If you have a case you'd like Judge Judy to hear - fill out this form and a representative from the show will contact you if additional information is required. All lines with an asterisk * must be filled out or we cannot accept your submission.

* First Name * Last Name * Street Address * City * State * Zip Code 99999-9999 * Phone 555-555-5555 * E-mail * Birthdate mm/dd/yyyy Gender Male Female * Marital Status * Occupation * Defendant's First Name * Defendant's Last Name Defendant's Contact Information (optional) * What is the relationship between you and the defendant? * How much are you suing for? (e.g. $1000) * When did the action that lead to the lawsuit occur? * Have you filed small claims/civil case in court? Yes No If you answered "yes" to the above question, please answer the next three questions: In what court? What is the docket number of your case? Is there a counter claim? Yes No * Please give us a short summary of your case/complaint: I agree to the Terms of Use