Form SC-802 Last revised 01/14/2013
Cause No. 49- ___ - __ - SC- .
The Defendant hereby files a Counterclaim against the Plaintiff. (This Counterclaim, and your original claim,
will be heard on the same date, time and place as your original claim. The Court may enter a default judgment
against you on the Counterclaim if you fail to appear.)
A brief statement of the nature of this Counterclaim against you is as follows: ___________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
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_________________________________________________________________________________________ .
(Attach document(s) that support the above statement.)
The Defendant requests judgment against the Plaintiff for $ ____________ , and court costs.
_________________ ____________________________________
Date Signature of Attorney or Pro Se Party
CERTIFICATE OF SERVICE
I hereby certify that I served a copy of this Motion on ___/___/___ by placing a copy in the United States Mail,
First Class, postage prepaid, addressed to:
_________________________________
_________________________________
_________________________________
_________________________________
__________________________________
Signature of Attorney or Pro Se Party
COUNTERCLAIM
STATE OF INDIANA
COUNTY OF MARION
)
) SS:
)
______________________________________
______________________________________
_____________________
________________
Counter-Claimant (Original Defendant name,
address, phone),
vs.
______________________________________
______________________________________
______________________________________
Counter-Defendant (Original Plaintiff name,
address, phone).
IN THE SMALL CLAIMS COURT OF
___________________________
Township
____________________________________________
____________________________________________
_________________________________________
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