SMALL CLAIMS COMPLAINT TEMPLATE
State of Louisiana – City Court / Justice of the Peace Court
[COURT NAME], SMALL CLAIMS DIVISION, PARISH OF [PARISH NAME]
[// GUIDANCE: This template is drafted to comply with Louisiana Revised Statutes
R.S. 13:5201–5212 governing Small Claims Divisions. Confirm dollar limits,
local rules, filing fees, service methods, and appeal deadlines with the clerk
of the specific court prior to filing.]
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TABLE OF CONTENTS
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I. Document Header
II. Definitions
III. Operative Allegations
IV. Representations & Warranties of Plaintiff
V. Covenants & Restrictions
VI. Default & Remedies Requested
VII. Risk Allocation Statements
VIII. Dispute Resolution & Appeal Rights
IX. General Provisions
X. Execution Block (Verification, Signature, Notary)
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I. DOCUMENT HEADER
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STATE OF LOUISIANA
[COURT NAME], SMALL CLAIMS DIVISION
PARISH OF [PARISH]
PLAINTIFF: [PLAINTIFF FULL LEGAL NAME] DOCKET NO.: _____
[Plaintiff Street Address]
[City, State ZIP]
DIVISION “SC”
DEFENDANT: [DEFENDANT FULL LEGAL NAME]
[Defendant Street Address]
[City, State ZIP]
TITLE OF PLEADING: PETITION FOR MONEY JUDGMENT
FILED: [DATE]
Recital of Jurisdiction
- Plaintiff brings this action pursuant to La. R.S. 13:5201 et seq. (Small
Claims Court Act), which grants this Court jurisdiction over monetary
claims not exceeding Five Thousand and 00/100 Dollars ($5,000.00), exclusive
of interest, court costs, and allowable attorney’s fees. - The events giving rise to this claim occurred within the territorial
jurisdiction of this Court, and venue is therefore proper.
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II. DEFINITIONS [// GUIDANCE: Optional—delete if unnecessary]
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For purposes of this Petition, the following capitalized terms have the meanings
set forth below:
“Claim Amount” means the principal sum of money sought by Plaintiff,
not to exceed the statutory jurisdictional limit.
“Court” means the [COURT NAME], Small Claims Division.
“Small Claims Act” means La. R.S. 13:5201–5212, as amended.
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III. OPERATIVE ALLEGATIONS
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3. Parties.
a. Plaintiff is a resident of the Parish of [PARISH] and is of the full age
of majority.
b. Defendant is believed to be a resident of, or maintains a principal
place of business in, the Parish of [PARISH] and is subject to the
jurisdiction of this Court.
- Nature of Claim.
a.#######################################################################
SMALL CLAIMS COMPLAINT TEMPLATE
State of Louisiana – City Court / Justice of the Peace Court
[COURT NAME], SMALL CLAIMS DIVISION, PARISH OF [PARISH NAME]
[// GUIDANCE: This template is drafted to comply with Louisiana Revised Statutes
R.S. 13:5201–5212 governing Small Claims Divisions. Verify the most current
jurisdictional limit (presently $5,000 exclusive of interest, court costs, and
attorney’s fees), permitted claim types, local rules, filing fees, service
methods, and appeal deadlines with the clerk of the specific court before
filing. Remove sections not applicable to the particular claim.]
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TABLE OF CONTENTS
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I. Document Header
II. Definitions (Optional)
III. Operative Allegations
IV. Representations & Warranties of Plaintiff
V. Covenants & Restrictions
VI. Default & Remedies Requested
VII. Risk Allocation Statements
VIII. Dispute Resolution & Appeal Rights
IX. General Provisions
X. Execution Block (Verification, Signature, Notary)
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I. DOCUMENT HEADER
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STATE OF LOUISIANA
[COURT NAME], SMALL CLAIMS DIVISION
PARISH OF [PARISH NAME]
PLAINTIFF: [PLAINTIFF FULL LEGAL NAME] DOCKET NO.: _____
[Plaintiff Street Address]
[City, State ZIP]
DIVISION “SC”
DEFENDANT: [DEFENDANT FULL LEGAL NAME]
[Defendant Street Address]
[City, State ZIP]
TITLE OF PLEADING: PETITION FOR MONEY JUDGMENT
DATE FILED: [MM / DD / YYYY]
Recital of Jurisdiction
- Plaintiff brings this action pursuant to Louisiana’s “Small Claims Court
Act,” La. R.S. 13:5201–5212, which grants this Court jurisdiction over
money claims that do not exceed Five Thousand and 00/100 Dollars
($5,000.00), exclusive of interest, court costs, and any statutorily
recoverable attorney’s fees. - Venue is proper because the cause of action arose in, and/or Defendant
resides or does business in, the Parish of [PARISH NAME].
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II. DEFINITIONS (Optional)
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[// GUIDANCE: Delete this section if unnecessary for a straightforward claim.]
“Claim Amount” means the principal sum sought by Plaintiff, exclusive
of interest and costs, not exceeding the statutory limit.
“Court” means the above-captioned Small Claims Division.
“Small Claims Act” means La. R.S. 13:5201–5212, as amended.
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III. OPERATIVE ALLEGATIONS
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3. Parties.
a. Plaintiff is an individual of the full age of majority, domiciled in the
Parish of [PARISH NAME], State of Louisiana.
b. Defendant is [an individual / a Louisiana corporation / a foreign
corporation authorized to do business] whose domicile or principal place
of business is in the Parish of [PARISH NAME], State of Louisiana.
-
Factual Basis of Claim.
a. On or about [DATE], Plaintiff and Defendant entered into a
[describe agreement, transaction, or occurrence giving rise to the
claim—e.g., “written contract for home repair,” “sale of goods,”
“auto-collision,” etc.].
b. Defendant breached the foregoing obligation by [describe breach /
wrongful act—e.g., “failing to pay the agreed price of $____,”
“delivering non-conforming goods,” “negligently operating a motor
vehicle,” etc.].
c. As a direct and proximate result of Defendant’s actions, Plaintiff has
suffered damages in the sum of $[PRINCIPAL AMOUNT] (the “Claim Amount”),
which is within the jurisdictional limit of this Court. -
Compliance with Monetary Limits & Allowable Claims.
Plaintiff affirms that:
a. The Claim Amount sought does not exceed $5,000.00, exclusive of interest
and allowable costs.
b. The claim is for monetary relief only and is therefore an “allowable
claim” under La. R.S. 13:5202; no injunctive or other equitable relief
is requested.
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IV. REPRESENTATIONS & WARRANTIES OF PLAINTIFF
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6. Plaintiff represents, warrants, and affirms the following:
a. All statements of fact set forth herein are true and correct to the best
of Plaintiff’s knowledge, information, and belief.
b. Plaintiff is the proper party in interest and owns the claim asserted.
c. No other party has been granted an assignment or subrogation of this
claim.
d. The damages sought have been computed in good faith and are supported by
the documentation attached hereto as Exhibit “A” and incorporated by
reference.
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V. COVENANTS & RESTRICTIONS
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7. Plaintiff covenants as follows:
a. Plaintiff will promptly supplement or amend this Petition if additional
responsive pleadings, counterclaims, or defenses require clarification.
b. Plaintiff shall notify the Court and Defendant of any change in address
or contact information within ten (10) days of such change.
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VI. DEFAULT & REMEDIES REQUESTED
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8. Events Constituting Default.
Plaintiff requests that if Defendant fails to file a timely Answer or
appear at trial, the Court enter a default judgment in favor of Plaintiff
pursuant to applicable rules of the Small Claims Division.
- Requested Relief.
WHEREFORE, Plaintiff respectfully prays for:
a. Judgment in Plaintiff’s favor and against Defendant in the principal sum
of $[PRINCIPAL AMOUNT];
b. Legal interest from the date of judicial demand until paid;
c. All allowable court costs;
d. [If contract or statute provides] Reasonable attorney’s fees; and
e. All general and equitable relief to which Plaintiff may be entitled.
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VII. RISK ALLOCATION STATEMENTS
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10. Plaintiff expressly waives any claim for injunctive, declaratory, or other
equitable relief.
11. Plaintiff acknowledges that recovery is capped by the Small Claims Act and
does not seek damages in excess of the statutory limit.
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VIII. DISPUTE RESOLUTION & APPEAL RIGHTS
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12. Governing Law & Forum.
This dispute is governed exclusively by the laws of the State of Louisiana
and shall be heard in the Small Claims Division of the captioned Court.
-
Jury Waiver.
Jury trials are not available in the Small Claims Division. Plaintiff
therefore proceeds without demand for jury trial. -
Appeal Rights.
Any aggrieved party may file (i) a motion for new trial within seven (7)
days after notice of judgment or (ii) a suspensive or devolutive appeal
within fifteen (15) days after expiration of the new-trial period, all as
provided in La. R.S. 13:5206–5207 and applicable local rules.
[// GUIDANCE: Verify exact deadlines with the clerk—some courts measure time
from “date of judgment” rather than “notice of judgment.”]
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IX. GENERAL PROVISIONS
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15. Amendment.
Plaintiff reserves the right to amend this Petition to conform to the
evidence adduced at trial or to correct technical defects.
-
Severability.
Should any provision herein be deemed invalid, such invalidity shall not
affect the remaining provisions. -
Integration.
This Petition, including all exhibits, constitutes the entire pleading by
Plaintiff regarding the claim described herein.
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X. EXECUTION BLOCK
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Respectfully submitted this ___ day of __, 20___.
[PLAINTIFF PRINTED NAME]
Plaintiff, Pro Se
[Street Address]
[City, State ZIP]
[Phone] | [Email]
VERIFICATION
STATE OF LOUISIANA )
PARISH OF [PARISH NAME] )
BEFORE ME, the undersigned Notary Public, personally came and appeared
[PLAINTIFF NAME], who after being duly sworn, stated that he/she has read the
foregoing Petition and that the allegations contained therein are true and
correct to the best of his/her knowledge, information, and belief.
Sworn to and subscribed before me this __ day of __, 20_.
______ _____
NOTARY PUBLIC PLAINTIFF SIGNATURE
Printed Name: ____ Printed Name: ___
Notary I.D. / Bar No.: __ My Commission Expires: ___
[// GUIDANCE: Many Louisiana small-claims courts do not require notarized
verification. Check local rules; remove notary block if not required.]
CERTIFICATE OF SERVICE
I hereby certify that a copy of the foregoing Petition for Money Judgment,
together with all exhibits and the required Citation, was served on Defendant
as follows:
☐ By personal service through the Office of the Constable / Sheriff
☐ By certified mail, return receipt requested, postage prepaid
☐ Other: __________
on this _ day of __, 20___.
[PLAINTIFF NAME]
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END OF DOCUMENT
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