REVISED 04/02 IN THE JUSTICE COURT OF TETON COUNTY GEORGE R. KUVINKA, JUSTICE OF THE PEACE ) ) (NAME) ____________________________________________ ) (MAIL ADDRESS) PLAINTIFF, ) ) VS. ) ____________________________________________ ) COURT ) (NAME) COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ) . . . ____________________________________________ : (MAIL ADDRESS) DEFENDANT. ) ____________________________________________ : SMALL CLAIMS ACTION NO. SC-__________________ SMALL CLAIMS AFFIDAVIT Index No. Calendar No. I, ______________________________________________, being duly sworn 1. : on (TYPED OR PRINTED NAME OF PERSON SIGNING THIS AFFIDAVIT) JUDICIAL SUBPOENA Plaintiff(s) oath, state that the Defendant is justly indebted to the Plaintiff in the principal sum of -against: $_______________, plus the filing fee of $10, plus the Sheriff=s service fees of $__________, and for such other costs as Plaintiff is entitled. : Plaintiff=s claim is based upon the following: : ______________________________________________________________________________ Defendant(s) : ...................................................... ______________________________________________________________________________ ______________________________________________________________________________ THE PEOPLE OF THE STATE OF NEW YORK ______________________________________________________________________________ TO ______________________________________________________________________________ 2. GREETINGS: 3. Demand for payment has been made, and payment refused. Following are the Defendant=s: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Business Address:______________________________________________ , the Honorable at the Court Home Address: ________________________________________________ located at County of in room , on the , 20 , at o'clock in the noon, Phone Numbers: day of Business: _________________ Home: _______________ and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the 4. I request Judgment in the amount stated above. Your failure to ) STATE OF WYOMINGcomply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a ___________________________________________ ) SS result of your failure to comply. COUNTY OF TETON ) (Plaintiff=s / Agent=s signature) Witness, Honorable Subscribed and sworn to before me Court in County, day of this _____ day of _____________, 20____. , one of the Justices of the , 20 ___________________________________________ JUDGE / Clerk of Court / Notary Public (Attorney must sign above and type name below) Plaintiff=s: Business Address: __________________________________________________ Attorney(s) for Home Address: ____________________________________________________ Phone Numbers: Business _________________ Home:_____________________ Office and P.O. Address ******************************************************************************** NOTICE TO PLAINTIFF AND DEFENDANT Telephone No.: You are hereby notified that this case has been set for trial. If you choose to appear, you Facsimile No.: MUST bring with you the witnesses, papers and evidence which will prove your case or defend E-Mail Address: your position. IF YOU DON=T APPEAR, YOU MAY LOSE YOUR CASE. Additional information appears on the reverse side of this Affidavit. Mobile Tel. No.: PLEASE READ IT. American LegalNet, Inc. www.USCourtForms.com REVISED 5/99 INFORMATION FOR PLAINTIFFS AND DEFENDANTS Because the Court may have to contact you regarding this case, it is necessary that 1. the Court have your correct name, mailing address and telephone number(s). Therefore, if your name is incorrect or misspelled, or if the address or phone number(s) indicated for you on the Affidavit are incorrect in any way, please notify the Court immediately at PO Box 2906, Jackson; 733-7713. 2. If the Defendant wants to contest this case, he/she MUST APPEAR in Court on the date and at the time stated in the Summons. 3. If COURT the Defendant feels he/she has a COUNTERCLAIM against the Plaintiff COUNTYbasically. .the . same. . . . . . . . . . . . . . . . . . . .people, . incident, etc., he/she must file a separate OF. . . . . . . . . circumstances, facts, . . . . . . . . . involving. . . . . ....... : Small Claims Action immediately. In this instance, it may be necessary No. reset the Court date for Index to the original case so that both matters (cases) will be heard by the Judge at the same time. : Calendar No. Attorneys in Small Claims actions are neither necessary nor encouraged, but you 4. may bring an attorney with you to advise youPlaintiff(s) hearing. : during the JUDICIAL SUBPOENA -against- : The Court date scheduled for this case generally cannot be changed UNLESS BOTH 5. PARTIES AGREE, preferably in writing. You may call the Court Clerk at 733-7713 to ascertain : future available Court dates, discuss them with the other party, and agree on a new date; both parties must contact the Court to advise their agreement to the new date, or appear together at the : Court=s office to sign a Stipulation for Continuance. Defendant(s) : ...................................................... 6. NOTE: Both parties must bring to the trial (hearing) THREE (3) COPIES OF ALL MATERIAL YOU WISH TO SUBMIT TO THE JUDGE AS EVIDENCE (all papers, THE PEOPLEpictures, STATE OFbills, etc.) about this case. You may also bring witnesses, documents, OF THE receipts, NEW YORK people who know anything at all about the case. TO If you need a witness who will not appear voluntarily, you may ask the Court to 7. issue a SUBPOENA. You must supply an exact location (residence and/or employment) where the GREETINGS: witness can be served by the Sheriff. Subpoenas must be requested in person no less than five (5) days before the trial date. The Sheriff=s Office will charge youbeing laid aside, you andSubpoena. attend before WE COMMAND YOU, that all business and excuses a $10 fee to serve each each of you , the Honorable at the Court 8. If the Defendantlocated at money claimed, he/she should pay the Plaintiff directly owes the County of before acceptance of payment ,(be sure a check will clear theand at any recessed in room the Court , date. Upon day of on the , 20 at o'clock in the noon, bank), the Plaintiff or adjourned date, to testify and give evidence as a witness in this action on the part of the must inform the Court that the suit should be dismissed. If the Defendant owes the money but cannot pay it all at once, he/she may make 9. Your with the comply withsign subpoena is punishable as a contempt of court bothwill makeagreeliable to failure to Plaintiff to this a STIPULATED JUDGMENT, in which and parties you arrangements the party on whose be paid and when itwasto be paid a maximum penaltydue$50 and all damages sustained as a on the amount to behalf this subpoena is issued for (e.g., installments of when). Both parties must resultthisyour failure to comply. Notary Public, which can be done at the Court=s office at any time sign of Stipulation before a prior to Noon on the date set for trial, or in the Courtroom just prior to 2:00 p.m. on your scheduled Witness, Honorable , one of the Justices of the Court date. Court in County, day of , 20 10. If the Defendant does not appear in Court on the date stated in the Summons, the Court will assume that all allegations in the Small Claims Affidavit are true and will award the Plaintiff the amount requested in the suit (maximum $3,000), plus Courtabove and type nameis called a (Attorney must sign costs. This below) DEFAULT JUDGMENT. If the Plaintiff does not appear in Court on the date stated in the Summons, the case 11. Attorney(s) for will be dismissed. APPEALS of Small Claims actions to the District Court shall be processed pursuant 12. to W.R.A.P.C.L.J. and only on questions of law and not a review of the sufficiency of evidence. Office and P.O. Address 13. If you have any other questions that are not covered above, call the Court Clerk at 733-7713, or stop by the Court=s office in the Teton County Courthouse, 180 South King Street, Telephone No.: Jackson. Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com