Form 2DC05 "Statement of Claim and Notice (Disagreement About Security Deposit-Residential)" - Hawaii

What Is Form 2DC05?

This is a legal form that was released by the Hawaii District Courts - a government authority operating within Hawaii. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 25, 2017;
  • The latest edition provided by the Hawaii District Courts;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 2DC05 by clicking the link below or browse more documents and templates provided by the Hawaii District Courts.

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Download Form 2DC05 "Statement of Claim and Notice (Disagreement About Security Deposit-Residential)" - Hawaii

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S
C
n
Form #2DC05
tatement of
laim and
otiCe
(d
S
d
- r
)
iSagreement about
eCurity
epoSit
eSidential
i
S
C
d
n the
mall
laimS
iviSion of the
d
C
S
C
iStriCt
ourt of the
eCond
irCuit
d
iviSion
S
h
tate of
awai
i
Plaintiff(s)
Reserved for Court Use
Defendant(s)
Civil No.
Filing Party Name, Attorney, Address, Telephone and Fax Number
Statement of claim
Plaintiff alleges as follows:
I am a resident at
.
Since (date)
, 20
, Defendant owes me the sum of $
for
Defendant resides and/or does business at
in the State of Hawai‘i.
Plaintiff asks for judgment in the principal amount of $
.
In addition, the Court may award court costs and interest. Where the Court determines that the landlord WRonGfUllY and
WillfUllY retained all or part of the security deposit, it maY award the tenant damages equal to three times the security deposit
retained, pursuant to Hawai‘i Revised Statutes §521-44(h).
DeclaRation
i DeclaRe UnDeR PenaltY of PeRJURY tHat tHe folloWinG iS tRUe anD coRRect.
Signature of Plaintiff:
Print/Type Name:
Date:
I certify that this is a full, true and correct
copy of the original on file in this office.
___________________________________________________________________
Clerk, District Court of the Above Circuit, State of Hawai‘i
RepRogRaphics (01/10)
page 1 of 2
2d-p-303
RevaComm 508 Certified
S
C
n
Form #2DC05
tatement of
laim and
otiCe
(d
S
d
- r
)
iSagreement about
eCurity
epoSit
eSidential
i
S
C
d
n the
mall
laimS
iviSion of the
d
C
S
C
iStriCt
ourt of the
eCond
irCuit
d
iviSion
S
h
tate of
awai
i
Plaintiff(s)
Reserved for Court Use
Defendant(s)
Civil No.
Filing Party Name, Attorney, Address, Telephone and Fax Number
Statement of claim
Plaintiff alleges as follows:
I am a resident at
.
Since (date)
, 20
, Defendant owes me the sum of $
for
Defendant resides and/or does business at
in the State of Hawai‘i.
Plaintiff asks for judgment in the principal amount of $
.
In addition, the Court may award court costs and interest. Where the Court determines that the landlord WRonGfUllY and
WillfUllY retained all or part of the security deposit, it maY award the tenant damages equal to three times the security deposit
retained, pursuant to Hawai‘i Revised Statutes §521-44(h).
DeclaRation
i DeclaRe UnDeR PenaltY of PeRJURY tHat tHe folloWinG iS tRUe anD coRRect.
Signature of Plaintiff:
Print/Type Name:
Date:
I certify that this is a full, true and correct
copy of the original on file in this office.
___________________________________________________________________
Clerk, District Court of the Above Circuit, State of Hawai‘i
RepRogRaphics (01/10)
page 1 of 2
2d-p-303
RevaComm 508 Certified
notice
to
:
this Statement of claim will be heard by a Judge at the address checked below on
,
20
at
m.
YoU mUSt Be PReSent on tHiS tRial Date to aVoiD JUDGment BY DefaUlt.
coURt aDDReSS
q
Wailuku Division
2145 Main Street, Courtroom 3D, Third Floor, Wailuku, Hawai‘i 96793
q
Lahaina Division
1870 Honoapi‘ilani Highway, Lahaina, Hawai‘i 96761
-
-
q
Ha na Division
4974 Uakea Road, Ha na, Hawai‘i 96713
q
Moloka‘i Division
55 Makaena Place, Kaunakakai, Hawai‘i 96748
-
-
q
La na‘i Division
312 8th Street, La na‘i City, Hawai‘i 96763
mailing address for the court: 2145 Main Street, Room 106, Wailuku, Hawai‘i 96793
If you have witnesses, or documents related to this claim, you should bring them with you to trial.
If you wish to subpoena witnesses for trial, contact the clerk as soon as possible before trial.
You may not be represented by an attorney in the Small Claims Division for security deposit cases.
You have no RiGHt to aPPeal from a judgment of the Small Claims Division.
if YoU Do not aPPeaR anD DefenD on tHe Date anD time StateD aBoVe, a
DefaUlt JUDGment maY Be enteReD aGainSt YoU foR tHe amoUntS ReQUeSteD
in tHiS Statement of claim.
Clerk
This notice shall not be personally delivered between 10:00 p.m. and 6:00 a.m. on premises not open to the
public, unless the court permits, in writing on this notice, personal delivery during those hours.
In accordance with the Americans with Disabilities Act , and other applicable State and Federal laws, if you require an accommodation for
your disability when working with a court program, service, or activity please contact the District Court Administration Office at PHONE
NO. 244-2800, FAX 244-2849, or email adarequest@courts.hawaii.gov at least (10) working days before your preceeding, hearing, or
appointment date. For Civil related matters, please call 244-2706 or visit the Service Center at 2145 Main Street, Room 141A, Wailuku.
Clear form
2d-p-303
(Rev 7/25/2017)
RepRogRaphics (01/10)
page 2 of 2
RevaComm 508 Certified
Page of 2