Defendant (also known as debtor) is the person or entity being sued. Please fill out defendant details below.

Defendant Type

Individual

Company/Corporation/DBA

Defendant Details

First Name

Last Name

Business Name

Representative Name

Email

Phone

Address

City

State

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Zip

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Total Amount Owed

$

Describe the reason for the amount owed : (please try to make it short)

When this conflict occurred? (A specific date or period of time)

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