Statement of Claim
The District Court of Western Australia statement of claim template sets out the facts and relief a plaintiff relies on. It is served with the writ or within 14 days after appearance.
Word document from District Court of Western Australia's website.
DraftOur fillable copy of this form has not been through editorial review yet. Check it against District Court of Western Australia's current form before you rely on it.
- Format
- Word (DOCX)
- Category
- Court form
- Version
- ve7bf2f48
- Last updated
- 14 October 2026
District Court of Western Australia · Rules of the Supreme Court 1971 (WA) (applied to District Court civil proceedings)

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 the Statement of Claim is for
A statement of claim is the plaintiff's first pleading in an action started by writ. Order 20 of the Rules of the Supreme Court 1971 (WA), applied in the District Court by rule 6 of the District Court Rules 2005, requires the plaintiff to serve it either with the writ or within 14 days after the defendant enters an appearance, unless it is indorsed on the writ or the Court orders otherwise (O 20 r 1). It must state the relief claimed and cannot raise a cause of action not mentioned in the writ or arising from the same facts (O 20 r 2). The Court publishes this Word template with the standard heading and party details.
When you need it
- You have issued a writ in the District Court with a short indorsement of claim and now need to set out the full claim.
- You prefer to serve the full claim with the writ. It can be indorsed on the writ instead, except in claims based on fraud or for defamation, malicious prosecution, false imprisonment, seduction or breach of promise of marriage (O 6 r 3).
- The claim is within the Court's civil jurisdiction: personal injury and death claims, and other personal actions up to $750,000 (excluding interest), according to the Court's website.
How to fill it in
- 1
Complete the heading
Insert the action number and year and the parties' names. State on its face the date the writ was issued (O 20 r 2(4)), and the description and filing date of the pleading (O 20 r 7(1)).
- 2
Fill in the party details
Date of document, date of filing, who prepared it, and the plaintiff's address, phone, fax, email and reference for service (O 20 r 7(4)).
- 3
Plead the material facts
Set out in numbered paragraphs, one allegation per paragraph where convenient, the material facts in summary form, not the evidence (O 20 rr 7(2), 8). Use figures for dates, sums and numbers (O 20 r 7(3)).
- 4
Give particulars
Include the necessary particulars, such as particulars of any misrepresentation, fraud or breach of trust (O 20 r 13). Exemplary or aggravated damages must be specifically pleaded with the facts relied on (O 20 r 9(3)).
- 5
Claim interest properly
If claiming interest, say which part of the claim it relates to and its basis. For statutory interest, identify the provision, the rate and the date it runs from (O 20 r 9(4)).
- 6
State the relief and sign
Finish with the specific relief or remedy claimed; costs need not be claimed specifically (O 20 r 2(1)). Sign as counsel, solicitor or, if acting in person, the plaintiff (O 20 r 7(5)).
Filing, lodging and service
- File the statement of claim before serving it, and serve the copy within one working day after filing (O 20 r 3), unless it is indorsed on the writ.
- Serve it on each defendant with the writ or within 14 days after that defendant enters an appearance (O 20 r 1). After appearance, it can be served at the address for service in the defendant's memorandum of appearance.
- Lawyers must eLodge through the ECMS. Self-represented parties who are not registered users may email districtcourt@justice.wa.gov.au (preferred) or lodge at the registry (PNC 1.2.1).
- The defendant then has 14 days to serve a defence (O 20 r 4).
Common mistakes
- Keep the claim within the writ. You can alter, modify or extend the indorsed claim in the statement of claim, but not add an unrelated cause of action (O 20 r 2(2)-(3)).
- A defendant can apply to strike out a pleading that discloses no reasonable cause of action or is embarrassing, generally within 21 days of service (O 20 r 19).
- In a damages claim, particulars of damage are generally due within 60 days of the first defence under DCR r 45C (PNC 1.3).
Frequently Asked Questions
When must the statement of claim be served in the WA District Court?
With the writ, or at any time after the writ is served but within 14 days after the defendant enters an appearance, unless the Court gives leave otherwise (RSC O 20 r 1).
What is the difference between the writ and the statement of claim?
The writ starts the action and carries a concise indorsement of the nature of the claim and relief sought (O 6 r 1). The statement of claim sets out the material facts and particulars in full.
Checked against the official sources on 26 October 2026
- Rules of the Supreme Court 1971 (WA) O 6 rr 1, 3, O 20
- District Court Rules 2005 (WA) rr 6, 45C
- District Court of WA - Statement of Claim template (Word)
- District Court of WA - Representing Yourself
- District Court of WA - Procedure Guide for Self-Represented Litigants (Part 4)
- District Court of WA - Practice Notes Civil (PNC 1.2, 1.3)
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
8 boxes on the Statement of Claim fill from your matter. 1 is for you to complete: ticks, signatures and anything that needs judgement.
- Our Firm
- Firm address, Firm email, Firm name, Firm phone
- Client
- Client email, Client phone
- Matter
- Matter / file reference
- Key Dates
- Current date
Matter plans that use this form
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