SMALL CLAIMS (CONCILIATION COURT) COMPLAINT

State of Minnesota, District Court, [] Judicial District
[] County • Conciliation Court

Court File No.: [Assigned by Court]

Plaintiff

[PLAINTIFF LEGAL NAME], an individual/resident business entity
Address: [STREET, CITY, STATE ZIP]
Telephone: [() -_] • E-Mail: [_]

Defendant

[DEFENDANT LEGAL NAME], an individual/resident business entity
Address: [STREET, CITY, STATE ZIP]
Telephone: [() -_] • E-Mail: [_]

SMALL CLAIMS COMPLAINT FOR MONETARY DAMAGES

(Amount Claimed: $[_] plus allowable filing fees, service costs, and statutory interest)

[// GUIDANCE: Minnesota Conciliation Court (a/k/a “Small Claims”) cannot award more than $15,000—reduced to $4,000 if the claim arises from a “consumer credit transaction.” See Minn. Stat. § 491A.01 (2024). Confirm your claim is within these limits before filing.]

1. Parties

1.1 Plaintiff is [DESCRIPTION—e.g., “a Minnesota-resident individual” / “a Minnesota-registered limited liability company”] whose address is listed above.
1.2 Defendant is [DESCRIPTION] whose address is listed above.
1.3 All parties are subject to the personal jurisdiction of this Court.

2. Jurisdiction & Venue

2.1 This action is filed in Conciliation Court pursuant to Minn. Stat. § 491A.01 (2024).
2.2 The amount in controversy does not exceed the statutory maximum for Conciliation Court.
2.3 Venue is proper in [___] County under Minn. Stat. § 491A.01, subd. 4 (2024) because [EXPLAIN—e.g., “the cause of action arose in this county” or “Defendant resides/does business here”].

3. Statement of Facts

3.1 On or about [DATE], Plaintiff and Defendant entered into [BRIEF DESCRIPTION OF AGREEMENT/TRANSACTION].
3.2 Plaintiff performed all material obligations, including [LIST KEY PERFORMANCE ITEMS].
3.3 Defendant breached by [DESCRIBE CONDUCT—e.g., “failing to pay the agreed price of $_ despite demand”].
3.4 As a direct and proximate result, Plaintiff suffered monetary damages in the amount of $[____].

[// GUIDANCE: Keep factual allegations concise and numbered. Attach copies of contracts, invoices, or correspondence as Exhibits A, B, C, etc., if available.]

4. Cause(s) of Action

Count I – [E.G., BREACH OF CONTRACT / ACCOUNT STATED / NEGLIGENCE]
4.1 Paragraphs 1.1 – 3.4 are incorporated by reference.
4.2 [ELEMENT-BY-ELEMENT RECITATION OF CLAIM under Minnesota law.]
4.3 Plaintiff has sustained damages of $[_] as a result.

[// GUIDANCE: Add additional counts in separate, clearly labeled sections if needed. Conciliation Court is limited to monetary relief and cannot issue injunctive or equitable orders.]

5. Damages

5.1 Principal Amount ……………… $[_]
5.2 Pre-filing interest (if contractually/statutorily authorized) … $[_]
5.3 Court filing fee……………………………………………… To be added
5.4 Service of process costs…………………………………… To be added
5.5 Post-judgment interest at the statutory rate from the date of judgment until paid in full.

6. Prayer for Relief

Plaintiff respectfully requests that the Court:
A. Enter judgment in favor of Plaintiff and against Defendant in the total amount of $[_] plus costs and statutory interest;
B. Award such further relief as the Court deems just and equitable within Conciliation Court jurisdiction.

7. Certification of Conciliation Court Limits

Plaintiff certifies that the relief sought is solely monetary and does not exceed the jurisdictional limits of Minnesota Conciliation Court.

8. Appeal Rights Notice

Either party may remove this matter to District Court for a new trial (“trial de novo”) within twenty (20) days after receipt of the notice of judgment. See Minn. Stat. § 491A.02, subd. 5 (2024).

Verification (Minn. R. Gen. Prac. 509)

I, [PLAINTIFF NAME], declare under penalty of perjury under the laws of the State of Minnesota that the foregoing is true and correct to the best of my knowledge, information, and belief.

Dated: [__]

[PLAINTIFF SIGNATURE]
[PLAINTIFF PRINTED NAME], Pro Se
(or)

[ATTORNEY NAME], Esq. (#_)
[LAW FIRM NAME]
Address: [___]
Phone: [() -] • E-Mail: [____]
Attorney for Plaintiff

Certificate of Service

I certify that on [DATE] I served a true and correct copy of this Complaint on Defendant by [U.S. Mail / personal service] in compliance with Minn. R. Gen. Prac. 508.

[SERVER’S NAME & SIGNATURE]

[// GUIDANCE:
1. File the completed Complaint and pay the filing fee with the Court Administrator.
2. Obtain the Court’s Summons (Conciliation Court “Statement of Claim and Summons”) and follow the court-specific service instructions.
3. Retain proof of service for your records.
4. Calendar the hearing date and any removal/appeal deadlines.
5. Bring all evidence (contracts, receipts, photos, witnesses) to the hearing.
]