Print Form Clear Form SMALL CLAIMS PRE-FILING INFORMATION This form does not constitute a completed notice of small claims filing and may not be used as such. This form is submitted to the clerk’s office for assignment of case number and court dates. This information will be used to create the Notice of Small Claim. The $29.00 fee must be paid by check or cash at time of filing. The court clerk will witness your signature on the final Small Claims Notice at this time. PHONE (509) 477-4770 EXT. 8 FAX (509) 477-6387 Plaintiff Name #1 YOU ARE THE PLAINTIFF Address YOUR ADDRESS City State Zip Plaintiff Name #2 (IF NEEDED) Address Home Phone Home Phone Work Phone VS. Defendant Name #1 PERSON/BUSINESS YOU ARE SUING Address City State Home Phone Zip Work Phone City State Zip Work Phone Defendant Name #2 (IF NEEDED) Address City State Home Phone Zip Work Phone The defendant owes $________ which became due on _________ (date). TOTAL AMOUNT DUE WITHOUT COURT COSTS The amount owing is for: Auto Damages-Date of Accident_______ Wages Loan Damage Deposit Rent Property Damage Breach of Contract Goods/Services Other __________________________________________________ __________________________________________________________ For Court use only CASE #________________ CT DATE___________ TIME__________ JUDGE_________ ROOM______ INLAND______ FULCRUM_______ DATE_____________ TIME_________ Revised 7/5/05 American LegalNet, Inc. www.USCourtForms.com SMALL CLAIMS PRE-FILING INFORMATION This form does not constitute a completed notice of small claims filing and may not be used as such. This form is submitted to the clerk’s office for assignment of case number and court dates. This information will be used to create the Notice of Small Claim. The $29.00 fee must be paid by check or cash at time of filing. The court clerk will witness your signature on the final Small Claims Notice at this time. PHONE (509) 477-4770 EXT. 8 FAX (509) 477-6387 Plaintiff Name #1 Plaintiff Name #2 Address Address City State Home Phone Zip Work Phone City State Home Phone Zip Work Phone VS. Defendant Name #1 Defendant Name #2 Address Address City State Home Phone Zip Work Phone City State Home Phone Zip Work Phone The defendant owes $________ which became due on _________ (date). TOTAL AMOUNT DUE WITHOUT COURT COSTS The amount owing is for: Auto Damages-Date of Accident_______ Wages Loan Damage Deposit Rent Property Damage Breach of Contract Goods/Services Other __________________________________________________ __________________________________________________________ For Court use only CASE #________________ CT DATE___________ TIME__________ JUDGE_________ ROOM______ INLAND______ FULCRUM_______ DATE_____________ TIME_________ Revised 7/5/05 American LegalNet, Inc. www.USCourtForms.com