Form
12 (version 2)
UCPR 14.2
UCPR 14.2
STATEMENT OF ISSUES
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COURT DETAILS
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Court
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#Division
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#List
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Registry
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Case number
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TITLE OF PROCEEDINGS
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[First] plaintiff
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[name]
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#Second plaintiff #Number of
plaintiffs (if more than two)
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[First] defendant
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[name]
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#Second defendant #Number of
defendants (if more than two)
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FILING DETAILS
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Filed for
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[name] [role of party eg
plaintiff]
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#Filed in relation to
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[eg
plaintiff's claim, (number) cross-claim]
[include
only if form to be eFiled]
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#Legal representative
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[solicitor on record] [firm]
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#Legal representative reference
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[reference number]
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Contact name and telephone
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[name] [telephone]
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Contact email
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[email address]
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STATEMENT OF ISSUES
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- [state the issues in the proceedings]
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SIGNATURES
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[Role of party]
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#Signature
of legal representative
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#Signature
of or on behalf of party if not legally represented
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Capacity
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[eg
solicitor, authorised officer, role of party]
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Date of
signature
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[repeat
as required for each party signing]
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