Fillable Form 1: 2 3 4 5 6 7 (Civil Law Self-Help Center)

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Form 1: 2 3 4 5 6 7 (Civil Law Self-Help Center)

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(Rev. 06/29/2010)
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© 2010 Clark County Civil Law
Self-Help Center
IN THE JUSTICE COURT OF
CLARK COUNTY, STATE OF NEVADA
,
Defendant(s)/Counterclaimant(s),
vs.
,
Plaintiff(s)/Counterdefendants.
Case No.: _____________________________
COUNTERCLAIM
(Small Claims)
I,
, being duly sworn, state: that the Plaintiff/Counterdefendant
owes the Defendant/Counterclaimant the sum of $
for
; that demand for payment
has been made; that the Plaintiff/Counterdefendant refuses to pay; that the Plaintiff/Counterdefendant either resides,
works or does business in the Township of _________________________, County of Clark, State of Nevada.
Per NRS 53.045, “I declare under penalty of perjury that the foregoing is true and correct.”
Executed on
(Date) (Signature)
Address: __________________________________________
__________________________________________________
Phone: ____________________________________________
SUMMONS & ORDER TO APPEAR
NOTICE: YOU HAVE BEEN SUED. THE COURT MAY DECIDE AGAINST YOU WITHOUT YOUR BEING HEARD
UNLESS YOU APPEAR ON THE FOLLOWING DATE:
You are hereby ordered to appear for trial at the Justice Court at the following location:
DEPARTMENT NO. _________, COURTROOM NO. __________, ON THE ______ DAY OF _________________________, 20_____, AT
THE HOUR OF _____________ and present any defense you may have. You are further notified that in the event you do not appear, Default
Judgment will be given against you in the amount claimed due by the Defendant/Counterclaimant, which may result in the garnishment of wages
and the seizure of property. PLEASE BRING WITH YOU ALL WITNESSES, AN ORIGINAL AND 2 COPIES OF ANY EVIDENCE,
RECEIPTS OR BOOKS, NECESSARY TO PROVE YOUR CASE.
APPROPRIATE COURTROOM ATTIRE REQUIRED. NO SHORTS, HALTER OR TANKTOPS.
SHOES ARE REQUIRED. NO FOOD OR DRINK PERMITTED. NO SMOKING IN THE COURTHOUSE.
CHILDREN MUST REMAIN QUIET
__________________________ TOWNSHIP
______________________________________________________________________________________________________________
JUSTICE COURT, TOWNSHIP OF (insert township name)
___________________________,
Clark County, Nevada
Name of Plaintiff(s):
VERSUS
Name of Defendant(s):
Case No.
Department No.
AFFIDAVIT OF SERVICE
(Insert name of person performing service) _______________________________________________, being duly sworn or under penalty of
perjury, states that at all times relevant, I was over 18 years of age and not a party to or interested in the above-captioned case;
that I received a copy of the
(insert name of documents you served) _________________________________________________________
_________________________________ on
(insert date you received documents) ____________________, 20____; and that I served the
same on Defendant
(insert Defendant's name) ________________________________________________________________ on (insert
date and time you served documents)
____________________, 20____, at the hour of ______ __.M., by (complete appropriate paragraph below):
1. For personal service per JCRCP 4(d)(6): Delivering and leaving a copy with Defendant at (insert address at which you served)
_______________________________________________________________________________________________________.
2. For substitute service per JCRCP 4(d)(6) (o
ther than Orders for Protection): Delivering and leaving a copy with (insert
name or physical description of person served)
_________________________________________________________________________, a
person of suitable age and discretion residing at Defendant’s dwelling house or usual place of abode, at
(insert Defendant's address)
____________________________________________________________________
__________.
3. For service by registered or certified mail per JCRCP 91 (if allowed): Depositing a copy in a mailbox of the United
States Post Office, enclosed in a sealed envelope, postage prepaid, certified or registered mail, return receipt requested, addressed to
Defendant at
(insert Defendant's address) _______ _____ ____________________ ________________________________
_____________________________________________________________________.
(A copy of the signed return receipt must be attached.)
4. For service on a business entity per JCRCP 4(d)(1) or (2): Delivering and leaving a copy with (insert name or physical
description of person served)
______________________________________________________________________, who is Defendant's
(check one) president or other head, secretary, cashier, managing agent, resident agent, or other (specify) _______________
___________________________________________________________________________
, at (insert address at which you served) ____________________________
_____________________________________________________________________________________________________________________________________
.
Date:
______________________________ Signature: ______________________________________________________ __________________
Residential/ Business Address: ______________________________________________________________________ Phone: _____________________
You MUST check one of the following boxes AND have this affidavit notarized (bottom left) or sign the unsworn declaration
per NRS 53.045
(bottom right):
I am a licensed process server or an employee of a licensed process server; my license or registration number is (insert license or
registration number)
: ______________________________________________.
I am not required to be licensed under chapter 648 of the Nevada Revised Statutes or another provision of law because I
am not engaged in the business of serving legal process within the State of Nevada.
SUBSCRIBED AND SWORN to before me this
____ day of ____________________, 20____.
__________________________________________________
NOTARY PUBLIC in and for the
County of _____________________, State of _____________.
"I declare under penalty of perjury under the law of the State of
Nevada that the foregoing is true and correct."
(Signature): _________________________________________
(Date): _________________________________________
(Rev. 06/21/2011 JEB)
© 2011 CLARK COUNTY CIVIL LAW SELF-HELP CENTER
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Completed 8 January 2021

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