|
IN THE DISTRICT COURT OF POLK COUNTY,
ARKANSAS COMPLAINT |
|||
| CASE NUMBER: | |||
PLAINTIFF: |
|||
|
TELEPHONE |
|||
| ADDRESS | |||
|
ZIP |
|||
DEFENDANT |
|||
|
TELEPHONE |
|||
| ADDRESS | |||
|
ZIP |
|||
| NATURE OF CLAIM: | DAMAGES OR | BREACH OF CONTRACT | (CIRCLE ONE) |
| DOLLAR AMOUNT CLAIMED | $ |
DATE CLAIM AROSE |
|
FACTS SHOWING WHY CLAIM IS OWED: |
|||
|
SIGNATURE OF PLAINTIFF |
|||
| NOTICE TO PARTIES | THIS CASE IS SET FOR DISPOSITION ON THE | ||
|
DAY OF |
200__ AT 1:30 PM |
||
|
|
|||
| FILED ON THIS | |||
| DAY OF | 200__ | ||
| CLERK | |||
| BY | D.C. | ||
| RECEIPT NO. | |||
| TO DEFENDANT: PLEASE SEE DEFENDANT'S INSTRUCTIONS ON REVERSE SIDE | |||
|
06/04/05 11:34 AM |
|||