(complete this form for all commercial claims arising out of a Consumer Transaction)


I hereby certify that I have mailed a demand letter by ordinary first class mail to the party complained against not less than ten
(10) days and not more than one hundred eighty (180) days before I commenced this claim.

                                                                                                                                    Signature of Claimant

Sworn to before me this ___________

day of __________________________

Notary Public or Clerk of the Court

Note: The Commercial Claim Court will not allow your action to proceed if this certification is not made, properly completed
and filed with the Court.