TOWN OF FISHKILL COURT OFFICE
Small Claims Court Worksheet
$0.00 to $1,000.00 = $10.00 fee THE CLERKS ARE NOT PERMITTED TO HELP YOU.
$1,000.00 to $3,000.00 = $15.00 fee YOU MUST FOLLOW THE INSTRUCTIONS THAT
WERE GIVEN TO YOU.
**No personal or business checks**
Plaintiff’s Information:
Name:_________________________________________________________________
Address:___________________________________________________________________________________
___________________________________________________________________________________________
________________________________________________ Telephone #_______________________________
Defendant’s Information:
Name:______________________________________________________________________________________
Address:_____________________________________________________________________________________
_________________________________________________ Telephone#__________________________________
Claim Information:
Amount of Claim: ______________________
Brief Reason for Claim:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Signature:_______________________________________Date:__________________________________________
**You must appear in person to file your claim**
________________________________________________________________________________________
-For Office Use Only-
DKT# :_______________________ Case#:__________________________Receipt#:__________________________
_______________________________________________________________________________________________
Town of Fishkill – 807 Route 52 – Fishkill, NY 845-831-7860
Note: Please do not e-mail the Court for information, you must call or write to the Court for further information.
