IN THE CIRCUIT COURT OF ST. LOUIS COUNTY, MISSOURI
(Please Print Clearly)
SMALL CLAIMS COURT
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PLAINTIFF(s)
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CASE NUMBER __________________________________________ AMOUNT CLAIMED
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ADDRESS
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CITY/STATE/ZIP CODE
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COURT DATE AND TIME
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TELEPHONE NUMBER
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DIVISION
VS
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DEFENDANT(s)
(OTHER INFORMATION)
__________________________________________ __________________________________________ __________________________________________ __________________________________________
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ADDRESS
_____________________________________________
CITY/STATE/ZIP CODE
_____________________________________________
TELEPHONE NUMBER
COUNTERCLAIM (ARISING) ( NOT ARISING) OUT OF SAME TRANSACTION
The defendant states he/she has a claim against the plaintiff in the amount of $ ____________________________. The counterclaim arose on or about the _______day of __________________, 20____, as a result of the following events: ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ The defendant states that the information contained in the counterclaim is true and correct to the best of his/her knowledge, and he/she is not an assignee of this counterclaim, and that he/she has not filed more than twelve other claims in Missouri Small Claims Courts during the current calendar year. Defendant understands that, should he/she become successful in this action and obtain judgment, and if the plaintiff does not appeal within ten (10) days, this judgment becomes final. The defendant cannot commence another action involving the same parties and issues. ______________________________________ SIGNATURE OF DEFENDANT ______________________________________ DATED
Read the Instructions on the reverse side of this form carefully.
KEEP A COPY OF THIS COUNTERCLAIM AND BRING IT TO COURT.
CCAC150 Rev. 02/08 WHITE-File YELLOW-Plaintiff PINK-Plaintiff GOLDENROD-Defendant
INSTRUCTIONS TO PLAINTIFF
1. By using this form, the defendant is countersuing you. 2. To defend yourself: a. You must appear at the date and time set for the hearing. b. You should bring with you all books, papers, witnesses, and evidence you have to establish your defense. c. At your request the clerk will issue a subpoena for any witness you may need. 3. Rules of Evidence do not apply, and you may defend this action with or without the assistance of an attorney.
Special Needs: If you have special needs addressed by the American With Disabilities Act, please notify the Circuit Clerk's office at 314/615-8029, Fax 314/615-8739 or TTY 314/615-4567 at least three business days in advance of the court proceeding.
CCAC10 Rev. 12/99
WHITE-File
YELLOW-Plaintiff
PINK-Plaintiff
GOLDENROD-Defendant