1 2 3 4 5 6 7 8 9 10 VS.
IN THE SUPERIOR COURT OF GUAM SMALL CLAIMS DIVISION ) ) ) ) ) ) ) ) ) ) SMALL CLAIMS CASE NO.
SD_______________
Plaintiff(s),
DECLARATION
Defendant(s). ) __________________________________________) The Defendant(s) is/are indebted to the Plaintiff(s) in the sum of $____________________
11 resulting from __________________________________________________________________ 12 ______________________________________________________________________________ 13 ______________________________________________________________________________ 14 ______________________________________________________________________________ 15 Plaintiff(s) has/have demanded payment of said sum; the Defendant(s) refuse(s) to pay the same, and 16 no part thereof has been paid except the sum of $______________. The Defendant(s) work(s) at 17 ________________________________________, Telephone: ______________ and reside(s) at 18 _______________________________________________________, Telephone: ______________ 19 in the Territory of Guam. The obligation sued on was contracted at ________________________in 20 the Territory of Guam. The Declarant(s) reside(s) at ____________________________________ 21 ____________________________________________________________________________. 22 Telephone: 23 24 I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF GUAM 25 (Title 6 Guam Code Annotated, ยง 4308) THAT THE FOREGOING IS TRUE AND 26 CORRECT. 27 28 EXECUTED: _________________________ _________________________ (H) ____________________ (W) ____________________
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