Form 3.49	Small Claims Court—response
Court Procedures Rules 2006
(see r 3742 (Small Claims Court—response to originating application))
In the Small Claims Court of the Australian Capital Territory

Application No		of (year)

(name)
Applicant

(name)
Respondent

To the Registrar:
Respondent
(if the respondent is an individual)
Full name:
*[Home/Business] address:
(if the respondent is a corporation)
Name of the body:
*[Australian Company Number/Australian Registered Body Number]:
Address of *[registered office/public officer]:
(if the respondent is represented by another person)
Representative’s full name:
Representative’s address:
How may the respondent be contacted?
Address for service of documents
(set out respondent’s address for service in the ACT)
*Telephone No:
(if represented by a solicitor the following information may be given)
*Document exchange box no:
*Fax:
*Email address:
(if liability is admitted (see rule 3754))
*Admission of liability
I admit liability (in whole or in part) and agree to the entry of judgment on the following terms:
* Judgment is to be entered in the amount of:	$	
* The following amount is paid into the Court:	$	
* The amount of the judgment is to be paid on or before (date)
* The amount of the judgment is to be paid by instalments on the following terms:		
* The following orders are to be made:
(if liability is not admitted)
*Disputed claim
I dispute the applicant’s claim on the following grounds:
(set out briefly the grounds for disputing the claim)
(if the respondent has a counterclaim or set-off)
*Counterclaim *[and set-off]
*The following counterclaim *[and set-off] is made:	$	
(set out briefly the grounds of the counterclaim and set-off)

Date:
(signature of respondent or respondent’s representative)
(name of respondent or respondent’s representative)
*omit if, or whichever is, inapplicable