ch]]SC-100[/ch]
Plaintiff (list names):Joe Johnson IV
Case Number (for clerk):
One.
The Plaintiff (the person, business, or public entity that is suing) is:
Name:Joe Johnson IV
Phone:353435
Street Address (Street, City, State, Zip): -
Mailing Address (if different): J.Johnson@saonline.sa
If more than one Plaintiff, list next Plaintiff here:
Name:
Phone:
Street Address (Street, City, State, Zip):
Mailing Address (if different):
Two.
The Defendant (the person, business, or public entity being sued) is:
Name:The Police Department
Phone: 311
Street Address (Street, City, State, Zip): -
Mailing Address (if different): -
If more than one Defendant, list next Defendant here:
Name:
Phone:
Street Address (Street, City, State, Zip):
Mailing Address (if different):
Three.
The Plaintiff claims the Defendant owes $250000$
Four.
List the evidence you have regarding the claims listed in three.
Five.
You must ask the Defendant (in person, in writing, or by phone) to pay you before you sue. Have you done this?
I did report it to their website.
Six.
I understand that by filing a claim in court, I have no right to appeal this claim.
I declare, under penalty of perjury under San Andreas State law, that the information above and on any attachments to this form is true and correct.
Date: INSERT Joe Johnson IV Joe Johnson IV
Date: INSERT - -
Plaintiff (list names):Joe Johnson IV
Case Number (for clerk):
One.
The Plaintiff (the person, business, or public entity that is suing) is:
Name:Joe Johnson IV
Phone:353435
Street Address (Street, City, State, Zip): -
Mailing Address (if different): J.Johnson@saonline.sa
If more than one Plaintiff, list next Plaintiff here:
Name:
Phone:
Street Address (Street, City, State, Zip):
Mailing Address (if different):
Two.
The Defendant (the person, business, or public entity being sued) is:
Name:The Police Department
Phone: 311
Street Address (Street, City, State, Zip): -
Mailing Address (if different): -
If more than one Defendant, list next Defendant here:
Name:
Phone:
Street Address (Street, City, State, Zip):
Mailing Address (if different):
Three.
The Plaintiff claims the Defendant owes $250000$
[*=left]Why does the Defendant owe the Plaintiff money? I was hit by a speeding police vehicle (atleast 150 km/h) close to IGS. THe vehicle had no strobes on, and after I was hit, she/he did not come back to assist me.
[*=left]When did this happen? (Date): 10th June 2014
[*=left]If no specific date, give the time period: Date started: INSERT HERE Through: INSERT HERE
Four.
List the evidence you have regarding the claims listed in three.
- Evidence 4.1
- Mr H.Smith
- My witness no.1
- The police officer that called the ambulance after I was hit.
- Evidence 4.2
- Mr A Shadows
- My witness no2
- THe paramedic that saved my life.
Five.
You must ask the Defendant (in person, in writing, or by phone) to pay you before you sue. Have you done this?
[*=left][ X ] Yes ---------- [] No
Six.
I understand that by filing a claim in court, I have no right to appeal this claim.
I declare, under penalty of perjury under San Andreas State law, that the information above and on any attachments to this form is true and correct.
Date: INSERT Joe Johnson IV Joe Johnson IV
Date: INSERT - -