Statement Of Claim (Accident)

IN THE COUNTY COURT OF THE EIGHTH JUDICIAL CIRCUIT, IN AND FOR ALACHUA COUNTY, FLORIDA 201 East University Avenue - Post Office Box 600 Gainesville Florida 32602 (352) 374-3636 Case No.: PLAINTIFF Division: Address City, State Zip Code Phone -vs- DEFENDANT DEFENDANT Address Address City, State Zip Code City, State Zip Code Phone Phone STATEMENT CLAIM (Accident) Plaintiff(s), , sue(s) Defendant(s), and alleges: 1. This is an action for damages which do not exceed the sum of $5,000.00, exclusive of costs, interest and attorneys fees. 2. On or about , , in the vicinity of in County, Florida, a motor vehicle owned by , being operated by was in a collision with a motor vehicle owned by , being operated by . 3. The collision with Plaintiffs vehicle was caused by the negligent and careless operation of Defendants vehicle, whereby Plaintiffs vehicle was damaged and depreciated in value. If a Defendant is to be served with process outside the State of Florida, see Exhibit A, attached. WHEREFORE, Plaintiff(s) demands Judgment for damages against Defendant(s) in the amount of $ , plus $ Court costs. PLAINTIFF(S) Statement of Claim - Accident.doc