State of wisconsin, circuit court,   county

Дата канвертавання26.04.2016
Памер22.21 Kb.


For Official Use

Plaintiff: (Name [first, middle, last], Address, City, State, Zip)





 See attached for additional plaintiffs


To: Defendant(s) : (Name [first, middle, last], Address, City, State, Zip)





 See attached for additional defendants
If you require reasonable accommodations due to a disability to participate in the court process, please call       at least 10 working days prior to the scheduled court date. Please note that the court does not provide transportation.

Summons and Complaint

Small Claims
Case No.      
 Claim for money ($10,000 or less) 31001

 Return of property (replevin) 31003

 Eviction 31004

 Eviction due to foreclosure 31002

 Arbitration award 31006

 Return of earnest money 31008

 Tort/Personal injury ($5,000 or less) 31010


To the Defendant(s):

You are being sued as described below. If you wish to dispute this matter:

 You must appear at the time and place stated.

AND/OR (Clerk will circle one)

 You must file a written answer and provide a copy to the plaintiff or plaintiff’s attorney on or before the date and time stated.

If you do not appear or answer, the plaintiff may win this case and a judgment entered for what the plaintiff is asking.

When to Appear/File an Answer



Place to Appear/File an Answer


Clerk/Attorney Signature

Date Summons Issued


Date Summons Mailed



Plaintiff's Demand:

The plaintiff states the following claim against the defendant(s):

1. Plaintiff demands judgment for: (Check as appropriate)

 Claim for Money $        Tort/Personal injury $     

 Return of Earnest Money  Eviction  Eviction due to foreclosure

 Return of property (replevin) (Describe property in 2 below.)  Confirmation, vacation, modification or

(Not to include Wis. Stats. 425.205 actions to recover collateral.) correction of arbitration award.

Plus interest, costs, attorney fees, if any, and such other relief as the court deems proper.

2. Brief statement of dates and facts: (If this is an eviction action and you are seeking money damages, you must also state that claim on this form.)


 See attached for additional information. Provide copy of attachments for court and defendant(s).

Verification: Under oath, I state that the above complaint is true, except as those matters stated upon information and belief, and as to those matters, I believe them to be true.

I am:  plaintiff.  attorney for the plaintiff.

State of      

County of      

Subscribed and sworn to before me on      

Notary Public/Court Official


Name Printed or Typed

My commission/term expires:      

Signature of Plaintiff or Attorney



Attorney’s State Bar Number


Plaintiff'’s/Attorney's Telephone Number


Law Firm and Address


SC-500, 08/11 Summons and Compliant – Small Claims Chapter 799, Wisconsin Statutes

This form shall not be modified. It may be supplemented with additional material.

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