Struggling
to pay or
collect rent?
Struggling to pay rent and worried about eviction?
Waiting for rent payments and thinking about eviction?
A FREE program is available statewide from the Indiana Supreme Court.
The Landlord and Tenant Settlement Conference Program
uses a neutral person to help:
Visit courts.in.gov/facilitate
to learn more, nd resources,
and submit a request.
Meet with both sides
Discuss the situation
Find a solution
Page 1 of 2 Approved by the Coalition for Court Access
CCA-EV-0321-8001
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SMALL CLAIMS COMPLAINT
_______________________County Small Claims Division
_______________________________________________
Clerk’s telephone number: _______________________
Case Number: _________________________________________________________________
Plaintiff requests service by: Sheriff of _____________________ County
Certified mail
Plaintiff 1
Defendant 1
Plaintiff 2
Address
Address
Address
Address
City
City
State Zip
State Zip
Telephone
Telephone
Email
Email
If Plaintiff is represented by an attorney:
Attorney
Defendant 2
Attorney number
Address
Address
Address
Address
City
City
State Zip
State Zip
Telephone
Telephone
Email
Email
The Plaintiff(s) asks the court to enter a judgment against the Defendant(s) for $___________ plus court
costs and to issue an order for eviction because Defendant rented the property located at:
____________________________________________________________________________________
(if there is a written rental agreement/lease it is attached) and
rent is past due in the amount of $________________________________; and/or
the rental agreement/lease was violated as follows
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Date: __________________________________ __________________________________________
Plaintiff or Plaintiff’s attorney signature
CLERK’S NOTICE OF CLAIM FOR POSSESSION, RENT DUE AND DAMAGES
You (the Defendant) have been sued by the Plaintiff. You must go to a court hearing on the
following days and times:
1. You must appear for an immediate possession (eviction) hearing on:
Date: ________________________________________ Time: __________________________
Location: _____________________________________________________________________
2. You must appear for a trial on damages and money owed on:
Date: ________________________________________ Time: __________________________
Location: _____________________________________________________________________
You have a right to a jury trial. To demand a jury trial, a person must file an affidavit that identifies a fact
that is disputed (a fact that the Petitioner says is true and the Defendant says is not true). The affidavit
must follow Indiana Code 33-29-2-7 and say that the Defendant is acting in good faith and it must be filed
within ten (10) days of receiving this notice. If the request for a jury trial is granted, you must pay the fee
within ten (10) days. If you do not make the request or pay the fee on time, you no longer have a right to
a jury trial. If the court grants a jury trial, it cannot be withdrawn unless the other party agrees.
__________________________________________
Clerk
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IMPORTANT INFORMATION ABOUT THIS CLAIM
1. INDIANA HAS A FREE LANDLORD/TENANT SETTLEMENT PROGRAM. Landlords and
Tenants can request to use the settlement program at https://www.in.gov/courts/selfservice/facilitate/
.
If a settlement is made out of court, it should be in writing and signed by the Plaintiff and Defendant. The
written settlement needs to be given to the court and it will have the same effect as a judgment given by
the court.
2. You can represent yourself in court, or you can have an attorney represent you.
3. A small claims manual and court rules can be found at:
https://www.in.gov/courts/publications/small-
claims-manual/
4. Bring all documents and witnesses that you want the court to see to the hearing with you.
5. If the Defendant does not show up for a court date, a decision may be made against them (default
judgment). If a Petitioner does not show up, the case may be dismissed. However, the Petitioner may be
able to file it again.
6. Even if a Defendant agrees that what the Petitioner has said is true, a Defendant may still want to show
up for hearing to help decide on how payment will be made.
7. If you cannot go to court on a hearing date you will need to ask the court for a new date by filing a
Motion to Continue. You should file the motion as soon as possible. The court may or may not grant the
motion.
8. If the Defendant has a claim against the Plaintiff, the Defendant may want to file a counterclaim. It has
to be filed with the court early enough so that the Plaintiff receives it at least seven (7) days before the
hearing.
RETURN OF SUMMONS CERTIFICATE OF MAILING (If applicable)
I hereby certify that on ________________________________________ I mailed a copy of this Notice of
Claim to each of the defendants
______________________________________________________________________________ by certified mail
requesting a return receipt signed by the addressee only, addressed to each of said defendants
________________________________________________________
at the addresses furnished by the Plaintiff.
Date: ________________________________ ____________________________________
Clerk
RETURN BY SHERIFF OR OTHER PERSON OF SUMMONS (If applicable)
I hereby certify that on the below date:
I served this Notice of Claim for Possession, Rent Due and Damages by delivering a copy to the
Defendant;
I served this Notice of Claim for Possession, Rent Due and Damages by leaving a copy:
at the dwelling or usual place of abode of Defendant;
with a person of suitable age and discretion residing therein, namely
____________________________________________________;
and by mailing a copy of this Notice of Claim for Possession, Rent Due and Damages to the Defendant,
by first class mail, to the address listed on the Notice of Claim for Possession, Rent Due and Damages
(date copy mailed if different from below: ____________________________________________________)
I was unable to serve this Notice of Claim for Possession, Rent Due and Damages because
_____________________________________________________________________.
Date: ________________________________ ____________________________________
Sheriff of _________________ County
By: ________________________________