Small Claim and Notice of Small Claim (ORS 46.425) (OJD Official) (Jan 2026) Completed Form Examples and Samples
Explore detailed examples and samples of the official Oregon Small Claim and Notice of Small Claim form (ORS 46.425, OJD Official, Jan 2026). See how to correctly fill out the form for common disputes like unreturned security deposits or unpaid services. Our filled samples guide you through completing each section accurately to help you file your claim with confidence.
Small Claim and Notice of Small Claim Example – Unreturned Security Deposit
How this form was filled:
This example shows a completed Small Claim and Notice of Small Claim form for a common landlord-tenant dispute. The plaintiff (tenant) is suing the defendant (landlord) for the return of a $1,500 security deposit. The form correctly identifies both parties, clearly states the reason for the claim, and calculates the total amount owed, including court filing fees.
Information used to fill out the document:
- Court County: Multnomah
- Plaintiff Name: Alex Chen
- Plaintiff Address: 456 Oak Ave, Apt 7, Portland, OR 97204
- Plaintiff Phone: 503-555-0101
- Defendant Name: Beacon Properties LLC
- Defendant Address: 789 Pine St, Suite 200, Portland, OR 97205
- Claim Amount: $1,500.00
- Filing Fees: $61.00
- Total Claim: $1,561.00
- Reason for Claim: Defendant (landlord) failed to return the $1,500.00 security deposit within 31 days after the lease terminated on January 31, 2026, as required by Oregon statute ORS 90.300. Defendant did not provide an itemized accounting of any deductions.
- Date of Filing: March 15, 2026
- Signature of Plaintiff: Alex Chen
What this filled form sample shows:
- Clearly identifies the Plaintiff (tenant) and Defendant (landlord).
- Provides a concise and legally relevant reason for the claim, referencing the applicable Oregon statute (ORS 90.300).
- Accurately calculates the total amount claimed by adding the original debt and the court filing fees.
- Includes complete and properly formatted contact information and addresses for both parties, which is crucial for serving the notice.
- Shows a properly dated and signed declaration, certifying the information is true to the best of the plaintiff's knowledge.
Form specifications and details:
| Form Name: | Small Claim and Notice of Small Claim |
| Form Number: | ORS 46.425 |
| Issuing Body: | Oregon Judicial Department (OJD Official) |
| Revision Date: | Jan 2026 |
| Use Case: | Landlord-Tenant dispute over an unreturned security deposit. |
Created: February 04, 2026 02:19 AM
