_________________________________ Plaintiff NO. _________________ vs. __________________________________ Defendant COUNTERCLAIM I. COUNTERCLAIM 1.1 Defendant claims that plaintiff became indebted to defendant in the sum of $__________ on _______________________ for: (date) 1.2 Defendant has demanded payment from plaintiff and plaintiff refuses to pay. 1.3 Defendant prays that the court dismiss plaintiff’s case and enter judgment for defendant for the sum set forth in paragraph 1 above, plus court costs. II. CERTIFICATION I CERTIFY under penalty of perjury under the laws of the State of Washington that the foregoing claim is true and correct. Dated at __________________________________, Washington on ___________________. (Place) (Date) ______________________________________________ Defendant’s Signature ______________________________________________ Address ______________________________________________ Phone:_________________________________________ COUNTERCLAIM CRLJ1.3 Page 1 of 1 \\Dcned1\kc2\KCDC Clerical Procedures\Best Practice Procedures\Clerk Forms\Counterclaim 4-4-05.doc American LegalNet, Inc. www.FormsWorkflow.com