Small Claims Complaint

D.C. SMALL CLAIMS STATEMENT OF CLAIM

CV-471 preparation companion

DO NOT FILE THIS MARKDOWN. Transfer the reviewed information to the
current court-prescribed Statement of Claim, presently CV-471 / Small Claims
Form 11. Confirm the current form, fees, filing method, service options, and
hearing procedures with the Small Claims Clerk before filing.

1. Filing control

2. Branch-jurisdiction screen

D.C. Code § 11-1321 limits the Branch to actions that seek only money and in
which the amount in controversy does not exceed $10,000, excluding interest,
attorney fees, protest fees, and costs. The Branch may not hear an action that
affects an interest in real property.

Stop and obtain claim-specific legal review if the requested relief is not
money only, the amount exceeds the Branch ceiling, a real-property interest is
affected, or jurisdiction over any defendant is uncertain. The $10,000 figure
is a forum ceiling, not a cap on the defendant's possible liability elsewhere.

3. Specialized-case gate

This general companion is not a substitute for specialized pleading and
pre-filing research.

☐ The claim is not a consumer-debt collection action by a debt collector. If
it is, complete the additional Rule 3(a)(3) pleading requirements after
specialized review.

☐ The claim does not require separate treatment for housing possession,
government notice or immunity, a minor or protected person, probate, family
law, employment, professional malpractice, statutory damages, class relief,
or another specialized subject.

☐ The correct claimant, assignment history, defendant legal name, entity
status, registered agent or other service recipient, limitations period,
accrual date, and any required demand, notice, or opportunity to cure have
been verified from current sources.

4. Parties and contact information

Use the exact names and addresses required by current CV-471. Do not use a
trade name when the responsible legal person or entity can be identified.

Add a separately identified entry for every additional plaintiff or defendant
and prepare the exact copy required for each defendant under Rule 3(a)(1).

5. Simple but complete statement of claim

Rule 3 requires the court-prescribed form and a simple but complete claim
statement. Use concrete facts in date order. Do not add contract-style
definitions, warranties, covenants, severability, integration, arbitration
waivers, or unsupported legal conclusions.

1. Transaction or event: [________________________________]
2. Date and place: [________________________________]
3. What Plaintiff provided, paid, owned, or was entitled to: [________________________________]
4. What Defendant promised, did, or failed to do: [________________________________]
5. When payment or performance became due: [________________________________]
6. Payments, credits, returns, or setoffs included in the calculation: [________________________________]
7. How Defendant's act or omission caused the claimed loss: [________________________________]
8. Amount calculation: [________________________________]

Proposed CV-471 Statement of Claim text:

[____________________________________________________________]

[____________________________________________________________]

[____________________________________________________________]

[____________________________________________________________]

6. Request for relief

Proposed CV-471 Request for Relief text:

[____________________________________________________________]

[____________________________________________________________]

Do not request punitive or statutory damages, fee shifting, a particular
interest rate, joint-and-several liability, or another enhanced remedy unless
current claim-specific authority and supporting facts have been added after
legal review.

7. Required instruments and proof file

Rule 3 requires a copy of any contract, promissory note, or other instrument
on which the claim is based to accompany the Statement of Claim.

☐ Contract, lease, promissory note, invoice, receipt, or account record relied on

☐ Payment history with all credits and setoffs

☐ Demand, notice, cure, or termination record, if legally required

☐ Assignment, ownership, agency, or entity-authority record

☐ Messages, photographs, estimates, repair records, or other supporting documents

☐ Witness list and contact information

Attachment index and explanation: [________________________________]

Have counsel or the clerk confirm what personal information must be removed or
redacted. Do not attach irrelevant confidential material.

8. Verification and execution control

Current CV-471 contains a sworn verification and execution before a notary
public or deputy clerk. Do not sign, notarize, or submit a verification that is
incomplete or inaccurate.

9. Service and deadline control

The plaintiff is responsible under Rule 4(a) for service of the Statement of
Claim, verification, notice, attachments, and any filing-time order. Service
must be made by a person and method authorized by the current rule; the
plaintiff should not personally serve process or invent a proof of service.

Rule 4(m)(1) gives 60 days after filing for proof of service in ordinary cases
and 90 days for the debt-collection and subrogation cases identified in Rule
19(a). Calendar the correct category; do not assume the longer period applies.
If service cannot be completed, obtain advice before the applicable deadline
about a supported motion or other authorized step.

10. Jury-demand decision

Rule 6 permits a written jury demand on an issue triable of right at or before
the initial hearing, unless the court extends the time for good cause. The
demand must be served and accompanied by the required fee or court-approved
cost waiver. A properly demanded case is certified to the Civil Actions Branch
for expedited trial.

☐ No jury demand is planned.

☐ A jury demand may be appropriate; counsel will determine whether an issue is
triable of right and will prepare, serve, and file the separate written demand.

Initial-hearing date and jury-demand control date: [________________________________]

11. Hearing and mediation preparation

The instructions attached to current CV-471 state that a trained mediator will
meet with the parties before a case goes to trial to explore settlement and
that an unsettled case can be scheduled for trial on another day.

☐ Initial hearing date, time, location, and remote-access instructions confirmed

☐ Plaintiff, counsel, witnesses, and interpreter needs confirmed

☐ Originals and required copies of exhibits organized

☐ Damages calculation updated through the hearing date

☐ Settlement range and payment terms reviewed without assuming settlement

☐ Trial proof plan prepared if mediation does not resolve the case

12. Final transfer checklist

☐ Used the current court-prescribed form rather than filing this companion

☐ Completed every required CV-471 field legibly and consistently

☐ Kept the claim statement simple but complete

☐ Attached each relied-on contract, note, or other instrument

☐ Prepared an exact copy for every defendant

☐ Completed the sworn verification only after factual review

☐ Confirmed current filing, payment, service, and hearing instructions

☐ Retained a complete filed-and-served copy and deadline calendar

Attorney Review Certification: I have reviewed the completed official form,
the claim-specific law and facts, jurisdiction, service plan, requested relief,
attachments, verification, and current court instructions.

Attorney: [________________________________] D.C. Bar No.: [____________]

Signature: [________________________________] Date: [__/__/____]