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Here is the text we could read:

ĐƠN KHIẾU KIỆN NHỎ VÀ  
THÔNG BÁO XÉT XỬ

		TÒA  

THÀNH PHỐ BOSTON

 Chỉ Sử 
Dụng Cho
 Tòa Án


SỐ TRONG SỔ GHI ÁN
KHÔNG NỘP CHO TÒA. 
CHỈ ĐỂ THAM KHẢO.

	 	TÒA QUẬN
____________________________  

Tòa Án Giải Quyết Các Khiếu 
Kiện Nhỏ của Tòa Sơ Thẩm 
Massachusetts

	 	TÒA NHÀ Ở
______________________________

TÊN, ĐỊA CHỈ, MÃ ZIP VÀ ĐIỆN THOẠI CỦA NGUYÊN ĐƠN

LUẬT SƯ CỦA NGUYÊN ĐƠN (nếu có)

__________________________________________________________________

Tên:    

__________________________________________________________________
 

__________________________________________________________________

Địa Chỉ:  

__________________________________________________________________
 

__________________________________________________________________

__________________________________________________________________
 

SỐ ĐIỆN THOẠI:

CỦA BỊ ĐƠN TÊN, ĐỊA CHỈ, MÃ ZIP VÀ ĐIỆN THOẠI

SỐ ĐIỆN THOẠI: 

BỊ ĐƠN BỔ SUNG (nếu có)

BBO:

__________________________________________________________________

Tên:    

__________________________________________________________________
 

__________________________________________________________________

Địa Chỉ:  

__________________________________________________________________
 

__________________________________________________________________

__________________________________________________________________
 

 

 

SỐ ĐIỆN THOẠI:

SỐ ĐIỆN THOẠI: 

KHIẾU KIỆN CỦA NGUYÊN ĐƠN. Bị đơn nợ $_________ cộng $_________ chi phí tòa án vì các lý do sau:
Nêu ngày diễn ra vụ việc là cơ sở của khiếu kiện của quý vị.

	Chỉ Sử Dụng Cho Tòa Án	

CẢ NGUYÊN 
ĐƠN VÀ BỊ 
ĐƠN ĐỀU PHẢI 
CÓ MẶT TẠI 
TÒA ÁN NÀY 
VÀO NGÀY VÀ 
GIỜ ĐÃ QUY 
ĐỊNH

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

CHỈ ĐỂ THAM KHẢO

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

CHỮ KÝ CỦA NGUYÊN ĐƠN X 

NGÀY

PHẦN 
5

HÒA GIẢI: Có thể hòa giải khiếu kiện này trước khi xét xử nếu cả hai bên đồng ý thảo luận vấn đề với người hòa giải, người này sẽ trợ giúp các 
bên nhằm cố gắng giải quyết tranh chấp dựa trên các điều khoản hai bên cùng đồng ý. Nguyên đơn phải thông báo cho tòa án nếu người đó 
muốn hòa giải; bị đơn có thể đồng ý hòa giải vào ngày xét xử.
	Nguyên đơn sẵn sàng cố gắng giải quyết khiếu kiện này thông qua hòa giải của toàn án.

BẢN KHAI CÓ TUYÊN THỆ VỀ QUÂN SỰ: Theo hậu quả và hình phạt về tội khai man, nguyên đơn tuyên bố rằng:

		(các) bị đơn nói trên đang phục vụ 

trong quân đội

x
____________________________  
CHỮ KÝ CỦA NGUYÊN ĐƠN 
 

 ______
NGÀY

PHẦN 
6

		(các) bị đơn ở trên hiện đang không phục vụ 
trong quân đội và hiện tại sống hoặc làm việc 
tại địa chỉ trên.

THÔNG BÁO CHO BỊ ĐƠN: 

TÊN VÀ ĐỊA CHỈ CỦA TÒA ÁN

Quý vị đang bị nguyên đơn có tên ở trên kiện tại Toà Án 
Khiếu Kiện Nhỏ. Quý vị phải có mặt cho phiên xét xử khiếu 
kiện này vào ngày và giờ đã nêu ở phía bên phải. 

Nếu quý vị muốn giải quyết khiếu kiện này trước ngày xét xử, 
quý vị cần liên hệ với nguyên đơn hoặc luật sư của nguyên đơn. 

NGÀY VÀ GIỜ XÉT XỬ

XEM CHỈ DẪN BỔ SUNG Ở MẶT SAU CỦA MẪU NÀY

THẨM PHÁN THỨ NHẤT

CHÁNH LỤC SỰ HOẶC NGƯỜI ĐƯỢC CHỈ ĐỊNH

_________________   TẠI   _________________ 
NGÀY                                               GIỜ

CHỈ DẪN NỘP KHIẾU KIỆN NHỎ – Quý vị phải hoàn thành các Phần 1-6 của mẫu này. Xem chỉ dẫn ở mặt sau.

SỐ PHÒNG

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.

PHẦN 
1

PHẦN 
2

PHẦN 
3

PHẦN 
4

THÔNG BÁO XÉT XỬ

This form is for reference only.  Do not submit to the court. Mẫu đơn này chỉ dùng để tham khảo.  Xin đừng đệ trình mẫu đơn này lên tòa.Statement of Small Claim and Notice of Trial Vietnamese 08/2012 www.mass.gov/courts/forms

Tiếng Việt

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.

About This Form:

Sourced from www.mass.gov (2023-03)
Page(s): 1
Fields(s): 27
Average fields per page: 27
Reading Level: Grade 6
LIST Grouping(s): GO-00-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

nha was to_a_nha__ơ (0.64 conf)
qu_n was to_a_quâ_n (0.46 conf)
n was tên (0.45 conf)
n_chi_zip_va_thoa_cu_nguy was tên__đi_a_chi_ma__zip_va__điện_thoa_i_cu_a_nguyên_đơn (0.44 conf)
u_n_na_chi_kha_xin_l was m_â_u_đ_ơ_n_na_y_chi__du_ng_đê__tha_m_kha_o_xin_đ_ư__ng_đê__tri_nh_m_â_u_đ_ơ_n_na_y_lên_to_a (0.49 conf)
unknown__1 was 2 (0.38 conf)
n_thoa was sô__điện_thoa_i (0.40 conf)
page_field__1 was page_0_field_7 (0.31 conf)
page_field__2 was page_0_field_8 (0.31 conf)
cu_bi_n_chi_zip_va_thoa was cu_a_bi__đơn_tên__đi_a_chi_ma__zip_va__điện_thoa_i (0.41 conf)
chi was đi_a_chi (0.48 conf)
unknown__2 was 3 (0.38 conf)
page_field__3 was page_0_field_12 (0.31 conf)
page_field__4 was page_0_field_13 (0.31 conf)
c_ng was cô_ng (0.45 conf)
page_field__5 was page_0_field_15 (0.31 conf)
u_nga_di_ra_vu_vi_la_cu_khi_ki was nêu_nga_y_diê_n_ra_vu__viê_c_la__cơ_sơ__cu_a_khiê_u_kiê_n_cu_a_quy__vi (0.49 conf)
ph_n was phâ_n (0.43 conf)
page_field__6 was page_0_field_18 (0.31 conf)
unknown__3 was 4 (0.38 conf)
page_field__7 was page_0_field_20 (0.31 conf)
ch_ky_cu_nguy_n_x was chư__ky__cu_a_nguyên_đơn_x (0.48 conf)
page_field__8 was page_0_field_22 (0.31 conf)
page_field__9 was page_0_field_23 (0.31 conf)
ta was ta_i (0.42 conf)
page_field__10 was page_0_field_25 (0.31 conf)
ch_tham_kh was chỉ_để_tham_khảo (0.45 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

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Identified Data Fields:

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02