[COURT SEAL OR HEADING—OPTIONAL]
COMMONWEALTH OF KENTUCKY
[COUNTY] DISTRICT COURT – SMALL CLAIMS DIVISION
Case No. ________
PLAINTIFF: [PLAINTIFF FULL LEGAL NAME]
Address: [PLAINTIFF STREET ADDRESS]
[CITY], Kentucky [ZIP]
Telephone: [XXX-XXX-XXXX]
E-Mail: [EMAIL ADDRESS]
v.
DEFENDANT: [DEFENDANT FULL LEGAL NAME]
Address: [DEFENDANT STREET ADDRESS]
[CITY], Kentucky [ZIP]
Telephone: [XXX-XXX-XXXX]
E-Mail: [EMAIL ADDRESS]
VERIFIED SMALL CLAIMS COMPLAINT
[// GUIDANCE: This template is drafted for use in Kentucky District Court Small Claims Division. Kentucky law currently caps small-claims actions at $2,500.00 exclusive of interest and costs. Confirm the limit and any recent amendments before filing.]
1. JURISDICTION & VENUE
1.1 This action is brought pursuant to Kentucky’s Small Claims statutory framework (KRS Chapter 24A et seq.) and seeks a money judgment not exceeding the statutory limit of [$______].
1.2 Venue is proper in this Court because the Defendant [resides / does business / the cause of action arose] in [COUNTY] County, Kentucky.
1.3 No request for injunctive or equitable relief is made; the relief sought is exclusively monetary.
2. PARTIES
2.1 Plaintiff. [PLAINTIFF NAME] is [a natural person / a Kentucky-domiciled business entity] with the address stated in the caption.
2.2 Defendant. [DEFENDANT NAME] is [a natural person / business entity] residing or doing business at the address stated in the caption.
3. STATEMENT OF CLAIM (FACTS)
3.1 On or about [DATE], Plaintiff and Defendant entered into [briefly describe transaction or agreement—e.g., “a written contract for the sale of goods”].
3.2 Defendant agreed to pay Plaintiff [$______] in consideration for [describe goods/services] on or before [DUE DATE].
3.3 Plaintiff fully performed all obligations required, including [describe performance].
3.4 Despite demand, Defendant has failed and refused to pay the outstanding balance.
3.5 As a direct and proximate result, Plaintiff has been damaged in the principal amount of [$______], plus statutory interest from [DATE].
[// GUIDANCE: Attach invoices, contracts, correspondence, or other exhibits as needed. Label them “Exhibit A,” “Exhibit B,” etc., and reference them here.]
4. DAMAGES SOUGHT
Plaintiff demands:
a. Principal: ................................................... [$______]
b. Pre-judgment interest (if applicable): ........ [$______]
c. Court costs & allowable fees: .................... [$______]
d. Post-judgment interest at the statutory rate.
[// GUIDANCE: Kentucky small-claims practice generally bars attorney-fee recovery unless a statute or written agreement expressly provides for it. Insert only if supportable.]
5. PRAYER FOR RELIEF
WHEREFORE, Plaintiff respectfully requests that the Court enter judgment in favor of Plaintiff and against Defendant for:
1. The amounts set forth in Section 4;
2. Post-judgment interest as provided by law;
3. Such other and further relief as the Court deems just and proper.
6. APPEAL RIGHTS NOTICE (REQUIRED DISCLOSURE)
Either party may, within the time period prescribed by Kentucky law [currently 10 days] after entry of judgment, appeal to the Circuit Court for a trial de novo. Failure to perfect a timely appeal will result in the judgment becoming final.
[// GUIDANCE: Verify the current appeal deadline under KRS 24A.340 or successor statutes before filing.]
7. VERIFICATION
I, [PLAINTIFF NAME], certify under penalty of perjury that I am the Plaintiff in the above-styled action; that I have read the foregoing Complaint; and that the statements made herein are true and correct to the best of my knowledge, information, and belief.
Date: ____ _________
[PLAINTIFF NAME], Plaintiff
8. SIGNATURE BLOCK
Respectfully submitted,
[PLAINTIFF SIGNATURE (or Attorney for Plaintiff)]
[PRINTED NAME]
[If attorney: Kentucky Bar # __]
[ADDRESS]
[PHONE] | [EMAIL]
9. CERTIFICATE OF SERVICE
I certify that a true and correct copy of this Verified Small Claims Complaint was served on Defendant as follows:
☐ Certified U.S. Mail, Return Receipt Requested
☐ Commercial courier
☐ Personal service by process server
to the address stated in the caption, on [DATE].
[NAME & SIGNATURE]