Form 3.54	Small Claims Court—default judgment
Court Procedures Rules 2006
(see r 3757 (Small Claims Court—default judgment) and r 3765 (Small Claims Court conference—failure to attend))
In the Small Claims Court of the Australian Capital Territory

Application No		of (year)

(name)
Applicant

(name)
Respondent

The Court enters judgment as follows:
*Amount stated in claim
The applicant recover against the respondent (state amount):	
$	
The respondent pay $ (amount) to the applicant.
*Debt declaration
The Court declares:
*The applicant is not indebted to the respondent.
*The applicant is indebted to the respondent in the amount of:
*The applicant is not indebted to the respondent in an amount exceeding the amount of:	

$

$	
The applicant recover against the respondent the following amount for fees, charges and out-of-pocket expenses:	
$	

*Amount not stated in claim—damages to be assessed
The applicant recover against the respondent damages to be assessed.
*Other orders sought in claim
Judgment for the applicant against the respondent with orders to be decided.

Date:
Registrar