Fillable Form 100 00050 (Vermont Judiciary)

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Form 100 00050 (Vermont Judiciary)

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100-00050 - Complaint (07/2019) Page 1 of 2
STATE OF VERMONT
SUPERIOR COURT
CIVIL DIVISION
Unit
Docket No.
Plaintiff
Defendant(s)
vs.
COMPLAINT
My name is (print or type) ___________________________________________.
I am suing the person/people/organization/company listed above as defendant(s) because he/she/they/it did
the following:
1. _______________________________________________________________________________
2. _______________________________________________________________________________
3. _______________________________________________________________________________
4. _______________________________________________________________________________
(add additional numbered lines on separate page if necessary)
I am asking for:
1. _______________________________________________________________________________
2. _______________________________________________________________________________
3. _______________________________________________________________________________
4. _______________________________________________________________________________
I believe the following rule or law applies:
1. _______________________________________________________________________________
2. _______________________________________________________________________________
3. _______________________________________________________________________________
I understand that I must have all of the following documents served on every Defendant by the Sheriff’s or
Constable’s office, OR have the Defendant sign a form agreeing to accept the papers by mail (a Waiver of
Service form):
• a Summons signed by the Clerk,
• a blank Notice of Appearance form for the Defendant to fill in, and
• a copy of this Complaint (and any attachments).
100-00050 - Complaint (07/2019) Page 2 of 2
I also understand that:
• I must promptly file the proof of service or the signed waiver form with the Court
• anything else I file with the Court must be sent to every party in the case, and I must file a Certificate
of Service form with each filing showing that I did that, and
• I have to follow the Vermont Rules of Civil Procedure.
Date
_________________________
___________________________________________
Signature
_______________________________________
Print/Type Name
_______________________________________
Address
_______________________________________
Address 2
_______________________________________
Email
________________________________________
Phone Number
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Form 100 00050 (Vermont Judiciary)

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Completed 16 July 2020

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