Justice Court Cover Sheet Justice C ourt Cover Sheet Revised October 18 , 2017 Page 1 Interpretation. If you do not speak or understand English, contact the court at least 3 days before the hearing or mediation, and an interpreter will be provided. Plaintiff/Petitioner (First) Name Address City, State, Zip Phone Email First Plaintiff/Petitioner222s Attorney* Name Bar Number ---------------------------------------------------------------------------------- Plaintiff/Petitioner (Second) Name Address City, State, Zip Phone Email Second Plaintiff/Petitioner222s Attorney* Name Bar Number Interpretaci363n. Si usted no habla o entiende el Ingl351s contacte al tribunal por lo menos 3 d355as antes de la audiencia o mediaci363n y le proveer341n un int351rprete. Defendant/Respondent (First) Name Address City, State, Zip Phone Email First Defendant/Respondent222s Attorney* Name Bar Number ---------------------------------------------------------------------------- Defendant/Respondent (Second) Name Address City, State, Zip Phone Email Second Defendant/Respondent222s Attorney* Name Bar Number Total Claim for Damages $ Claim may not exceed $11,000 Schedule of Fees: 24778a-2-301.5 -- SMALL CLAIMS AFFIDAVIT - - -- OTHER - - $ 60 Damages $2 , 000 or less $ 135 Expungement Petition $100 Damages $2,001 or $7,499 $ 50 Writ $185 Damages $7,500 - $11,000 $ 35 Open Sealed Record -- SMALL CLAIMS COUNTER AFFIDAVIT -- - - SMALL CLAIMS APPEAL -- $ 5 0 Damages $2 , 000 or less $ 10 Notice of Appeal to District Court $ 70 Damages $2,001 or $7,499 $255 Appeal/Trial de novo Filing Fee payable to District Court $ 120 Damages $7,500 - $11,000 is attached to be paid at District Court American LegalNet, Inc. www.FormsWorkFlow.com