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Summary Cause Forms

Act of Sederunt (Summary Cause Rules) 2002 No. 132
Appendix 1

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Form A1 - Form of statement by prospective lay representative for pursuer/defender
A lay representative is someone who represents you in court (for example, an adviser, support worker or friend) but who isn’t a qualified lawyer. If you decide that you want to apply to the court for a lay representative to speak on your behalf, this is the form they must fill in before the court can allow them to do so.
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Form 1a (and Form 1) - Application Form for use when defender is individual and the action is for, or includes, payment of sum of money
You should fill in this application form if you are raising a claim either for, or including, payment of a sum of money, against an individual or individuals or an individual(s) trading as. Form 1, which is the court copy of the application, will also appear. You must fill in both Form 1 and Form 1a.
Applications lodged on or after 1 September 2012
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Schedule of timetable under personal injuries procedure
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Form 1b (and Form 1) - Application form for use when defender is company / organisation and action is for, or includes, payment of sum of money
You should fill in his application form if you are raising a claim either for, or including, payment of a sum of money, against a company or other organisation. Form 1, which is the court copy of the application, will also appear. You must fill in both Form 1 and Form 1b.
Applications lodged on or after 1 September 2012
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Form 1c (and Form 1) - Application form for use in all cases when action does not includes claim for payment of a sum of money
You should fill in his application form if you are raising an action which DOES NOT include a claim for payment of a sum of money, e.g. an action for recovery of heritable property. Form 1, which is the court copy of the application, will also appear. You must fill in both Form 1 and Form 1c.
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Form 1d (and Form 1) - Application form for multiplepoinding
You should fill in his application form if you are raising a claim for a special type of summary cause called a multiplepoinding. This type of action can be raised where someone is holding money or goods belonging to someone else and there are two or more people that can make a claim for it in court. Form 1, which is the court copy of the application, will also appear. You must fill in both Form 1 and Form 1d.
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Form 1e (and Form 1) - Application Form for use when the defender is an individual and the action is for damages for personal injury
You should fill in this application form if you are raising a claim for personal injuries, either against an individual or individuals or an individual(s) trading as. Form 1, which is the court copy of the application, will also appear. You must fill in both Form 1 and Form 1e. (See also Form 10 below)
Application lodged on or after 1 September 2012
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Form 1f (and Form 1) - Application Form for use when defender is a company/organisation and the action is for damages for a personal injury
You should fill in his application form if you are raising a claim for personal injuries, against a company or other organisation. Form 1, which is the court copy of the application, will also appear. You must fill in both Form 1 and Form 1f. (See also Form 10 below)
Application lodged on or after 1 September 2012
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Form 2 - Form of claim in a summons for payment of money
If you are claiming for payment of a sum of money, you should use this form of wording to fill in box 4 on your application form.
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Form 3 - Claim in a summons for recovery of possession of heritable property
If you are raising an action for the recovery of heritable property (e.g. a house or a piece of land), you should use this form of wording to fill in box 4 on your application form.
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Form 3a - Notice of removal under sections 34, 35 or 36 of the Sheriff Courts (S) Act 1907
This form is to be completed by the solicitor/sheriff officer serving the notice of removal.
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Form 3b - Notice of removal under section 37 of the Sheriff Courts(S) Act 1907
This form is to be completed by the solicitor/sheriff officer serving the notice of removal.
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Form 3c - Letter of removal
This is the form of letter of removal to be prepared by the solicitor/sheriff officer.
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Form 4a - Notice informing defender of right to apply for orders under the Debtors (S) Act 1987
Any cause commenced prior to 1 April 2008
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Form 4b - Certificate of Sequestration
Any cause commenced prior to 1 April 2008
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Form 5 - Claim in a summons of multiplepoinding
If you are raising a claim for a special type of summary cause called a multiplepoinding, and are using Form 1d, you should use this form of wording to fill in box 4 on your application form.
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Form 5a - Statement by holder of fund or subject when not the pursuer
This is the form that is to be completed in an action of multiplepoinding where the holder of the property is not the pursuer.
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Form 5b - Claim on fund/subject in multiplepoinding
This form should be used in an action of multiplepoinding if the sheriff requests it for a claim hearing.
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Form 6 - Claim in a summons of furthcoming
If you are raising an action of furthcoming, you should use this form of wording to fill in box 4 on your application form.
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Form 7 - Claim in a summons for delivery
If you are claiming for delivery of recovery of an item of moveable property you should use this form of wording to fill in box 4 on your application form.
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Form 8 - Claim for implement of an obligation
If you are applying to the court for an order to get someone to do something, you should use this form of wording to fill in box 4 on your application form.
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Form 9 - Claim in a summons for count, reckoning and payment
If you are raising an action of count, reckoning and payment, you should use this form of wording to fill in box 4 on your application form.
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Form 10 - Claim for damages for personal injury (1)
If you are claiming for payment of a sum of money from someone you feel was responsible for a personal injury that you have received, you should use this form of wording to fill in box 4 on your application form.
Application lodged before 1 September 2012
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Form 10 - Form of statement of claim in a personal injuries action (2)
If you are claiming for payment of a sum of money from someone you feel was responsible for a personal injury that you have received, you should complete this statement along with your application form
Application lodged on or after 1 September 2012
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Form 10a - Claim for provisional damages (1)
If you are claiming for damages for personal injury, and wish to include a claim for provisional damages, you should also use this form of wording to fill in box 4 on your application form in addition to the wording in form 10 above.
Application lodged before 1 September 2012
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Form 10a - Form of response (action for damages: personal injuries) (2)
If someone has made a claim against you for damages for their personal injury, you should fill in this form to respond to their claim
Application lodged on or after 1 September 2012
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Form 10b - Form of response (1)
If someone has made a claim against you for damages for their personal injury, you should fill in this form to respond to their claim.
Application lodged before 1 September 2012
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Form 10b - Form of order of court for recovery of documents in personal injuries action (2)
This is the form of order granting recovery of documentary evidence that is in someone else’s possession, in a personal injury action.
Application lodged on or after 1 September 2012
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Form 10c - Statement of valuation of claim (1)
You need to complete this statement of valuation of claim, at least 28 days prior to the proof, if you are party to a personal injury action.
Application lodged before 1 September 2012
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Form 10c - Form of docquet for deemed grant of recovery of documents in a personal injuries action (2)
This form will be completed by the sheriff clerk (depute) in a personal injury action.
Application lodged on or after 1 September 2012
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Form 10d - Intimation to connected persons (1)
This form is to be completed by the solicitor or sheriff officer intimating an action for damages for personal injury to a person, not being a party to the action, who has title to sue the defender in respect of personal injuries causing death.
Application lodged before 1 September 2012
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Form 10d - Form of timetable (2)
This is the timetable outlining the various dates by which parties have to complete tasks and lodge documents with the court in a personal injury action
Application lodged on or after 1 September 2012
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Form 10e - Specification of documents (1)
This is the form of order granting recovery of documentary evidence,that is in someone else’s possession, in an action for personal injury.
Application lodged before 1 September 2012
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Form 10e - Form of statement of valuation of claim (2)
You need to complete this statement of valuation of claim, by the date given to you in the timetable, if you are party to a personal injury action.
Application lodged on or after 1 September 2012
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Form 10f - Application for further damages (1)
This is the form of minute to be filled in if you are applying to the court for further damages in an action for damages for personal injury.
Application lodged before 1 September 2012
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Form 10f - Minute of pre-proof conference (2)
This is the form of minute to be filled in outlining what was discussed and what was agreed at the pre-proof conference in a personal injury action.
Application lodged on or after 1 September 2012
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Form 10g - Notice of application for further damages (1)
This form is to be filled in by the solicitor or sheriff officer intimating an application for further damages in an action for damages for personal injury.
Application lodged before 1 September 2012
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Form 10g - Form of intimation to connected persons (2)
This form is to be filled in by the solicitor or sheriff officer intimating an application in an action for damages for personal injury to someone who may have a connection to the case
Application lodged on or after 1 September 2012
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Form 10h - Form of claim for provisional damages
This is the form to be filled in if you are applying to the court for provisional damages in a personal injury action
Application lodged on or after 1 September 2012
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Form 10i - Form of application for further damages
This is the form to be filled in if you are applying to the court for further damages in a personal injury action
Application lodged on or after 1 September 2012
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Form 10j - Form of notice of application for further damages
This form is to be filled in by the solicitor or sheriff officer intimating an application for further damages in a personal injury action
Application lodged on or after 1 September 2012
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Form 11 - Form of service
This form is to be completed by the solicitor or sheriff officer serving the summary cause application.
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Form 12 - Form of certificate of execution of service
This form is to be completed by the solicitor or sheriff officer serving the summary cause application.
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Form 13 - Service on person whose address is unknown Form of advertisement
This is the form of wording to be used when service of the application is made by an advert in a newspaper, where the address of the defender is unknown. It is to be completed by the solicitor or sheriff officer arranging service of the application.
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Form 14 - Service on person whose address is unknown - notice for walls of court
This is the form of wording to be used when service of the application is made by displaying it on the walls of court, where the address of the defender is unknown. It is to be completed by the solicitor or sheriff officer arranging service of the application.
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Form 15 - Service by post - form of notice
This is the form of wording to be added to the front of the envelope containing the application. It is to be completed by the solicitor or sheriff officer serving the application.
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Form 15a - Statement to accompany application for interim diligence
This form is to be submitted along with any incidental application for warrant for diligence by arrestment or inhibition on the dependence of an action or warrant for arrestment on the dependence of an admiralty action.
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Form 15b - Form of schedule of arrestment on the dependence
This is the form to that has to be served on the defender by a solicitor or sheriff officer when a warrant for arrestment on the dependence has been granted.
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Form 15c - Form of certificate of execution of arrestment on the dependence
This certificate is to be filled in by the solicitor or sheriff officer who has served the arrestment on the dependence.
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Form 16 - Recall or restriction of arrestment - Certificate authorising the release of arrested funds or property
This certificate is to be filled in by the sheriff clerk (depute) certifying the authorisation to release arrested funds or property following the recall or restriction of an arrestment.
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Form 17 - Minute - no response lodged by defender
If the defender does not respond to the summons, you should fill in this form to let the court know what order you would like the court to make.
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Form 18 - Minute - pursuer not objecting to time to pay direction/time order
If the defender has applied for either a time to pay direction or a time order, you should fill in this form if you ACCEPT the offer made.
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Form 19 - Form of minute - pursuer opposing an application for a time to pay (1)
If the defender has applied for either a time to pay direction or a time order, you should fill in this form if you DO NOT ACCEPT the offer made.
Application lodged before 1 December 2009
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Form 19 - Minute - pursuer opposing time to pay direction/time order (2)
If the defender has applied for either a time to pay direction or a time order, you should fill in this form if you DO NOT ACCEPT the offer made.
Application lodged on or after 1 December 2009
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Form 20 - Form of oath for witnesses
This is the wording of the oath sworn by a witness before giving evidence.
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Form 21 - Form of affirmation for witnesses
This is the wording of the affirmation made by a witness before giving evidence.
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Form 22 - Form of third party notice
If you believe that you have a right of relief in respect of the claim against some other person or organisation (a claim against a third party) you can apply to the court to have that party added to the action. You can apply for this by completing this form.
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Form 23 - Form of response to third party notice
If a third party notice has been served on you, this is the form of response that you should fill in if you wish to respond to the claim made against you.
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Form 23A - Form of minute of intervention by the Commission for Equality and Human Rights
This form is to be filled in by the Commission for Equality and Human Rights if the Commission wishes to intervene in a case.
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Form 23B - Form of minute of intervention by the Scottish Commission for Human Rights
This form is to be filled in by the Scottish Commission for Human Rights if it wishes to intervene in a case.
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Form 23C - Invitation to the Scottish Commission for Human Rights to intervene
This form is to be filled in by the sheriff clerk( depute) if the court decides to invite the Scottish Commission for Human Rights to intervene in a case.
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Form 24 - Order and certificate in optional procedure for recovery of documents
This form is to be filled in by either the solicitor in the process of obtaining documentary evidence which is in someone else’s possession.
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Form 25 - Minute in an application for letter of request
This is the form of wording you should use if you are applying to the court to request a foreign court to take evidence from a specified person within its jurisdiction or to serve Scottish court documents on that person.
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Form 25a - Form of letter of request
This is the form filled in by the sheriff clerk(depute) requesting a foreign court to take evidence from a specified person within its jurisdiction or to serve Scottish court documents on that person.
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Form 25b - Form of minute in application for taking evidence in the European Community
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Form 26 - Form of witness citation
This form is to be filled in by the solicitor or sheriff officer serving the witness citation.
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Form 26a - Form of certificate of witness citation
This form is to be filled in by the solicitor or sheriff officer serving the witness citation.
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Form 26B - Form of child witness notice
You should fill in this application if you plan to call a witness who is a child (i.e. under 16). Special procedures will apply.
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Form 26C - Form of vulnerable witnesses application
You should fill in this application if you plan to call a witness who is vulnerable (i.e. has a mental disorder, or is experiencing fear or distress in connection with giving evidence in this case). Special procedures will apply.
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Form 26D - Form of certificate of intimation
This form is to be filled in by the solicitor or sheriff officer serving intimation of a child witness notice or a vulnerable witness notice.
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Form 26E - Form of application for review
You should fill in this application if you would like the court to review arrangements that have already been made for a child witness or a vulnerable witness.
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Form 26F - Form of certificate of intimation
This form is to be filled in by the solicitor or sheriff officer serving intimation of a child witness notice or a vulnerable witness notice
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Form 27 Form of reference to the European Court
This form is to be filled in by the sheriff clerk (depute)where a reference has been made to the European Court.
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Form 28 - Form of extract decree – basic
This is a basic style of the document that is issued at the end of the case, containing the order made by the court.
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Form 28a - Form of extract decree -– payment
This is the form of court order issued at the end of the case for payment of a sum of money in favour of one of the parties.
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Form 28b - Form of extract decree - recovery of possession of heritable property
This is the form of court order issued at the end of the case for recovery of possession of heritable property where there are no rent arrears.
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Form 28ba - Form of extract decree – recovery of possession of heritable property in accordance with section 16(5A) of the Housing (Scotland) Act 2001
This is the form of court order issued at the end of the case for recovery of possession of heritable property under section 16(5A) of the Housing (Scotland) Act 2001 (non-payment of rent)
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Form 28bb - Form of extract decree – recovery of possession of heritable property in other cases (non-payment of rent)
This is the form of court order issued at the end of the case for recovery of possession of heritable property where there are rent arrears, in other cases (not under section 16(5A) of the Housing (Scotland) Act 2001)
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Form 28c - Form of extract decree and warrant to sell in sequestration for rent and sale
Any cause commenced prior to 1 April 2008
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Form 28d - Form of extract - warrant for ejection and to re-let in sequestration for rent and sale
Any cause commenced prior to 1 April 2008
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Form 28e - Form of extract decree – furthcoming
This is the form of court order issued at the end of the case for furthcoming.
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Form 28f - Form of extract decree – delivery
This is the form of court order issued at the end of the case for delivery of moveable property.
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Form 28g - Form of extract decree - delivery - payment failing delivery
This is the form of court order issued at the end of the case for delivery of moveable property and, failing delivery, for payment of a sum of money
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Form 28h - Form of extract decree – aliment
This is the form of court order issued at the end of the case for payment of aliment.
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Form 28i - Form of extract - ad factum praestandum
This is the form of court order issued at the end of the case for payment of a sum of money where the person has failed to carry out a task or perform a duty.
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Form 28j - Form of extract decree- absolvitor
This is the form of court order issued at the end of the case meaning that the defender is exonerated the defender (as a result, the pursuer is not allowed to bring the same matter to court again)
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Form 28k - Form of extract decree – dismissal
This is the form of court order issued at the end of the case bringing to an end the proceedings in the claim ( although it may be possible for a new claim to be brought if not time barred)
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Form 29 - Certificate by sheriff clerk Service of charge where address of defender is unknown
This certificate is to be completed by the sheriff clerk (depute) where a charge (order to obey a decree of court) is displayed on the walls of court (where the address of the defender is unknown.
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Form 30 - Minute for recall of decree (1)
You should fill in this form if you want the court to recall a decree that has been granted.
Actions raised prior to 4th April 2011 but not determined prior 4 April 2011
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Form 30 - Minute for recall of decree (2)
You should fill in this form if you want the court to recall a specific court order
Actions raised on or after 4th April 2011; and for actions raised and determined prior to April 4th April 2011
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Form 30a - Minute for recall of decree - service copy (1)
You should fill in this form if you want the court to recall a decree that has been granted. This is the service copy of form 30.
Actions lodged prior to 4th April 2011 but not determined prior to 4 April 2011
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Form 30a - Minute for recall of decree - service copy (2)
You should fill in this form if you want the court to recall a decree that has been granted. This is the service copy of form 30
Actions raised on or after 4th April 2011; and for actions raised and determined prior to April 4th April 2011
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Form 31 - Form of note of appeal to the sheriff principal
You should fill in this form if you want to appeal to the sheriff principal against a final court decree/order
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Form 32 - Application for leave to appeal against time to pay direction
This form is to be completed if you want to appeal against the court’s decision on a time to pay application. This form is for leave to appeal and you have to get this before you actually lodge the application for appeal.
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Form 33 - Appeal against time to pay direction
You should fill in this form if you would like to appeal against the court’s decision on a time to pay direction.
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Form 34 - Application for certificate of suitability for appeal to the Court of Session
You should fill in this form if you want to apply to the Sheriff Principal to certify that the case is suitable for appeal to the Court of Session.
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Form 35 - Form of receipt for money paid to the sheriff clerk
This receipt is to be completed by the sheriff clerk (depute) in relation to money paid to them under Chapter 26 of the Summary Cause Rules.
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Form 36 - Action for aliment - Form of notice of intimation to children and next of kin where address of defender is unknown
This is the form of notice of intimation to any children or next of kin where the address of the defender is not known in an action for aliment. It is to be completed by the solicitor or sheriff officer serving the notice.
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Form 37 - Action for aliment - form of notice of intimation to children, next of kin and guardian where defender suffers from mental disorder
This is the form of notice of intimation to any children, next of kin or guardian where the defender suffers from mental disorder in an action for aliment. It is to be completed by the solicitor or sheriff officer serving the notice.
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Certificate B - Response to an Order for recovery of documents
This certificate should be completed by the person that is served with a specification of documents.
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Form - Incidental application
You should fill in this application if you would like the court to make an order during the course of your summary cause action.
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Form A - Record of proceedings
This form is used by the sheriff clerk (depute).
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Appendix 1a

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Schedule of timetable under personal injuries procedure
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