Form Aoc-175-Small Claims Complaint
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2AOC- 175
Doc. Code: COM
Case No. ____________________
Rev. 5-11
Page 1 of 2
l e x
e t
Court _______________________
District Small Claims
j u s t i t i a
Commonwealth of Kentucky
Court of Justice
County ______________________
KRS 24A.260
SMALL CLAIMS COMPLAINT
Assigned Court Date: ___________________________
Plaintiff:
[ ] Company
[ ] Individual
(for individual, enter first, middle and last names)
Name
__________________________________________________________________________________
Address
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Plaintiff’s Attorney (if any):
[ ] Firm
[ ] Individual
Name
__________________________________________________________________________________
Address
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Defendant:
[ ] Company
[ ] Individual
(for individual, enter first, middle and last names)
Name
__________________________________________________________________________________
Address
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
NOTICE TO EACH DEFENDANT - READ CAREFULLY
You are being sued in Small Claims Court by the Plaintiff shown above. The judge has not made a decision in
this case. You are to appear in court on the date shown on the attached summons to tell your side of the dispute.
If you fail to appear in court on the date shown on the attached summons, a court judgment may be taken against
you for the money or property demanded in the Claim on page 2 of this document. This could lead to garnishment of
your paycheck and/or sale of your home or other belongings (unless protected by law) to satisfy the judgment. If you
have questions or need assistance, consult the Small Claims information pamphlet (P-6) or call an attorney.
WARNING REGARDING JURY TRIAL
(KRS 24A.320; 29A.270)
There are no jury trials in Small Claims Court. If the amount in controversy exceeds $250, you may have a jury
trial by going into District Civil Court.
However, the simplified and informal procedures used in Small Claims
Court do not apply in District Civil Court. If you request a jury, you will be required to pay an additional fee.
To the Plaintiff:
If you want a jury trial, file your claim in District Civil Court instead of Small Claims Court
To The Defendant:
If you want a jury trial, you must notify the court clerk in writing at least seven (7) days
before the court date listed on the attached summons to have the case transferred from Small
Claims Court to District Civil Court.
Clerk
___________________________________________
Address
___________________________________________
___________________________________________
___________________________________________
Phone No.
___________________________________________
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