Town of Otsego
New York

Town Court

Small Claims Application

APPLICATION TO FILE SMALL CLAIM

(Please read the Guide to Small Claims Court before filling out this form)

Filing Fee - Money Order, Certified Bank Checks or Cash only (No Personal or
Business Checks accepted)

Type of claim: Filing Fee: (Check One)
Small Claim $10.00 - Claim of $1,000 or less __________
$15.00 - Claim between $1,000
and $3,000 (limit) __________

Counterclaim $3.00 + $2.67 postage __________

Date:_____________________________

Name of Claimant (list all necessary parties):__________________________________

Address________________________________________________________________

Telephone no: ___________________________________________________________
(work) (home)
against

Name of Defendant (list all necessary parties): _________________________________

_______________________________________________________________________
(if a business-provide business name and name of individual who owns/operates/manages business

________________________________________________________________________
Mailing and Physical Address (Home or Bus./Place of Employment must be in Town of Otsego - except for counterclaims)

Telephone:____________________ (if known)

Amount of claim $________________________ (Do not include filing fee)

Nature of Claim to include all pertinent information including descriptions, dates, addresses, invoice numbers, etc.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Bring this completed form and the correct filing fee to the Court Clerk who will prepare a Summons and schedule a date for your Hearing. We suggest you call for an appointment.
before you come to file. (607-547-5689)