_________________________________
Plaintiff
 

            Vs.                                                                                                   Docket No. _________________
 
 
 

_________________________________
Defendant
 
 
 
 
 

I, _________________________________, hereby withdraw my small claim / commercial claim
(name of plaintiff/claimant)
 

action against ___________________________________ which is scheduled for
                                     (name of defendant)
 

___________________________________ 20 _____.
(date of scheduled court hearing)
 
 
 

Dated: ___________________________________