Complaint sample. PDF. Complaint fill in. PDF.What forms of relief could the court grant me in a civil action? 15. What format should I follow to generate a complaint? Intheblanks form required for any matter originating and electronically filed in Supreme or Surrogate's Courts in Richmond County. Together with, and subject to, the rights, obligations, easements, restrictions, agreements and other provisions set forth. Next, a Summons with Notice or a Summons and Verified Complaint must be efiled and served upon the defendant. 4. Kings Mountain Police Department. (Traffic Complaint Form). Michael A. Huerta, an attorney at HUERTA PLLC, files a negligence complaint on behalf of JEFFREY CABREJA.