Click to Download Form 3 R. 22, 514 (Microsoft Word)

MAGISTRATES COURT OF QUEENSLAND

Plaintiff.

AND

Defendant:

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MINOR DEBT CLAIM

STATEMENT OF PARTICULARS OF CLAIM (Set out as briefly as the nature of the case permits all
material facts relied on to bring this claim, including description of any goods/services involved, reasons for making claim, including dates and places. Also include the amount or amounts claimed including interest (if any); how the plaintiff claims the amount is worked out and came to be owing. Attach additional sheets of A4 size paper if insufficient space)

The Plaintiff claims the amount set out below and elects to have this claim heard and decided in the Magistrates Court under the simplified procedures as a Minor Debt Claim:-

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$
$
$
$

Claim
Filing fee
Bailiffs service fee
Total

 

 

To the defendant[s]: TAKE NOTICE that you are being sued by the plaintiff in the Court. If you intend to dispute this claim you must within 28 days of service upon you of this claim file a Notice of Intention to Defend and Defence to a Minor Debt Claim in this Registry. If you do not comply with this requirement., Judgment may be given against you for the amount claimed without further notice to you. The Notice should be in Form 4 to the Uniform Civil Procedure Rules.You must serve a sealed copy of it at the plaintiffs address for service shown in the claim as soon as possible.

Address of registry:

If you object that these proceedings have not been commenced in the correct district or that this Court does not have jurisdiction in this matter, that objection should be included in your Notice of Intention to Defend and Defence to a Minor Debt Claim.

Minor Debt Claim filed on behalf of the plaintiff
Form 3 R. 22, 514

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

 

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2

PARTICULARS OF THE PLAINTIFF:

Name:
Plaintiff s residential or business address:
Name of solicitor or agent (if any):
Business address of solicitor or agent:
Address for service:
Dx (if any):
Telephone:
Fax:
E mail address (if any):

[If the plaintiff has no solicitor or agent:
----------plaintiffs address for service:
----------plaintiff s telephone number or contact number:
----------plaintiff s fax number (if any):
--------- plaintiff s e mail address (if any)]

Signed: (plaintiff, solicitor or agent)

Description: (of signatory)

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)]

ISSUED WITH THE AUTHORITY OF THE MAGISTRATES COURTS OF
QUEENSLAND

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

-----------------------------------------------------Registrar: (registrar to sign and seal)

Note: All relevant documents must be brought with you and made available to the Court at any hearing of this proceeding.

Print Form 3 R. 22, 514

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