The statement of claim, verification, and notice shall be in substantially the following form:

Magistrate Court of __________ County State of Georgia

______________ Plaintiff

______________ Address

v.

______________ Defendant

Statement of Claim

(Here the plaintiff or, at his request, the court will insert a statement of the plaintiff's claim and, if the action is on a contract, either express or implied, the original statement of the plaintiff's claim which is to be filed with the court may be verified by the plaintiff or his agent as follows:)

STATE OF GEORGIA COUNTY OF __________

______________, being first duly sworn on oath, says the foregoing is a just and true statement of the amount owing by defendant to plaintiff, exclusive of all setoffs and just grounds of defense.

_____________ Plaintiff or agent Sworn and subscribed before me this ______ day of ______________, ____.

______________ Notary public or attesting official

Notice

TO: ______________ Defendant

______________ Home Address

or

______________ Business Address You are hereby notified that ______________ has made a claim and is requesting judgment against you in the sum of __________ dollars ($______), as shown by the foregoing statement. The court will hold a hearing upon this claim at (address of court) at a time to be set after your answer is filed.

YOU ARE REQUIRED TO FILE OR PRESENT AN ANSWER TO THIS CLAIM WITHIN 30 DAYS AFTER SERVICE OF THIS CLAIM UPON YOU. IF YOU DO NOT ANSWER, JUDGMENT BY DEFAULT WILL BE ENTERED AGAINST YOU. YOUR ANSWER MAY BE FILED IN WRITING OR MAY BE GIVEN ORALLY TO THE JUDGE.

If you have witnesses, books, receipts, or other writings bearing on this claim, you should bring them with you at the time of hearing.

If you wish to have witnesses summoned, see the court at once for assistance.

If you have any claim against the plaintiff, you should notify the court at once.

If you admit the claim, but desire additional time to pay, you must come to the hearing in person and state the circumstances to the court.

You may come with or without an attorney.

______________ Magistrate of _______ County.