MAGISTRATES COURT OF QUEENSLAND

----------------------------------------------------REGISTRY:
----------------------------------------------------NUMBER:

PLAINTIFF:

------------------------------------------AND

DEFENDANT:

________________________________________________________________________

-------------------------------------------------CLAIM
The plaintiff claims: (state concisely the relief claimed by the plaintiff)

The plaintiff makes this claim in reliance on the facts alleged in the attached Statement of Claim.

ISSUED WITH THE AUTHORITY OF THE MAGISTRATES COURT OF QUEENSLAND

And filed in the ---------------Registry on (date)

--------------------------------------------------------Registrar

To the defendant(s):

TAKE NOTICE that you are being sued by the plaintiff in the Court. If you intend to dispute this claim or wish to raise any counterclaim against the plaintiff, you must within 28 days of the service upon you of this claim file a Notice of Intention to Defend in this Registry. If you do not comply with this requirement judgment may be given against you for the relief claimed and costs without further notice to you. The Notice should be in Form 6 to the Uniform Civil Procedure Rules. You must serve a sealed copy of it at the plaintiff's address for service shown in this claim as soon as possible.

Address of Registry:

If you assert that this Court does not have jurisdiction in this matter or assert any irregularity you must file a Conditional Notice of Intention to Defend in Form 7 under Rule 144, and apply for an order under Rule 16 within 14 days of filing that Notice.

If you object that these proceedings have not been commenced in the correct district of the Court, that objection mustbe included in your Notice of Intention to Defend.

[The plaintiff is suing in a representative capacity namely (insert details see Rule 18)]

[The (first) defendant is sued in a representative capacity (insert details see Rule 18)]

Claim filed on behalf of the plaintiff
Form 2 R.22

 

(Narne, address for service. telephone number and fax number of solicitor or party filing, document)

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---------------------------------------------2 .

PARTICULARS OF THE PLAINTIFF:

Name:
Plaintiffs residential or business address:
Plaintiffs solicitors name:
-------- and firm name:
Solicitors business address:

Address for service:
Dx:
Telephone:
Fax:
E mail address:

[If the plaintiff has no solicitor:
-------plaintiff. s address for service:
------ plaintiff s telephone number or contact number:
------ plaintiffs fax number:
------ plaintiffs e-mail: address:

Signed: (plaintiff or solicitor)

Description: (ofsignatory)

Dated:

This Claim is to be served on: (First defendant's name)
Of: (First defendant's address)
[and on: (Second defendant's name)
of: (Second defendant's address)

_________________________________PageBreak________________________________

3.

STATEMENT OF CLAIM

This claim in this proceeding is made in reliance on the following facts: (in consecutively numbered paragraphs, each containing, as far as practicable, a separate allegation)

1 ---------(set out as briefly as the nature of the case permits all material facts relied on as-----------------------------------------required in the Uniform Civil Procedure Rules, Chapter 6, Parts 1, 2 and 3)

2.

 

3.

 

The plaintiff claims the following relief:

--------(set out in full the relief claimed including full particulars of the nature and amount of each --------type of damages claimed and full particulars of interest required by Rule 159.)

 

[The plaintiff elects trial by jury] (if the plaintiff elects under Rule 4 72 and no Act excludes a trial by jury) i.

 

Signed: (plaintiff or solicitor)

Description: --(of signatory)

[This pleading was settled by (name) of Counsel].

 

NOTICE AS TO DEFENCE

 

Your defence must be attached to your notice of intention to defend.

NOTICE UNDER RULE 150(3)ii

The plaintiff claims:

-------$
-------$--------------- for interest; and
-------$--------------- for costs of issuing the claim and this statement of claim.

The proceeding ends if you pay those amounts before the time for filing your notice of intention to defend ends. If you are in default by not filing a notice of intention to defend within the time allowed, the plaintiff is'entitled to claim
additional costs of $------------, costs of entering judgment in default.

 

_____________________________
i Supreme Court and District Court only
ii This notice is to be included if the plaintiff s claim is for a debt or liquidated demand only.

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