Small Claim and Notice of Small Claim (ORS 46.425) (OJD Official) (Jan 2026) Instructions

Enter the full legal name of the defendant.

Enter the full legal name of an additional defendant, if applicable.

Enter the full legal name of the first plaintiff.

Enter the full legal name of an additional plaintiff, if applicable.

Enter the plaintiff's inmate SID number, if applicable.

Enter the court case number assigned to this small claim case.

Enter the dollar amount you are claiming the defendant owes you (or the value of the property).

Enter the dollar amount of filing fees you have paid or will pay for this case.

Enter the total dollar amount of fees to include in the summary box (typically the filing fees).

Enter the total dollar amount of costs to include in the summary box (typically service costs).

Enter the dollar amount of service costs you have paid or will pay.

Enter the total dollar amount requested, combining the claim amount, fees, and costs.

Enter the date on or about when the defendant owed you the money or property.

Enter the dollar amount you claim the defendant owes you (or the value of the property).

Briefly state the reason the defendant owes you this amount.

Continue the brief reason the defendant owes you this amount, if needed.

Provide a detailed explanation of the facts supporting your claim, including what happened and why the defendant is responsible.

Enter the date you asked or demanded that the defendant pay, after which the amount remained unpaid.

Enter the Oregon county where this circuit court case is filed.

Enter the court-assigned case number for this small claims matter.

Enter the first line of the court’s name, address, or phone number.

Enter the second line of the court’s name, address, or phone number.

Enter the third line of the court’s name, address, or phone number.

Check this box if the defendant’s contact information (such as name or address) continues on an attached page.

Enter the full legal name of the defendant (or the registered agent name if required).

Enter the defendant’s street address (do not use a P.O. Box).

Enter the defendant’s city, state, and ZIP code.

Enter the defendant’s phone number.

Enter the county where the defendant is located or resides.

Enter the filing fee amount required to demand a hearing when the amount claimed is $2,500 or less. Fill only if 'Claim $' is $2,500 or less.

Enter the filing fee amount required to demand a hearing when the amount claimed is more than $2,500. Fill only if 'Claim $' is more than $2,500.

Enter the filing fee amount required to demand a jury trial when the amount claimed is over $750. Fill only if 'Claim $' is more than $750.

Check this box if the defendant is a public body (such as a government agency or public entity).

Enter the business or organization name of the defendant’s registered agent, if applicable.

Enter the full name of the defendant’s registered agent.

Enter the registered agent’s street address (not a P.O. Box).

Enter the city, state, and ZIP code for the registered agent’s address.

Enter the county where the registered agent is located.

Describe the specific good faith efforts you made to collect the claim from the defendant(s) before filing this case.

Enter the language or type of interpreter requested if selecting the “other” option. Fill only if 'Interpreter Request - Other' is 'Yes'.

Check this box if you need a Spanish interpreter.

Check this box if you need an American Sign Language (ASL) interpreter.

Check this box if you need an interpreter in a language other than Spanish or ASL.

Check this box if you have complied with ORS 646A.670(1) and UTCR 5.180 and have attached the required Consumer Debt Collection Disclosure Statement. Fill only if 'Subject to ORS 646A.670(1) and UTCR 5.180(2)' is 'Yes'.

Check this box if you are providing the plaintiff’s contact information (such as name/address) on an attached page instead of in the spaces on this form.

Enter the plaintiff’s name as it should appear in the case caption.

Enter the plaintiff’s full legal name for contact and service purposes.

Enter the plaintiff’s street address.

Enter the plaintiff’s city, state, and ZIP code.

Enter the county where the plaintiff is located.

Enter the date on which the plaintiff signs the declaration.

Provide the plaintiff's signature to certify the declaration.

Enter the plaintiff's email address.

Enter the plaintiff's full name as printed.

Check this box if this small claim is subject to UTCR 5.180(3).

Check this box if this small claim is subject to ORS 646A.670(1) and UTCR 5.180(2).

Enter the text you want displayed in the large header area at the top of the form.