Statement of claim (UCPR) (Form 16)
Form 16 is the statement of claim used in the Queensland Supreme, District and Magistrates Courts. It is attached to the claim (Form 2) and sets out the material facts the plaintiff relies on and the relief claimed.
Word document from Queensland Courts' website.
DraftOur fillable copy of this form has not been through editorial review yet. Check it against Queensland Courts' current form before you rely on it.
- Format
- Word (DOCX)
- Category
- Court form
- Form number
- Form 16
- Version
- v06ff2ef4
- Last verified
- 5 July 2026
Supreme Court · District Court · Magistrates Court · Uniform Civil Procedure Rules 1999

For law practices: this form maps to the published matter-field vocabulary, so your practice management system fills it from your matter data - on your own machine. Practice management systems can fetch and assemble it through the document assembly API.
What Form 16 is for
A plaintiff must attach a statement of claim to the claim (r 22(2)(b), Uniform Civil Procedure Rules 1999 (Qld)). It is a pleading, so it must meet the formal requirements in rule 146 (numbered pages, consecutively numbered paragraphs each containing a separate allegation, signed, and naming counsel if counsel settled it) and the content rules in chapter 6: be as brief as the case permits, state all material facts but not the evidence, and state specifically any relief claimed (r 149). Some matters, such as breach of contract, fraud, negligence, misrepresentation and interest, must be specifically pleaded (r 150), and damages and interest need particulars (rr 155, 159).
When you need it
- You are starting a proceeding by claim (Form 2). Every claim must have a statement of claim attached.
- You are amending your pleaded case. An amended statement of claim follows the same rules.
- Not with an originating application. Applications have no pleadings and rely on affidavits instead.
How to fill it in
- 1
Copy the heading from the claim
Use the same court, registry, number and party names as the claim.
- 2
Plead the material facts
Set out, in consecutively numbered paragraphs, each containing as far as practicable a separate allegation, the material facts you rely on (rr 146, 149). Plead the facts that make up your cause of action, not the evidence that proves them. Identify any specific provision of an Act you rely on (r 149(1)(e)).
- 3
State the relief claimed
Set out in full the relief claimed, including the nature and amount of each type of damages (r 155). If you claim interest, give the amount it is claimed on, the rate, the date it runs from and the method of calculation (r 159), unless you claim at the practice direction rate.
- 4
Elect a jury if you want one
In the Supreme or District Court, the plaintiff may elect trial by jury in the statement of claim unless an Act excludes it (r 472). The form notes this option is for the Supreme and District Courts only.
- 5
Sign and note counsel
The plaintiff or solicitor signs and describes the signatory. If counsel settled the pleading, state counsel's name (r 146(1)(g)).
- 6
Complete the notices
Keep the notice as to defence, which tells the defendant to attach their defence to the notice of intention to defend. If the claim is only for a debt or liquidated demand, complete the rule 150(3) notice showing the amount claimed, interest and costs, and the additional costs of default judgment.
Filing, lodging and service
- File the statement of claim together with the claim (Form 2), in the central registry or the district where a defendant lives or carries on business, or where the cause of action arose (r 35).
- Serve the claim and statement of claim personally on each defendant (rr 22(3), 105). The claim is in force for 1 year from filing (r 24).
- Legal practitioners can lodge statements of claim in claim proceedings in the Supreme Court at Brisbane through the Queensland Courts and Tribunals Online Services Portal (Principal Registrar Approval 1 of 2025).
- The filing fee is paid on the claim. Check the current fee schedule.
Common mistakes
- Do not plead evidence or argument. The court can strike out all or part of a pleading that discloses no reasonable cause of action or tends to prejudice or delay the fair trial, with costs (r 171).
- For a debt or liquidated demand only, rule 150(3) requires particulars of the debt, interest particulars, the costs of issuing, and a statement that the proceeding ends if the defendant pays before the time for a notice of intention to defend runs out.
- Plead the damages properly. For general damages, give the nature of the loss, the exact circumstances in which it was suffered, and how the amount was worked out or estimated (r 155(2)).
Frequently Asked Questions
Is there an example of a UCPR Form 16 statement of claim in Queensland?
The official Word form contains bracketed drafting instructions in each section. Queensland Courts' Starting a claim fact sheet also explains what a statement of claim must contain. The content depends on your facts, so there is no one-size template.
Do I need a statement of claim if I have filed a claim?
Yes. Rule 22(2)(b) requires a statement of claim to be attached to every claim, and both must be filed and served together.
What is the rule 150(3) notice on Form 16?
It is used only where the claim is solely for a debt or liquidated demand. It tells the defendant the amount claimed, interest and costs, that the proceeding ends if they pay those amounts before the time for filing a notice of intention to defend, and the extra costs if default judgment is entered.
Checked against the official sources on 26 October 2026
- Uniform Civil Procedure Rules 1999 (Qld) rr 22, 146, 149, 150, 155, 159, 171, 472
- Queensland Courts - Form 16 Statement of claim (Word)
- Queensland Courts - Starting a claim fact sheet
- Principal Registrar (Supreme and District Courts) Approval 1 of 2025 - electronic filing
General information about the form, not legal advice about your matter. Rules and forms change: if anything here differs from the court or agency's current instructions, theirs apply.
Field map
7 boxes on the Statement of claim (UCPR) (Form 16) fill from your matter.
- Our Firm
- Firm address, Firm email, Firm name, Firm phone
- Client
- Client full name(s)
- Matter
- Matter / file reference
- Operator
- User First Name
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