Petition Small Claims Court
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1IN THE CIRCUIT COURT OF
COUNTY, MISSOURI
Judge or Division:
Case Number:
Plaintiff(s):
1.
(Date File Stamp)
Plaintiff's Address (No. 1):
Defendant's Address (No. 1):
2.
vs.
City, State, Zip:
City State, Zip:
Defendant(s):
Telephone Number:
Telephone Number:
1.
Plaintiff's Address (No. 2):
Defendant's Address (No. 2):
2.
City, State Zip:
City, State, Zip:
Telephone Number:
Telephone Number:
Petition Small Claims Court
The plaintiff states he/she has a claim against the defendant in the amount of $
. The claim
arose on or about
(date) as a result of the following events:
(include additional page if necessary)
The plaintiff states that the information contained in this petition is true and correct to the best of his/her knowledge, that
he/she is not an assignee of this claim and that he/she has not filed more than twelve (12) other claims in the Missouri small
claims courts during the current calendar year.
The plaintiff understands that, should he/she be successful in this action and obtain judgment, and if the defendant does
not appeal within ten days, this judgment becomes final. The plaintiff cannot commence another action involving the same
parties and issues. The plaintiff understands that he/she is waiving the right to jury trial on these issues in the small claims
court.
Date
Signature of Plaintiff
Keep a copy of this petition and bring it to court.
OSCA (10-04) SC40
1 of 1
Rule 141..01, 482.330, 482.340 RSMo
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