STATEMENT OF CLAIM
To The Respondent: RESPONDENT_NAME
The Claimant CLAIMANT_NAME claims the amount of $CLAIM_AMOUNT, particulars of the grounds for which and the manner in which it is calculated are set out as follows:
The grounds for the claim are: (Set out sufficient particulars to inform the Respondent of the grounds for the claim.)
1. At when/which period the Claimant(s) & the Respondent(s) entered into an agreement/arrangement (also state the relationship between the parties)
2. What are the arrangement / agreement details?
3. And what happened?
4. What are the details of the claim?
The amount of claim is calculated as follows:
Invoice issued date: (if applicable) INVOICE_DATE
Invoices Nos.: (if applicable) INVOICE_NUMBER
Claim amount calculation: (How the amount is calculated and whether it includes any interest or expenses.)