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. Plaintiff has not filed more than twenty-five (25) claims in this calendar year in the Small Claims Division of any Kentucky District Court, as limited by KRS 24A.250.

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.

Statutory Interest Rate: Kentucky's statutory post-judgment interest rate is set pursuant to KRS 360.010 (currently 6% per annum on judgments unless otherwise provided by contract).

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 at the rate provided by KRS 360.010;
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 has the right to appeal the judgment of the Small Claims Division to the Circuit Court for a trial de novo (a completely new trial). Under KRS 24A.340, the appeal must be filed within ten (10) days after entry of judgment. The appealing party must file a notice of appeal with the District Court Clerk and pay the applicable Circuit Court filing fee. Failure to file a timely appeal will result in the judgment becoming final and enforceable.

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).

Use AOC Form 175 (official Kentucky Small Claims Complaint form) or this complaint adapted to local requirements. Some clerks require use of the official AOC form.

B. Filing Fee

The filing fee for small claims actions is set by KRS 24A.270. Contact the Circuit Court Clerk's office in the county of filing for the current fee amount. As of this template's date, the fee is typically modest but varies by county.

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 — KRS 24A.250
• Business entities: Entitled to 25 claims per established location that has been in operation for at least 6 months — KRS 24A.250(2)

D. Service of Process

After filing, the Clerk will issue a notice to the Defendant. Service must be accomplished as follows (KRS 24A.280):

☐ Certified Mail, Return Receipt Requested — The Clerk mails the complaint and notice of hearing to the Defendant by certified mail. The return receipt (green card) serves as proof of service.

☐ Personal Service by Sheriff or Process Server — If certified mail is returned undelivered, request personal service through the Sheriff's office or a qualified process server.

☐ Warning Order Attorney — If the Defendant cannot be located after diligent search, the court may appoint a warning order attorney pursuant to KRS 454.210.

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.
• Proceedings are informal. The Kentucky Rules of Evidence are relaxed in small claims proceedings (KRS 24A.260).
• Attorneys are permitted but not required.
• Parties may request a jury trial by filing a written demand and paying the required jury fee; otherwise, the matter is heard by a judge.

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. CERTIFICATE OF SERVICE

I certify that a true and correct copy of this Verified Small Claims Complaint was served upon the Defendant as follows:

☐ Certified U.S. Mail, Return Receipt Requested, to the address stated in the caption
☐ Personal service by Sheriff of [________________________________] County
☐ Personal service by qualified process server
☐ Commercial courier service
☐ Other method approved by the Court: [________________________________]

Date of service: [__/__/____]

[________________________________]
Signature

[________________________________]
Printed Name

Sources and References

• KRS 24A.220 — Small Claims Division established
• KRS 24A.230 — Jurisdiction and authority ($2,500 limit)
• KRS 24A.240 — Commencement of action; form of complaint
• KRS 24A.250 — Limitation on number of claims (25 per year)
• KRS 24A.260 — Hearing procedure
• KRS 24A.270 — Filing fee
• KRS 24A.280 — Service of process
• KRS 24A.290 — Transfer to regular division
• KRS 24A.340 — Appeal to Circuit Court (10-day deadline)
• KRS 360.010 — Legal rate of interest
• KRS 383.580 — Security deposit return requirements
• KRS 367.220 — Consumer protection (unfair trade practices)
• KRS 454.210 — Warning order 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/