Columbia Statement Of Claim Form PDF Details

Columbia offers a statement of claim form to its students who have been sexually assaulted. The form is designed to help the studentthrough the process of filing a legal claim. The form asks for detailed information about the assault, and can be helpful in building a case. It is important to note that Columbia University is not responsible for prosecuting crimes, and victims are encouraged to speak with law enforcement officials. However, the statement of claim form can be a useful tool in seeking damages from the assailant.

QuestionAnswer
Form NameColumbia Statement Of Claim Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other nameshow district columbia small claims court, claims small district columbia, small claims court forms dc, district of columbia small claims

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Superior Court of the District of Columbia

Small Claims Form 11

 

CIVIL DIVISION

General

 

SMALL CLAIMS AND CONCILIATION BRANCH

 

 

 

Bldg. B, 510 4th Street, N.W., RM –120

 

 

WASHINGTON, D.C. 20001

TELEPHONE 879-1120

 

____________________________________

 

(1) ______________________________________

 

Plaintiff(s)

 

 

Defendant(s)

____________________________________

vs.

(2) ______________________________________

____________________________________

 

(3) ______________________________________

Address

Zip Code

 

 

 

Phone No. ______________________

No. SC ______________

 

STATEMENT OF CLAIM

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

DISTRICT OF COLUMBIA, ss: ______________________________________________________ being first 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.

__________________________________________________________

___________________________________________

Plaintiff /Agent (Sign and Print Name)

Address

 

___________________________________________

Title:______________________________________________________

City/State/Zip Code

 

Phone No.: __________________________________

Subscribed and sworn to before me this __________ day of ____________________________________________, 20 ________

 

(month and year)

 

____________________________________________________

 

Deputy Clerk (or notary public)

______________________________________________________

Attorney for Plaintiff (Sign and Print Name)

 

______________________________________________________

Address

Zip Code

Bar No.: _____________________Phone No.: ________________

NOTICE (All parties must notify the court of any address changes.)

To:

 

 

 

(1) ___________________________________________

(2) _____________________________________________________

 

Defendant

 

Defendant

_____________________________________________

_____________________________________________________

Address

Zip Code

Address

Zip Code

Home

Business

Home

Business

You are hereby notified that ___________________________________________________________________________________

______________________________________________________________________ has made a claim and is requesting judgment

against you in the sum of ___________________________________________________________ dollars ($__________________),

as shown by the foregoing statement. The court will hold a hearing upon this claim on ____________________________________

__________________________________________________________________________________________________________

at 9:00 a.m. in the Small Claims and Conciliation Courtroom 119, Bldg. B, 510 4th Street, N.W.,

SEE REVERSE SIDE FOR COMPLETE INSTRUCTIONS BRING THIS NOTICE WITH YOU AT ALL TIMES

CV-471/AUG. 12

Deputy Clerk

Small Claims and Conciliation Branch

INSTRUCTIONS TO DEFENDANTS

IMPORTANT: IF YOU FAIL TO APPEAR AT THE TIME STATED OR AT ANY OTHER TIME THE COURT NOTIFIES YOU TO DO SO, A JUDGMENT BY DEFAULT MAY BE ENTERED AGAINST YOU FOR THE MONEY, DAMAGES OR OTHER RELIEF DEMANDED IN THE STATEMENT OF CLAIM. IF THIS OCCURS, YOUR WAGES OR BANK ACCOUNT MAY BE ATTACHED OR WITHHELD OR ANY PERSONAL PROPERTY OWNED BY YOU MAY BE TAKEN AND SOLD TO PAY THE JUDGMENT. DO NOT FAIL TO APPEAR AT THE REQUIRED TIME.

Before any case goes to trial in the Small Claims and Conciliation Branch, a trained mediator will meet with all parties to see if a settlement can be worked out. If all parties are present when your case is called, you and the plaintiff will be able to see a mediator and hopefully settle your dispute without having to go to trial.

You may come with or without a lawyer. The Statement of Claim indicates whether the plaintiff has a lawyer. If the plaintiff does have a lawyer and you wish to dispute the claim, it would be in your best interest to have your own lawyer.

If you wish to have legal advice and feel that you cannot afford to pay a fee to a lawyer, you may contact the Neighborhood Legal Services Program at (202) 269-5100, the DC Law Students in Court Program at (202) 638-4798, Legal Counsel for the Elderly at

(202)434-2170 or the Legal Aid Society at (202) 628-1161. If you need further help, come to Building B, 510 4th Street, N.W., Room 120, for more information concerning places where you may ask for such help. You may also consult the legal aid directory on www.lawhelp.org/dc. Act promptly.

If it is impossible for you to appear on the date of trial, attempt to contact the Plaintiff to arrange a new date. If parties agree on a date, notify the clerk of the Small Claims Branch of this court in person or by phone of the new date. If parties cannot agree, you may contact the clerk who will inform you regarding procedures. If you do not appear on the new date, a judgment may be entered against you.

Whenever correspo di g with the S all Clai s lerk’s offi e y ail, please i lude your ase u er a d your date to appear in court.

You are given the following additional instructions in the event that you intend to appear without a lawyer:

If you have witnesses, books, receipts, or other writings bearing on this claim, you should bring them with you at the time of the hearing.

If you wish to have witnesses summoned, see the clerk at once for assistance.

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.

PUEDE OBTENERSE COPIAS DE ESTE FORMULARTO EN ESPAÑOL EN EL TRIBUNAL SUPERIOR DEL DISTRITO DEL COLUMBIA, BUILDING B, 510 4TH STREET N.W., SALA 120.

YOU MAY OBTAIN A COPY OF THIS FORM IN SPANISH AT THE SUPERIOR COURT OF D.C. BUILDING B, 510 4TH STREET N.W., ROOM 120.

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Best ways to fill out how to dc statement part 1

2. The third part is usually to fill out these blank fields: Subscribed and sworn to before me, month and year Deputy Clerk or, Attorney for Plaintiff Sign and, Zip Code, NOTICE All parties must notify the, To Address, Zip Code, Defendant, Home, Business, Defendant, Address, Zip Code, Business, and Home.

Business, Business, and To Address inside how to dc statement

As to Business and Business, make certain you do everything properly in this section. Both these could be the most significant ones in this form.

3. This next step is normally rather uncomplicated, for more information concerning, wwwlawhelporgdc Act promptly, If it is impossible for you to, agree on a date notify the clerk, agree you may contact the clerk, be entered against you, Whenever correspociddicidg with, appear in court, You are given the following, If you have witnesses books, the hearing, If you wish to have witnesses, If you admit the claim but desire, circumstances to the Court, and PUEDE OBTENERSE COPIAS DE ESTE - every one of these blanks needs to be completed here.

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