SMALL CLAIMS COMPLAINT (MONEY DAMAGES)

State of Hawai‘i — District Court, Division of Small Claims

[// GUIDANCE: This template is designed for money-damage claims not exceeding the Hawai‘i small-claims monetary limit (currently $5,000, exclusive of interest and costs) pursuant to Haw. Rev. Stat. § 633-27. Confirm the limit and any filing-fee schedules with the clerk before filing.]

TABLE OF CONTENTS

1. Document Header (Caption & Party Identification)
2. Definitions (Optional)
3. Operative Allegations
   3.1 Jurisdiction & Venue
   3.2 Parties
   3.3 Statement of Facts
   3.4 Cause(s) of Action
   3.5 Damages Sought
4. Prayer for Relief
5. Verification
6. Certificate of Service
7. Exhibit Index (Optional)

1. DOCUMENT HEADER

IN THE DISTRICT COURT OF THE ____ CIRCUIT
STATE OF HAWAI‘I
DIVISION OF SMALL CLAIMS
| | |
|------------|----------------------------------|
| Plaintiff: | [PLAINTIFF FULL LEGAL NAME], an individual, |
| | Address: [PLAINTIFF ADDRESS] |
| v. | |
| Defendant: | [DEFENDANT FULL LEGAL NAME], an individual / entity, |
| | Address: [DEFENDANT ADDRESS] |

Case No.: ____
SMALL CLAIMS COMPLAINT (Money Damages)

2. DEFINITIONS (Optional – include only if helpful)

If specialized terms will be used repeatedly (e.g., “Agreement,” “Vehicle,” “Property”), define them alphabetically here for clarity.

3. OPERATIVE ALLEGATIONS

3.1 Jurisdiction & Venue
a. This Court has exclusive original jurisdiction over this matter because the amount in controversy is $[AMOUNT IN DEMAND] — which does not exceed the small-claims monetary limit established by Haw. Rev. Stat. § 633-27.
b. Venue is proper in this circuit under Haw. Rev. Stat. § 604-6 because Defendant (i) resides in, or (ii) the claim arose within, this circuit.
c. No party seeks injunctive or equitable relief, and no arbitration agreement governs the dispute.

3.2 Parties
a. Plaintiff is an individual of legal age and competent capacity, residing at the address stated above.
b. Defendant is an individual / [type of entity] who may be served at the address stated above.

3.3 Statement of Facts
1. On or about [DATE], Plaintiff and Defendant entered into a transaction/contract whereby [BRIEF DESCRIPTION OF TRANSACTION].
2. Defendant owed Plaintiff the sum of $[AMOUNT] payable on [DUE DATE].
3. Despite Plaintiff’s demand(s) on [DATE(S)], Defendant has failed to pay.
4. As a result, Plaintiff has suffered monetary damages in the amount pled below.

3.4 Cause(s) of Action
Count I — Breach of Contract (adapt as needed: e.g., Property Damage, Goods Sold & Delivered, Money Had & Received)
1. Plaintiff realleges and incorporates ¶¶1-4 above.
2. Defendant breached the parties’ agreement by failing to pay the amount due.
3. Plaintiff has sustained damages of $[AMOUNT], plus allowable interest and costs.

[// GUIDANCE: Add additional counts as necessary. Each count should track the essential elements recognized under Hawai‘i law (e.g., negligence: duty, breach, causation, damages).]

3.5 Damages Sought
Plaintiff seeks:
a. Principal: $[AMOUNT]
b. Pre-judgment interest at the statutory rate from [DATE] to judgment;
c. Court costs and allowable fees; and
d. Post-judgment interest as provided by law.

4. PRAYER FOR RELIEF

WHEREFORE, Plaintiff respectfully prays that the Court enter judgment in Plaintiff’s favor and against Defendant for:
1. $[AMOUNT] in principal damages;
2. Pre- and post-judgment interest as allowed by law;
3. Court costs, including service and filing fees; and
4. Such other and further relief as the Court deems just and proper.

Dated: _, 20
At: ____

Respectfully submitted,

[PLAINTIFF NAME]
Plaintiff, pro se / by counsel
Address: [ADDRESS]
Phone: [PHONE]
Email: [EMAIL]

5. VERIFICATION

I, [PLAINTIFF NAME], declare under penalty of perjury that I am the Plaintiff in the above-entitled action, that I have read the foregoing Complaint, and that the facts stated therein are true and correct to the best of my knowledge and belief.

Executed on ___, 20, at ____, Hawai‘i.

[PLAINTIFF NAME]

[// GUIDANCE: Some judges prefer an acknowledgment before a notary. Check_________
[PLAINTIFF NAME]

[// GUIDANCE: Some judges prefer an acknowledgment before a notary. Check local practice; notarization is not strictly required for small-claims verification but may add evidentiary weight.]

6. CERTIFICATE OF SERVICE

I certify that on _, 20, I served a copy of this Complaint (together with the Summons issued by the clerk) upon the Defendant by:

☐ Personal delivery by a licensed process server
☐ Certified mail, return receipt requested
☐ Other method authorized by Haw. Dist. Ct. R. Civ. P. 4

at the following address:

[DEFENDANT SERVICE ADDRESS]

[PLAINTIFF NAME]

7. EXHIBIT INDEX (attach as applicable)

1. Exhibit A — Copy of Contract / Invoice dated [DATE]
2. Exhibit B — Demand Letter dated [DATE]
3. Exhibit C — Proof of Non-Payment / Damage Estimate
   [// GUIDANCE: Label each exhibit sequentially and reference it in the Statement of Facts.]

ADDITIONAL STATE-SPECIFIC NOTES & APPEAL RIGHTS

1. Monetary Limit: Haw. Rev. Stat. § 633-27 currently caps small-claims money actions at $5,000 exclusive of interest and costs. Confirm no statutory revision has increased or decreased this ceiling.
2. Allowable Claims: Small claims in Hawai‘i are generally limited to (i) contractual money debts, (ii) damage to personal property, (iii) recovery of security deposits, and (iv) similar liquidated or readily-ascertainable sums. Equitable or injunctive relief is not available.
3. Appeal Rights: Under Haw. Rev. Stat. § 633-30, only the Defendant may appeal a small-claims judgment. The notice of appeal must be filed within 20 days after judgment. The Plaintiff may appeal solely on a question of law that was reserved in writing prior to judgment.

[// GUIDANCE: Because appeal rights are limited, draft carefully; errors may be irremediable for the Plaintiff.]

FILING CHECKLIST (internal use – do not file)

☐ Complete all [PLACEHOLDER] fields
☐ Attach exhibits and label consistently
☐ Prepare Summons on court-approved form (JSCCR Form 1-2)
☐ Tender filing fee (see current fee schedule)
☐ Arrange lawful service on Defendant
☐ Calendar return date supplied by clerk

DISCLAIMER

This template is provided for general informational purposes and must be tailored to the specific facts and procedural posture of each case. It does not constitute legal advice, nor does it create an attorney-client relationship. Always consult the Hawai‘i District Court Rules and the Hawai‘i Revised Statutes, and consider engaging qualified counsel for matters exceeding your expertise or comfort level.