__________________  For the following property ___________________________________________________ PART II: Defendant’s Election. (Note 1: Each defendant listed above must sign and file a separate notice of defendant’s election. Note 2: A husband and wife may file a joint election.) I elect to respond under ORS 46.455 as follows: 1._____ I ADMIT the plaintiff’s claim. I will pay the money or return any property claimed, together with the filing fees and service fees, directly to the plaintiff and mail proof of that delivery and payment to the court within 14 calendar days of the date the claim was served on me. 2._____ I DENY the claim and demand a Small Claims hearing. Enclosed are court fees of $________ (see Part III below). 3._____I DENY the claim, demand a Small Claims hearing and wish to file a COUNTERCLAIM arising out of the same transaction or occurrence that is the subject matter of the plaintiff’s claim. Enclosed are court fees of $______ (See Part III below). I claim that the plaintiff owes me $______________ because:_______________________________________________________________________________ ____________________________________________________________________________ 4._____I DENY the claim and demand a JURY TRIAL. (Only if the claim exceeds $750.00.) I enclose court fees of $__________ (See Part III below). This choice requires the plaintiff to file a formal complaint in circuit court. If the plaintiff does not file a complaint, I ask that my JURY FEE be refunded to me. The plaintiff can mail a copy of the formal complaint to me at: _________________________________________________________________________________ Street address City State Zip Code PART III: Fees. I understand that Court fees are based on the amount indicated in Part I, above, and may include other fees depending on how I respond in Part II above. I must contact the court for the appropriate fee amount. If the appropriate fees are not enclosed, the form will not be accepted for filing and may result in a default judgment against me. PART IV: Signature . I have read and understand the above. I have chosen one of the four options and have enclosed the appropriate fees. DATED:________________ SIGNED______________________________ ______________________________ Print name Mailing address: Street/PO Box City State Zip code _______________________________ Phone Public SmClaims Notice Defendant Election Page 1 of 1 9/8/09 American LegalNet, Inc. www.FormsWorkFlow.com