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Blank Oregon Small Claim Form

The Oregon Small Claim form is a legal document used to initiate a small claims case in Oregon's Circuit Court. This form allows individuals to seek compensation for amounts owed, typically under $10,000. Understanding how to complete this form correctly is essential for a smooth filing process and to ensure your claim is heard in court.

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The Oregon Small Claim form serves as a vital tool for individuals seeking to resolve disputes involving relatively small amounts of money, typically without the need for extensive legal representation. This form is designed for use in the Small Claims Department of the Circuit Court of Oregon and outlines the necessary information for both the plaintiff and the defendant. It includes sections for the names, addresses, and contact details of both parties involved, ensuring that all relevant information is readily available. Additionally, the form requires the plaintiff to specify the amount owed, the reasons for the claim, and any associated fees and costs. A declaration of a bona fide effort to collect the debt prior to filing is also mandated, reflecting the importance of attempting resolution outside of court. Furthermore, the form contains critical instructions for the defendant, emphasizing the need for timely action within 14 days of receiving the notice. This includes options to pay the claim, demand a hearing, or request a jury trial if applicable. The form also addresses specific circumstances, such as those involving military service members, and provides a clear pathway for individuals to seek justice while minimizing legal complexities.

Form Example

IN THE CIRCUIT COURT OF THE STATE OF OREGON

FOR

 

 

 

COUNTY

 

Small Claims Department

 

 

)

 

 

 

 

)

 

 

 

 

)

Case No: ____________________

 

Plaintiff

)

 

 

 

 

)

 

 

(Inmate ID #, if applicable, _____________)

)

 

 

v.

)

SMALL CLAIM AND

 

 

) NOTICE OF SMALL CLAIM

 

 

)

 

 

 

 

)

Filing fee at ORS 46.570

 

Defendant

)

Interpreter needed: Spanish Russian

Defendant is a public body

)

 

other: _______________

 

 

PLAINTIFF (Additional on attached page)

Name

Street

City / State / Zip

Phone

County

DEFENDANT (Additional on attached page)

Name (enter Registered Agent, if necessary, on next page)

Street (do not use a P.O. Box)

City / State / Zip

Phone

County

I, Plaintiff, claim that on or about (date)

 

, the above-named defendants owed me the

sum of $_____________ because

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

, and this amount is still due.

I have paid (or will pay):

filing fees of $_____________

and service costs of $____________

Claim $______________

+Fees $______________

+Costs $______________

TOTAL $______________

Form 15.010.1a SMALL CLAIM AND NOTICE OF SMALL CLAIM UTCR 15.010(1)(a)

 

(Revised 8-1-14)

Case No.

DECLARATION OF BONA FIDE EFFORT

I, Plaintiff, have made a bona fide effort to collect this claim from the defendants before filing this claim

with the court clerk.

I hereby declare that the above statements are true to the best of my knowledge and belief, and that I understand they are made for use in court and I am subject to penalty for perjury.

Date

Plaintiff Signature

________________________________

 

Email address*

Plaintiff Name (print)

*Some courts communicate with parties by email. By providing my email address I consent to receive notifications from the court by email instead of or in addition to other methods. I understand that if my email changes or if I choose to withdraw consent, I must notify the court in writing.

DEFENDANT’S REGISTERED AGENT:

Name

Street (do not use a P.O. Box)

City / State / Zip

Phone

County

Form 15.010.1a SMALL CLAIM AND NOTICE OF SMALL CLAIM UTCR 15.010(1)(a)

 

(Revised 8-1-14)

Case No.

NOTICE TO DEFENDANT:

READ THESE PAPERS CAREFULLY!

Within 14 DAYS* after receiving this notice you MUST do ONE of the following things in

writing:

Pay the claim plus filing fees and service expenses paid by plaintiff (send payment directly to the plaintiff, not to the court) OR

Demand a hearing and pay the fee required (below) OR

Demand a jury trial and pay the fee required (below). This option is available only if amount claimed is more than $750.

If you fail to do one of the above within 14 DAYS* after you get this notice, the plaintiff may ask the court to enter a judgment against you. The judgment will be for the amount of the claim, plus filing fees and service costs paid by the plaintiff, plus a prevailing party fee. If you are not able to respond in time because you are in active military service of the United States, talk to a legal advisor about the Servicemembers Civil Relief Act.

COURT NAME / ADDRESS / PHONE #

>

>

>

Defendant’s Filing Fees (must be filled in by the PLAINTIFF):

(1)

To demand a hearing if the amount claimed is $2,500 or less

$ ______

(2)

To demand a hearing if the amount claimed is more than $2,500

$ ______

(3)

To demand a jury trial (only if amount claimed is over $750)

$ ______

If you have questions about filing procedures, go to www.courts.oregon.gov for information and instructions, or you may contact the court clerk. The clerk cannot give you legal advice about the claim.

*NOTE: If the plaintiff is an inmate (ORS 30.642) AND the defendant is a government agency or other public body (ORS 30.260), the defendant must respond within 30 days after receiving this Notice.

Form 15.010.1a SMALL CLAIM AND NOTICE OF SMALL CLAIM UTCR 15.010(1)(a)

 

(Revised 8-1-14)

Case No.

Document Characteristics

Fact Name Details
Governing Law The Oregon Small Claim form is governed by ORS 46.570 and UTCR 15.010(1)(a).
Filing Fee The filing fee must be indicated on the form and varies based on the amount claimed.
Response Time Defendants must respond within 14 days of receiving the notice, unless the plaintiff is an inmate.
Claim Amount The form allows claims of up to $10,000 in Oregon small claims court.
Bona Fide Effort Plaintiffs must declare that they made a bona fide effort to collect the claim before filing.
Email Communication Providing an email address allows for electronic communication from the court regarding the case.
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