FORM 7.330. STATEMENT OF CLAIM (AUTO NEGLIGENCE)

(CAPTION)

STATEMENT OF CLAIM

The plaintiff, , sues the defendant, , and alleges: On
or about , in the vicinity of , on a public highway in
County, Florida, plaintiff’s motor vehicle, being operated by ,
collided with defendant’s motor vehicle, being operated by ; and the
collision with plaintiff’s vehicle was caused by the negligent and careless
operation of defendant’s vehicle, whereby plaintiff’s vehicle was damaged and
depreciated in value.

WHEREFORE, plaintiff demands judgment in the sum of $
.