This is an example of a completed statement of claim - goods. 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.
Sample statement of claim - goods (45kb)
For more information on completing this form, see Instructions for filling out a statement of claim - goods.This sample form is based on the following case study:
Case study - Natalie and her pet dog
Natalie went to Queensland for a six-month work contract. She could not take her pet dog, Charlie, with her. She asked her friend, Rachel to look after her dog while she was gone. When Natalie returned to Sydney, Rachel told her she was not going to give Charlie back. She said that Natalie had not looked after Charlie properly and left him for long periods alone. Rachel said that Charlie was better off with her. Natalie does not agree and wants Charlie back. Natalie sent Rachel a letter of demand and got a letter in reply saying that Rachel would like to keep Charlie and offered to pay her $100 instead. Natalie refused Rachel's offer and she has decided to apply to the Small Claims Division of the Local Court for the recovery of the dog, or $600 for the value of the dog.