Kentucky Small Claims Complaint

IMPORTANT: THIS IS A PREPARATION GUIDE — NOT THE OFFICIAL COURT FORM

Kentucky requires the use of official court form AOC-175 (Small Claims Complaint) for small claims
complaints. This template provides the substantive legal content to help you prepare —
but you must transfer your content to the official form before filing. The official form
is available at https://www.kycourts.gov/Legal-Forms/Legal%20Forms/175.pdf.
Do not file this document directly with the court.

VERIFIED SMALL CLAIMS COMPLAINT

Commonwealth of Kentucky — District Court, Small Claims Division

1. CASE CAPTION

COMMONWEALTH OF KENTUCKY
[________________________________] COUNTY
DISTRICT COURT — SMALL CLAIMS DIVISION

Case No. [________________________________]

PLAINTIFF:

Full Legal Name: [________________________________]

☐ Individual
☐ Sole Proprietorship (d/b/a [________________________________])
☐ Corporation / LLC (State of Organization: [____])
☐ Partnership
☐ Government Entity

Street Address: [________________________________]
City: [________________________________], Kentucky [____]
County of Residence: [________________________________]
Telephone: [________________________________]
Email: [________________________________]

Attorney for Plaintiff (if any):

Name: [________________________________]
Kentucky Bar No.: [________________________________]
Firm: [________________________________]
Address: [________________________________]
City: [________________________________], Kentucky [____]
Telephone: [________________________________]
Email: [________________________________]

v.

DEFENDANT:

Full Legal Name: [________________________________]

☐ Individual
☐ Sole Proprietorship (d/b/a [________________________________])
☐ Corporation / LLC (Registered Agent: [________________________________])
☐ Partnership
☐ Government Entity

Street Address: [________________________________]
City: [________________________________], Kentucky [____]
County: [________________________________]
Telephone (if known): [________________________________]
Email (if known): [________________________________]

Additional Defendant (if applicable):

Full Legal Name: [________________________________]
Address: [________________________________]
City: [________________________________], Kentucky [____]

VERIFIED SMALL CLAIMS COMPLAINT

2. JURISDICTIONAL STATEMENT

1. This action is brought pursuant to KRS 24A.220 et seq. in the Small Claims Division of the [________________________________] County District Court.

2. The Small Claims Division has jurisdiction over this matter because the amount in controversy does not exceed $2,500.00, exclusive of interest and costs, as required by KRS 24A.230.

3. Venue is proper in [________________________________] County because (check all that apply):

☐ The Defendant resides in this county
☐ The Defendant maintains a place of business in this county
☐ The cause of action arose in this county (the transaction or occurrence took place here)
☐ The property at issue is located in this county

4. This claim seeks exclusively monetary relief. No injunctive or equitable relief is requested, consistent with the jurisdictional limitations of the Small Claims Division under KRS 24A.230.

5. This claim is within the calendar-year filing limit in KRS 24A.250(1), including the separate allowance for each qualifying established business location, if applicable.

3. TYPE OF CLAIM (check one)

☐ Breach of Contract — Defendant failed to perform obligations under a written or oral agreement
☐ Breach of Warranty — Goods or services did not conform to express or implied warranty
☐ Property Damage — Defendant caused damage to Plaintiff's real or personal property
☐ Return of Security Deposit — Landlord failed to return security deposit in accordance with KRS 383.580
☐ Debt / Money Owed — Defendant owes money for goods sold, services rendered, or loans made
☐ Negligence — Defendant's negligent acts or omissions caused injury or damage to Plaintiff
☐ Conversion — Defendant wrongfully took or retained Plaintiff's personal property
☐ Fraud / Misrepresentation — Defendant made false statements inducing Plaintiff to act
☐ Consumer Protection (KRS 367.220) — Defendant engaged in unfair or deceptive trade practices
☐ Bad Check (KRS 514.040) — Defendant issued a check that was returned for insufficient funds
☐ Other: [________________________________]

4. STATEMENT OF FACTS

Plaintiff states the following facts in support of this claim:

Background:

1. On or about [__/__/____], [________________________________]

2. [________________________________]

3. [________________________________]

Agreement or Transaction:

4. The parties [entered into a written agreement / entered into an oral agreement / engaged in the following transaction]: [________________________________]

5. The terms of the agreement or transaction were: [________________________________]

6. The agreed-upon price, payment, or consideration was: $[________________________________]

7. Payment was due on or before: [__/__/____]

Performance by Plaintiff:

8. Plaintiff fully performed all obligations required under the agreement, including: [________________________________]

9. Plaintiff delivered / provided: [________________________________]

10. Plaintiff's performance was completed on: [__/__/____]

Breach or Wrongful Act by Defendant:

11. Defendant breached the agreement / committed the wrongful act on or about [__/__/____] by: [________________________________]

12. Specifically, Defendant: [________________________________]

Demand and Failure to Pay:

13. On [__/__/____], Plaintiff made written demand upon Defendant for payment of the amount owed. (See Exhibit [____], attached.)

14. Defendant has failed and refused to pay despite demand.

15. As of the date of this Complaint, the amount of $[________________________________] remains outstanding and unpaid.

5. ITEMIZED DAMAGES

Plaintiff claims the following damages:

Note: The principal amount claimed must not exceed $2,500.00 (KRS 24A.230). Interest and court costs are excluded from the jurisdictional limit.

Judgment Interest: KRS 360.040(1) generally sets six percent (6%) annual interest, compounded annually, from entry of judgment. Subsection (3) applies the interest rate in a contract or other written obligation to a judgment on that obligation; subsection (4) allows a court to set a lower rate for unliquidated damages after a hearing and notice.

6. EVIDENCE LIST

Plaintiff intends to present the following evidence at hearing:

A. Documentary Evidence

B. Witnesses

C. Photographs or Physical Evidence

☐ Photographs of damaged property (number of photos: [____])
☐ Defective goods or product
☐ Other physical evidence: [________________________________]

7. PRAYER FOR RELIEF

WHEREFORE, Plaintiff respectfully requests that this Court enter judgment in favor of Plaintiff and against Defendant for:

1. The principal sum of $[________________________________] as set forth in Section 5 above;
2. Pre-judgment interest at the statutory rate from [__/__/____] to the date of judgment;
3. Post-judgment interest under KRS 360.040, at the rate applicable to the judgment;
4. Court costs and filing fees as allowed by law;
5. Such other and further relief as the Court deems just and proper.

8. APPEAL RIGHTS NOTICE

IMPORTANT: Either party may appeal a Small Claims Division judgment to the Circuit Court. The appeal is limited to the record made in District Court under RAP 48(E); it is not a new trial. Under KRS 24A.340, file the notice of appeal within ten (10) days of the judgment. File it in District Court, serve the other parties, and pay the applicable fee or seek permission to proceed without prepayment. RAP 48(F) also requires a statement of appeal in Circuit Court within 30 days after the notice is filed.

9. VERIFICATION

I, [________________________________], state under penalty of perjury pursuant to KRS 523.020 that:

1. I am the Plaintiff in the above-captioned action [or am authorized to file this claim on behalf of the Plaintiff entity].
2. I have read the foregoing Verified Small Claims Complaint.
3. The statements of fact contained herein are true and correct to the best of my knowledge, information, and belief.
4. This claim is not frivolous and is brought in good faith.

Date: [__/__/____]

[________________________________]
Plaintiff / Authorized Representative

10. SIGNATURE BLOCK

Respectfully submitted,

[________________________________]
Signature of Plaintiff (or Attorney for Plaintiff)

Printed Name: [________________________________]
Kentucky Bar No. (if attorney): [________________________________]
Address: [________________________________]
[________________________________], Kentucky [____]
Telephone: [________________________________]
Email: [________________________________]

Date: [__/__/____]

11. FILING REQUIREMENTS AND INSTRUCTIONS

A. Where to File

File this complaint with the Office of the Circuit Court Clerk in the county where:

• The Defendant resides or does business; or
• The cause of action arose (the transaction or event occurred).

File the claim on the clerk-provided form as KRS 24A.260(1) requires. The court's current small-claims complaint is AOC-175 (Rev. 4-26). Put the facts needed for service in the form itself: AOC-175 warns that attachments will not be served on the Defendant.

B. Filing Fee

Under KRS 24A.270, the small claims filing fee is the same as the District Court filing fee for a claim of $500 or less. Ask the Circuit Court Clerk for the current fee and any applicable service costs.

C. Claim Limitations

• Maximum claim amount: $2,500.00 (exclusive of interest and costs) — KRS 24A.230
• Maximum claims per calendar year: 25 per party, subject to the statutory exceptions — KRS 24A.250(1), (4)
• A business engaged in trade or commerce has a separate 25-claim allowance for each established location in the district that has operated for at least six months — KRS 24A.250(1). Subsection (2) requires a filing affidavit about the claim limit.

D. Service of Process

Under KRS 24A.280(2), the clerk sends the Defendant a copy of the claim and a summons directing the Defendant to appear at the scheduled hearing. Use a mode of service authorized by the Kentucky Revised Statutes or Rules of Civil Procedure. Confirm the method and proof with the clerk; filing the claim or mailing a copy to counsel alone does not complete initial service.

E. Hearing

• The hearing will be scheduled by the court, typically within 20 to 40 days after proper service.
• Bring all original documents, photographs, and witnesses to the hearing.
• Hearings and dispositions in the Small Claims Division are informal. KRS 24A.330.
• Attorneys are permitted but not required.
• Small claims hearings are tried without a jury. A defendant who wants a jury trial must give the division written notice at least seven days before the hearing; the case then moves to the regular District Court docket. KRS 24A.320.

F. After Judgment

• If you win, and the Defendant does not pay voluntarily, you may pursue enforcement through garnishment, attachment, or other collection methods available under Kentucky law.
• If either party wishes to appeal, the appeal must be filed within 10 days under KRS 24A.340.

12. INITIAL PROCESS RECORD

Complete this record only after obtaining the actual service return or other proof. The clerk sends the claim with the summons under KRS 24A.280(2); an unserved draft is not proof of service.

Defendant served: [________________________________]

Summons and claim served by authorized method: [________________________________]

Date of service shown by proof: [__/__/____]

Service return or other proof filed with the clerk on: [__/__/____]

Sources and References

• KRS 24A.220 — Small Claims Division established
• KRS 24A.230 — Jurisdiction and authority ($2,500 limit)
• KRS 24A.240 — Appearance of attorneys and parties
• KRS 24A.250 — Claim limit, qualifying business-location allowance, and filing affidavit
• KRS 24A.260 — Commencement of action on clerk-provided form
• KRS 24A.270 — Filing fee
• KRS 24A.280 — Service of process
• KRS 24A.320 — Jury trial and removal to regular District Court docket
• KRS 24A.330 — Informal hearings
• KRS 24A.340 — Appeal to Circuit Court (10-day deadline); RAP 48 — appeal on the District Court record
• KRS 360.010 — Legal rate of interest
• KRS 383.580 — Security deposit return requirements
• KRS 367.220 — Consumer protection (unfair trade practices)
• CR 4.05–4.07 — Warning order service and attorney
• KRS 523.020 — Perjury provisions
• AOC Form 175 — Official Kentucky Small Claims Complaint: https://www.kycourts.gov/Legal-Forms/Legal%20Forms/175.pdf
• Kentucky Small Claims Handbook: https://www.kycourts.gov/Legal-Help/Documents/P-6_Small_Claims_Handbook.pdf
• Kentucky Court of Justice: https://www.kycourts.gov/