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Plaintiff, sues the Defendant,. What you get: Instant access to fillable Microsoft Word or PDF forms.STATEMENT OF CLAIM (AUTO NEGLIGENCE). (CAPTION). , sues the defendant(s),. Claims filed under General Liability or Automobile Liability coverages allege negligence on the part of a state employee, agent or volunteer. The Statement of Claims form must be completed in its entirety and signed. Statement of Claim – Auto Accident . Form NumberForm NameCategoryAO 10AFinancial Disclosure Report RequestOther FormsAO 30Certified CopyOther FormsAO 35Certificate of Official Court ReporterCourt Reporter Forms STATEMENT OF CLAIM (AUTO NEGLIGENCE). (CAPTION). Important Information About Suing in Small Claims Court .