Statement Of Claim Form - Notice And Summons printable pdf download

IN THE MAGISTRATE COURT OF WHITE COUNTY

STATE OF GEORGIA

_________________________________________

Plaintiff(s)

Address: _________________________________

__________________________________

VS.

CASE # ______-CI-_______

_________________________________________

Defendant(s)

Address: _________________________________

__________________________________

STATEMENT OF CLAIM

SUIT ON A NOTE

SUIT ON ACCOUNT

OTHER (Please Specify) __________________________________

_________________________________________________

The court has jurisdiction over the defendant because:

the defendant is a White County resident or

Other (please specify) ____________________________

_____________________________________________

Plaintiff claims the defendant is indebted to the plaintiff as follows: ______________________________________

_____________________________________________________________________________________________

That said claim is in the amount of $__________ principal, $__________ interest, plus $__________ court costs to

date, and all future costs of this suit.

State of Georgia, White County:

_____________________________ being duly sworn on oath, says the foregoing is a just and true statement of the

amount owing by the defendant to plaintiff, exclusive of all set-offs and just grounds of defense.

Sworn to and subscribed before me

__________________________________________

This _____ day ____________, 20____.

Plaintiff or agent

__________________________________________

________________________________________

(if Agent, give Title or Capacity)

Notary Public, Deputy Clerk

Phone Number: ___________________

NOTICE AND SUMMONS

To: _______________________________________________

You are hereby notified that the above-named plaintiff has made a claim and is requesting judgment against you in the

sum shown by the foregoing statement. You are required to file an answer to this claim within 30 days after service of

this claim upon you. If you do not answer, judgment by default will be entered against you. Your answer may be filed in

writing or may be given orally to the Clerk of Court, but only in person within the 30 day period. No telephone

answers are permitted. The court will hold a hearing upon the claim at the White County Courthouse located at 59 S.

Main Street, Cleveland, GA 30528, at a time to be set after your answer is filed. You may come with or without an

attorney. If you have witnesses, books, receipts or any other writings bearing this claim, you should bring them with you

at the time of the hearing. If you wish to have witnesses subpoenaed, contact the clerk’s office at once for assistance. If

you have a claim against the plaintiff, you should notify the clerk at once and file a written answer and counterclaim

immediately. If you admit the claim but desire additional time to pay, you must come to the hearing in person and state

the circumstances to the court.

__________________________________________

Clerk or Deputy Clerk

White County, Georgia

Statement Of Claim Form - Notice And Summons

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