STATE OF SOUTH CAROLINA COUNTY OF RICHLAND ) ) ) ) ) ) ________________________ CIVIL CASE NUMBER IN THE MAGISTRATE’S COURT CROSS-CLAIM PLAINTIFF(S) Vs DEFENDANT(S) ________________________________ Cross-Claimant vs _______________________________ Cross-Defendant I, _____________________, a party in this civil action do assert the following claims: 1. I believe that ____________________________________________________ is/are a resident(s) of Richland County, or is/are an appropriate party(s) to this action. 2. I make this Cross-Claim based on the following: (Attach supplement if necessary) 2. I believe, because of the above information, that I am entitled to and do request a judgment for $ __________________________ against _______________ and/or relief as below requested: including any costs resulting in this action. I STATE UNDER PENALTY OF PERJURY THAT THE ABOVE STATED FACTS ARE TRUE EXCEPT THOSE BASED ON MY BEST INFORMATION THAT I BELIEVE TO BE TRUE. __________________________________ DATE:________________ Signature of Plaintiff/Attorney American LegalNet, Inc. www.USCourtForms.com