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SMALL CLAIMS COUNTERCLAIM HAMILTON SUPERIOR COURT 4 One Hamilton County Square, Suite 292 Noblesville, Indiana 46060-2231 Telephone no. (317) 776-9612 (Original Defendants) Counter-Claimant 1 Counter-Claimant 2 Address Line 1 Address Line 2 City State Zip Telephone If Counter-claimant is represented by an attorney: Attorney Attorney Number Address Line 1 Address Line 2 City State Zip Telephone CAUSE NO. Plaintiff requests service by: Sheriff of County Certified mail vs. (Original Plaintiffs) Counter-Defendant 1 Address Line 1 Address Line 2 City State Telephone Counter-Defendant 2 Address Line 1 Address Line 2 City State Telephone NOTICE OF COUNTERCLAIM TO THE COUNTERCLAIM DEFENDANT (original Plaintiff) FROM THE CLERK OF THE COURTS: The original Defendant has filed a counterclaim against you. This counterclaim, and your original claim, will be heard in the Hamilton Superior Court No. 4 on the same date, time, and place as your original claim. The Court may enter a default judgment against you on the counterclaim if you fail to appear. The Counterclaim is for: Note, Contract, or Account (copy attached). Other A brief statement of the nature of the counterclaim against you is as The Counter-Claimant demands judgment against the original Plaintiff for plus interest from 20 (date), at the rate of and the court costs of this action. Signature of Counter-Claimant (or attorney) (attorney must sign if an attorney is representing Counter-Claimant) Clear Form ---PAGE BREAK--- NOTICE OF MAILING OF COUNTERCLAIM I hereby certify this Notice of Counterclaim was mailed via first class mail on the below date to the Counterclaim Defendant at the address shown on the front, allowing sufficient time for it to be received at least seven days prior to the trial set in this case. Dated: 20__. Clerk, Hamilton County Courts NOTICE OF RECEIPT OF COUNTERCLAIM I hereby certify that this Notice of Counterclaim was filed leaving insufficient time to guarantee delivery to the Counterclaim Defendant by first class mail at least seven days prior to the trial set in this case. Accordingly, the Notice of Counterclaim was placed in the Court’s file to effect personal service in open court. 20__. Clerk, Hamilton County Courts sc4form.005 (revised March 1, 2010)