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SC-500I, 02/23 Summons and Complaint – Small Claims Chapter 799, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 1 of 2
This form is also available in Spanish.
(Este formulario está disponible en español.)
Enter the name of the
county in which you are
filing this case.
STATE OF WISCONSIN, CIRCUIT COURT,
COUNTY
The plaintiff is the person
bringing the law suit.
Enter the Plaintiff’s name
and address. If two
plaintiffs are living at the
same address, then the
names and addresses may
be listed together.
For more plaintiffs, check
the “additional plaintiffs”
box and attach another
sheet with their names and
addresses.
Plaintiff:
First name Middle name Last name
Address
Address
City State Zip
See attached for additional plaintiffs.
-vs-
To: Defendant(s):
First name Middle name Last name
Address
Address
City State Zip
See attached for additional defendants.
If this is an Amended
Complaint, check the box.
Enter the case number
given you by the Clerk.
The defendant is the
person or business you are
suing. Enter the name(s)
and address(es) of the
defendant(s).
For more than two
defendants, check the
“additional defendants”
box and attach another
sheet with their names and
addresses.
Amended
Summons and Complaint
(Small Claims)
Case No.
Claim for money ($10,000 or less) 31001
Tort/Personal injury ($5,000 or less) 31010
Return of property (replevin) 31003
Eviction 31004
Eviction due to foreclosure 31002
Arbitration award 31006
Return of earnest money 31008
On the far right: Check
one of the boxes to show
what type of small claims
case you are filing.
Note: The clerk will
provide the phone number
for the disability box.
If you require reasonable accommodations
due to a disability to participate in the court
process, please call
prior to the scheduled court date. Please note
that the court does not provide transportation.
One or both parties require the services of an interpreter. Which party?
Which language? Complete and file the Interpreter Request (GF-149) form.
SUMMONS
Do not check either of
these boxes.
The clerk will check one
or both and circle “AND”
or “OR” according to local
court procedure.
The clerk will circle what
you need to do and will
provide the date, time, and
place to appear and/or
answer.
To the Defendant(s):
You are being sued as described on the attached
complaint. If you wish to dispute this matter:
You must appear at the time and place stated.
AND / OR (circle one, if applicable)
You must file a written answer and provide a
copy to the plaintiff or plaintiff’s attorney on or
before the date and time stated.
If you do not appear or answer, the plaintiff may win this
case and a judgment entered for what the plaintiff is asking.
When to Appear/File an Answer
Date Time
Place to Appear/File an Answer
Note: Leave dates blank;
the clerk or plaintiff’s
attorney will enter them.
Clerk/Attorney Signature Date Summons Issued Date Summons Mailed
Sima Albouyeh
Milwaukee
304 S Jones Blvd #6878
Las Vegas NV 89107
(I cannot receive mail at 3022A W Pierce St, 53215 MKE
Katryna Child-Rhodes
10201 W Watertown Plank Rd
Wauwatosa
WI 53226-3532
SC-500I, 02/23 Summons and Complaint – Small Claims Chapter 799, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 2 of 2
COMPLAINT
Plaintiff's Demand:
The plaintiff states the following claim against the defendant(s):
Check the box for the type
of small claims case you
have filed.
See Basic Guide to
Wisconsin Small Claims
Actions (SC-6000V).
1. Plaintiff demands judgment for: (Check as appropriate)
Claim for Money $
Tort/Personal injury $
Return of property (replevin) (Describe property in 2 below.)
(Not to include Wis. Stats. 425.205 actions to recover collateral.)
Eviction
Eviction due to foreclosure
Return of Earnest Money
Confirmation, vacation, modification or correction of arbitration award.
Plus interest, costs, attorney fees, if any, and such other relief as the court deems proper.
Briefly explain the facts
and why the court should
award you what you are
asking for.
For Eviction Actions: If
you are seeking money
damages, you must also
state that claim on this
form. If you do not know
the exact amount of money
damages yet, state that the
amount of money damages
cannot yet be determined.
2. Brief statement of dates and facts:
(If this is an eviction action and you are seeking money damages, you must also state that claim on this form.)
If you need more room,
check this box and attach
additional sheets.
See attached for additional information. Provide copy of attachments for court and
defendant(s).
Check if you are the
plaintiff or the attorney.
I am the plaintiff.
attorney for the plaintiff.
Enter your or your
attorney’s name and date.
►
Plaintiff
Name Printed or Typed
Address
Email Address
Telephone Number Date
Attorney’s Signature
Attorney’s Name Printed or Typed
Attorney’s Address
Attorney’s Email Address Telephone Number
Date State Bar No (if any)
Print or type your name.
Enter your or your
attorney’s phone number.
An attorney must enter his
or her State Bar Number,
law firm and address.
COPIES: For each person you are suing, make two copies of this signed original and any attachments, and bring them to the clerk of court.
x 10,000
This person "represented" a court offical in a Zoom hearing. According to the court (on
the record) the case did not exist. It was completely made up, and deliberately served (on the record, pls see
https://www.real-life-murder-mystery.com/the-fake-hearing-allegation where you can also hear a recording of
half of the hearing) to an address Ms Rhodes stated on the recorded they were told I am not at.
I only found out about the fake case (a PayPal credit card debt, but PayPal doesn't issue credit cards) through a
forwarding order via USPS.
To my knowledge, this hearing has been streamed on a gang stalker virtual machine (the CIA would know.)
The case has then be dismissed via forged document. The non-existing case.
Please see: https://www.real-life-murder-mystery.com/conclusion-of-the-fake-dnf-dobberstein-case
All parties are in together on it. The goal was to slander me, and put negative things in my background, in the context
of a FBI-reported murder conspiracy against me.
DNF and Dobberstein are led by fake identities. Some might be missing people.
The person named as "lawyer" on the forged court document is Jillian Caggiano. At first, I thought she's a missing
person from Ohio (voter registration in Ohio), but it turned out that she's a stalked FBI agent.
Sima Albouyeh
support@real-life-murder-mystery.com
304 S Jones Blvd #6878, Las Vegas, NV 89107
9177279307 08/10/2023

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  • 1. SC-500I, 02/23 Summons and Complaint – Small Claims Chapter 799, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 2 This form is also available in Spanish. (Este formulario está disponible en español.) Enter the name of the county in which you are filing this case. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY The plaintiff is the person bringing the law suit. Enter the Plaintiff’s name and address. If two plaintiffs are living at the same address, then the names and addresses may be listed together. For more plaintiffs, check the “additional plaintiffs” box and attach another sheet with their names and addresses. Plaintiff: First name Middle name Last name Address Address City State Zip See attached for additional plaintiffs. -vs- To: Defendant(s): First name Middle name Last name Address Address City State Zip See attached for additional defendants. If this is an Amended Complaint, check the box. Enter the case number given you by the Clerk. The defendant is the person or business you are suing. Enter the name(s) and address(es) of the defendant(s). For more than two defendants, check the “additional defendants” box and attach another sheet with their names and addresses. Amended Summons and Complaint (Small Claims) Case No. Claim for money ($10,000 or less) 31001 Tort/Personal injury ($5,000 or less) 31010 Return of property (replevin) 31003 Eviction 31004 Eviction due to foreclosure 31002 Arbitration award 31006 Return of earnest money 31008 On the far right: Check one of the boxes to show what type of small claims case you are filing. Note: The clerk will provide the phone number for the disability box. If you require reasonable accommodations due to a disability to participate in the court process, please call prior to the scheduled court date. Please note that the court does not provide transportation. One or both parties require the services of an interpreter. Which party? Which language? Complete and file the Interpreter Request (GF-149) form. SUMMONS Do not check either of these boxes. The clerk will check one or both and circle “AND” or “OR” according to local court procedure. The clerk will circle what you need to do and will provide the date, time, and place to appear and/or answer. To the Defendant(s): You are being sued as described on the attached complaint. If you wish to dispute this matter: You must appear at the time and place stated. AND / OR (circle one, if applicable) You must file a written answer and provide a copy to the plaintiff or plaintiff’s attorney on or before the date and time stated. If you do not appear or answer, the plaintiff may win this case and a judgment entered for what the plaintiff is asking. When to Appear/File an Answer Date Time Place to Appear/File an Answer Note: Leave dates blank; the clerk or plaintiff’s attorney will enter them. Clerk/Attorney Signature Date Summons Issued Date Summons Mailed Sima Albouyeh Milwaukee 304 S Jones Blvd #6878 Las Vegas NV 89107 (I cannot receive mail at 3022A W Pierce St, 53215 MKE Katryna Child-Rhodes 10201 W Watertown Plank Rd Wauwatosa WI 53226-3532
  • 2. SC-500I, 02/23 Summons and Complaint – Small Claims Chapter 799, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2 COMPLAINT Plaintiff's Demand: The plaintiff states the following claim against the defendant(s): Check the box for the type of small claims case you have filed. See Basic Guide to Wisconsin Small Claims Actions (SC-6000V). 1. Plaintiff demands judgment for: (Check as appropriate) Claim for Money $ Tort/Personal injury $ Return of property (replevin) (Describe property in 2 below.) (Not to include Wis. Stats. 425.205 actions to recover collateral.) Eviction Eviction due to foreclosure Return of Earnest Money Confirmation, vacation, modification or correction of arbitration award. Plus interest, costs, attorney fees, if any, and such other relief as the court deems proper. Briefly explain the facts and why the court should award you what you are asking for. For Eviction Actions: If you are seeking money damages, you must also state that claim on this form. If you do not know the exact amount of money damages yet, state that the amount of money damages cannot yet be determined. 2. Brief statement of dates and facts: (If this is an eviction action and you are seeking money damages, you must also state that claim on this form.) If you need more room, check this box and attach additional sheets. See attached for additional information. Provide copy of attachments for court and defendant(s). Check if you are the plaintiff or the attorney. I am the plaintiff. attorney for the plaintiff. Enter your or your attorney’s name and date. ► Plaintiff Name Printed or Typed Address Email Address Telephone Number Date Attorney’s Signature Attorney’s Name Printed or Typed Attorney’s Address Attorney’s Email Address Telephone Number Date State Bar No (if any) Print or type your name. Enter your or your attorney’s phone number. An attorney must enter his or her State Bar Number, law firm and address. COPIES: For each person you are suing, make two copies of this signed original and any attachments, and bring them to the clerk of court. x 10,000 This person "represented" a court offical in a Zoom hearing. According to the court (on the record) the case did not exist. It was completely made up, and deliberately served (on the record, pls see https://www.real-life-murder-mystery.com/the-fake-hearing-allegation where you can also hear a recording of half of the hearing) to an address Ms Rhodes stated on the recorded they were told I am not at. I only found out about the fake case (a PayPal credit card debt, but PayPal doesn't issue credit cards) through a forwarding order via USPS. To my knowledge, this hearing has been streamed on a gang stalker virtual machine (the CIA would know.) The case has then be dismissed via forged document. The non-existing case. Please see: https://www.real-life-murder-mystery.com/conclusion-of-the-fake-dnf-dobberstein-case All parties are in together on it. The goal was to slander me, and put negative things in my background, in the context of a FBI-reported murder conspiracy against me. DNF and Dobberstein are led by fake identities. Some might be missing people. The person named as "lawyer" on the forged court document is Jillian Caggiano. At first, I thought she's a missing person from Ohio (voter registration in Ohio), but it turned out that she's a stalked FBI agent. Sima Albouyeh support@real-life-murder-mystery.com 304 S Jones Blvd #6878, Las Vegas, NV 89107 9177279307 08/10/2023