State of Indiana in the Spencer County Circuit Court

STATE OF INDIANA IN THE SPENCER COUNTY CIRCUIT COURT COUNTY OF SPENCER SMALL CLAIMS DIVISION CLAIMANT______CAUSE NO# 74C01-______-SC-____

DEFENDANT______

NOTICE OF CLAIMS AND SUMMONS THE DEFENDANT IS HEREBY NOTIFIED TO APPEAR IN THE COURTROOM OF THE SPENCER CIRCUIT COURT ON THE 3RD FLOOR OF THE COURTHOUSE IN ROCKPORT, INDIANA AT ______O’CLOCK A.M. ON THE ______DAY OF ______20______FOR TRIAL IN THIS CAUSE, (TRIAL DATE TO BE NOT LESS THAN (10) DAYS, NOR MORE THAN (40) DAYS AFTER SERVICE OF THIS CLAIM). THE CLAIMANT CLAIMS AS FOLLOWS: ______

SERVE BY: CERTIFIED MAIL______SHERIFF______

CLAIMANT______

IF THE CLAIM ARISES OUT OF A WRITTEN CONTRACT, A COPY MUST BE ATTACHED TO THIS NOTICE OF CLAIM. IF THE CLAIM ARISES FROM AN ACCOUNT, AN ITEMIZED STATEMENT MUST BE ATTACHED TO THIS NOTICE OF CLAIM. IF THE CLAIMANT IS A COLLECTION AGENCY, A COPY OF THE WRITTEN ASSIGNMENT GIVING THE AGENCY THE RIGHT TO BRING THIS ACTION MUST BE ATTACHED TO THIS NOTICE OF CLAIM. BOTH CLAIMANT AND DEFENDANT MAY APPEAR EITHER IN PERSON OR WITH AN ATTORNEY ON THE DATE OF TRIAL INDICATED HEREIN ABOVE. THE PARTIES MUST BRING TO COURT ALL DOCUMENTS AND WITNESSES WHICH THEY INTEND TO PRESENT TO THE COURT CONCERNING THIS CLAIM. IF THE DEFENDANT INTENDS TO DISPUTE THIS CLAIM, OR CANNOT APPEAR AT THE TIME AND PLACE DESIGNATED, HE SHOULD NOTIFY THE COURT WITHIN FIVE (5) DAYS AFTER RECEIVING THIS NOTICE OF CLAIM BY TELEPHONE AT 649-6025 OR IN WRITING ADDRESSED TO JUDGE JON A. DARTT, SPENCER CIRCUIT COURT, PO BOX 152 ROCKPORT, IN. 47635. IF THE DEFENDANT DOES NOT WISH TO DISPUTE THE CLAIM HE MAY STILL APPEAR FOR THE PURPOSE OF ALLOWING THE COURT TO ESTABLISH THE METHOD BY WHICH THE JUDGMENT WILL BE PAID. IF THE DEFENDANT FAILS TO APPEAR AT THE TIME AND PLACE SET FOR TRIAL IN THIS CAUSE, A DEFAULT JUDGMENT MAY BE ENTERED AGAINST HIM. THE DEFENDANT IS HEREBY NOTIFIED THAT HE HAS THE RIGHT TO TRIAL BY JURY AND THAT SUCH RIGHT IS WAIVED UNLESS THE DEFENDANT REQUESTS A JURY TRIAL IN THIS COURT TEN (10) DAYS AFTER RECEIPT OF THIS NOTICE OF CLAIM.

______CLERK, SPENCER CIRCUIT COURT

CLAIMANT’S ADDRESS AND PHONE DEFENDANT ADDRESS AND PHONE

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