How to fill out Georgia's Statement of Claim (Magistrate Court, MAG 10-01)

"MAGISTRATE COURT OF ___ COUNTY, GEORGIA" — date filed, case number

The county where you are filing goes in the header; the date-filed and case-number lines are the clerk's.

Plaintiff's Name & Address / Defendant's Name & Address (two blocks)

Address blocks for the plaintiff and for up to two defendants — the second defendant block is labeled "(If two Defendants)."

Suit-type checkboxes

Three options as printed: "[ ] Suit on Note [ ] Suit on Account [ ] Other: ___" with a line to describe anything that isn't a note or account claim.

"The Court has jurisdiction over the defendant(s)" checkboxes

Two options: "the Defendant(s) is a resident of ___ County" (with the county filled in) or "other (please specify)" with a line for the basis. Georgia magistrate court venue generally follows the defendant's county of residence, and this item records why this county's court can hear the case.

"Plaintiff(s) claims the Defendant(s) is indebted to the Plaintiff(s) as follows"

Open lines for the claim, with the form's own requirement in parentheses: "(You must include a brief statement giving reasonable notice of the basis for each claim contained in the Statement of Claim)." This statement is what the defendant is served with and answers to.

"That said claim is in the amount of $___, principal $___ interest, plus ___ costs to date, and all future costs of this suit."

The claim broken into components — the form's blanks cover the principal, interest, and costs to date, with future costs of the suit claimed by the pre-printed language.

"State of Georgia, ___ County" oath block

Pre-printed text the signer swears to: "being duly sworn on oath says the foregoing is a just and true statement the amount owing by defendant(s) to plaintiff(s), exclusive of all set-offs and just grounds of defense." The signature line is labeled "Plaintiff(s) or Agent (If Agent, Title or Capacity)," with a daytime phone number line.

"Sworn and subscribed before me" — notary public / attesting official

The jurat: date lines and the signature of the notary public or attesting official who administered the oath. Magistrate court clerks commonly attest at the counter when you file in person.

"TO: All Defendant(s)" notice text

The bottom of the form is the summons the defendant receives. It states that an answer must be filed or presented within 30 days after service; that judgment by default will be entered if no answer is filed; that the answer may be in writing or given orally to the judge or clerk — orally only in person, with no telephone answers permitted; and that the answer must be received by the clerk within the 30 days. The date-and-signature line at the very bottom is completed by the court.