Repons pou Ti  

Reklamasyon

NIMEWO REJIS

FÒM SA A SE PA POU SOUMÈT 

NAN TRIBINAL. SE POU 

ENFÒMASYON SÈLMAN.

Tribinal Premye Enstans  

Massachusetts

Sesyon pou Ti Reklamasyon

Pleyan (yo):

Akize (yo):

SE POU REZON ENFÒMASYON SÈLMAN.

KONT

	Divizyon________ TRIBINAL MINISIPAL BOSTON 

	Divizyon ________ TRIBINAL DISTRI

	Divizyon ________ TRIBINAL LOJMAN

 

Mwen, Akize ki site nan Pwosè pou Ti Reklamasyon ki endike anwo a, mwen rekonèt nan 

Repons sa a, mwen dwe fè konnen, okonplè ak yon fason ki espesyal, ki enfòmasyon ki endike 

nan Deklarasyon Reklamasyon Pleyan an mwen pa aksepte, ak ki enfòmasyon mwen aksepte, 

epi mwen fè sa konsa:

NÒT POU AKIZE A:  

 

Si ou dakò avèk Reklamasyon pleyan an, epi si ou bezwen tan pou peye, 

tanpri endikesa anwo a.

 _____________________________

      Siyati Akize a

Dat: 

 

 

 __________________

This document was developed under Grant No. 11-T-162 of the State Justice Institute. The form does not necessarily represent the official position or policies of the State Justice Institute.

This form is for reference only. Do not submit to the court. Fòm sa a la sèlman pou referans.  Pa remèt li nan tribunal la.Answer Small Claims Haitian Creole 08/2012       www.mass.gov/courts/forms

Kreyòl ayisyen

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Massachusetts state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

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• Sourced from www.mass.gov (2023-03)
• Page(s): 1
• Fields(s): 5
• Average fields per page: 5
• Reading Level: Grade 8
• LIST Grouping(s): GO-00-00-00-00.

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