Sample statement of claim - car accidents - plaintiff (Form 3B)
This is an example of a completed statement of claim - car accidents. It is important to complete this form using your own details and based on your own circumstances. If you need more help, get legal advice. Do not try to file this sample form at court.
This sample form is provided in Word 
format.
For more information on completing this form, see Instructions for filling out a statement of claim - car accidents.
Case study - Rob and Mick
Rob parked his car at a shopping centre. After checking his mirrors, Rob slowly reversed out of a parking spot at the shops when he suddenly felt a bump. Rob had run into a car that was behind him. Rob does not have comprehensive car insurance. Rob tried to resolve the dispute with Mick and sent him a letter of demand to pay for the cost of repairs to his car. Mick has ignored Rob's phone calls and has not responded to the letter of demand. Rob wants to recover the cost of repairs to his car and has decided to start a claim in the Small Claims Division of the Local Court.