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Court Forms by Court Department

District Court forms

A list of forms for the District Court by subject.

Some District Court forms are also available in:

Arabic  |  Chinese  |  Haitian Creole  |  Khmer  |  Portuguese  |  Russian  |  Spanish  |  Vietnamese    

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In this list

Attorneys

Appearance of Counsel (PDF 159.35 KB)
Attorney Information Change Form (MassCourts, BasCOT & WMS) (PDF 635.32 KB)
Notice of Limited Appearance - District Court (PDF 530.01 KB)

Civil

Appearance of Counsel (PDF 159.35 KB)
General Purpose Motion (PDF 246.5 KB)
Military Affidavit (PDF 35.62 KB)
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Military Affidavit Instructions (PDF 58.55 KB)
Notice of Limited Appearance - District Court (PDF 530.01 KB)
Notice of Voluntary Dismissal (PDF 147.71 KB)
Notice of Withdrawal of Appearance (PDF 146.5 KB)
Request for Default (PDF 149.55 KB)
Request for Default Judgment (PDF 154.78 KB)
Acknowledgment of Satisfaction of Judgment (PDF 14.69 KB)
Springfield District Court Civil CMC Pilot (PDF 497.92 KB)
Statement of Damages Cover Sheet (PDF 161.71 KB)
Statement of Damages Form for Use in Norfolk County Pilot Program (PDF 1.27 MB)
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Stipulation of Dismissal (PDF 153.2 KB)
Trustee Summons (PDF 750.68 KB)
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Verification of Defendant's Address by Plaintiff (PDF 1.33 MB)
Worcester District Court Civil CMC Pilot (PDF 505.77 KB)

Criminal

Assignment of Cash Bail (PDF 15.5 KB)
Consent to Filing Criminal Charge (PDF 13.36 KB)
Defense Certificate of Discovery Compliance (PDF 42.15 KB)
General Purpose Motion (PDF 246.5 KB)
Motion Pursuant to Rule 19(a) for Relief from Election of Jury or Jury-Waived Trial (PDF 545.27 KB)
Petition for Forfeiture (G.L. c. 90 s.24W) (PDF 17.32 KB)
Petition to Seal Record under G.L. c. 276, Section 100C (PDF 1.13 MB)
Pretrial Conference Report - District Court (PDF 56.96 KB)
Prosecution Certificate of Discovery Compliance (PDF 44.8 KB)
Statement of Facts (DC-CR-34) (PDF 13.57 KB)
Tender of Plea or Admission (PDF 94.53 KB)
Waiver of Counsel Pursuant to SJC Rule 3:10 (PDF 1.25 MB)
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Waiver of counsel

Waiver of Counsel Pursuant to SJC Rule 3:10 (PDF 1.25 MB)
This form is also available in Arabic, Chinese, Khmer, Portuguese, Russian, Spanish & Vietnamese. This form may not display properly in your browser. Please download the form and open it using Acrobat reader.

E-filing forms

Fillable Forms for E-Filing Important Information (PDF 32.34 KB)
Military Affidavit for E-filing (PDF 1.64 MB)
Verification of Defendant's Address for E-filing (PDF 731.09 KB)

Eviction

Notice of Transfer to Housing Court - District Court (PDF 896.21 KB)
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Summary Process Complaint (sample form) (PDF 15.79 KB)

Indigency

Indigency (waiver of court fees)
Poverty Threshold Guidelines (PDF 54.77 KB)
Affidavit of indigency (PDF 1.88 MB)
Supplement to the Affidavit of Indigency (PDF 1.44 MB)
Instructions for Users (PDF 105.31 KB)
Inmate's Affidavit of Indigency (PDF 22.53 KB)
Court's Determination Regarding Fees and Costs (PDF 85 KB)

Mental health

Application for 3-Day Commitment (G.L. c. 123, s. 12[e]) (PDF 156.53 KB)
Petition for Commitment for Alcohol or Substance Use Disorder - G. L. c. 123 s. 35 (PDF 965.39 KB)
This form is also available in Arabic, Chinese, Portuguese, Russian, Spanish & Vietnamese. This form may not display properly in your browser. Please download the form and open it using Acrobat reader.
Petition for Commitment Pursuant to G.L. c. 123, s.s. 7 & 8 (PDF 898.16 KB)
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Petition for Commitment Pursuant to G.L. c. 123, s. 16(b) of Defendant Found to be Incompetent or Not Guilty by Reason of Mental Illness or Defect (PDF 898.4 KB)
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Petition for Commitment Pursuant to G.L. c. 123, s. 16(c) of Defendant Found to be Incompetent or Not Guilty by Reason of Mental Illness or Defect (PDF 898.43 KB)
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Petition for Commitment Pursuant to G.L. c. 123, s. 18(a) (PDF 898.11 KB)
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Petition for Determination of Incompetency and for Authorization of Medical Treatment for Mental Illness Pursuant to G.L. c. 123, s. 8B (PDF 1.2 MB)
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Petition for 30 Day Examination and Observation Pursuant to G.L. c. 123, s. 18(a) (PDF 896.71 KB)
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Request for Emergency Hearing (G.L. c. 123 s.s. 12[b]) (PDF 19.27 KB)
Respondent Information Form as Provided by Petitioner - G. L. c. 123 s. 35 (PDF 485.95 KB)
This form is also available in Arabic, Chinese, Portuguese, Russian, Spanish & Vietnamese. This form may not display properly in your browser. Please download the form and open it using Acrobat reader.

Miscellaneous

Application for Utility Company Administrative Warrant (G.L. c. 164 s. 116) (PDF 15.27 KB)
District Court Dispute Resolution Program Report (PDF 2.07 MB)
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District Court Dispute Resolution Program Report Instructions (PDF 492.82 KB)
Filing of Impounded Information (PDF 110.22 KB)
Petition to Find Unsuitability for Firearm Identification Card and Initial Determination (PDF 128.76 KB)
Request for Correction of Clerical Error in Electronic Docket Entry Pursuant to Trial Court Rule XIV, Rule 6 (PDF 1.59 MB)
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Motor vehicle

Petition for Review of License Suspension for Breath Test Refusal (PDF 843.8 KB)

Noncriminal citations

Municipal Notice of Violation (G.L. c. 40, s. 21D and c. 40U, s. 14) (PDF 13.85 KB)
Municipal Notice of Violation (G.L. c. 40, s. 21D) (PDF 12.83 KB)

Restraining order & harassment

Affidavit disclosing care or custody proceeding (OCAJ-1) (PDF 1.01 MB)
Am I Eligible for a Restraining Order? (PDF 15.71 KB)
This poster is also available in Haitian Creole, Khmer, Portuguese, Russian, Spanish & Vietnamese.
Complaint for Protection from Abuse (G.L. c. 209A) (page 1) (PDF 624.34 KB)
Complaint for Protection from Abuse (G.L. c. 209A) (page 2) (PDF 115.25 KB)
Complaint for Protection from Harassment (G.L. c. 258E) (PDF 26.55 KB)
Defendant Information Form (G.L. c. 209A or 258E) (PDF 1.16 MB)
Plaintiff Confidential Information Form (G.L. c. 209A or 258E) (PDF 46.96 KB)
Request for Access to Plaintiff Confidential Information (G.L. c. 209A or 258E) (PDF 17.6 KB)
Motion for Impoundment (G.L. c. 209A or 258E) (PDF 28.98 KB)
Affidavit for Filing Out-of-State Protective Order (G.L. c. 209A or 258E) (PDF 17.27 KB)
Instructions for Police Departments After Court Hours (G.L. c. 209A) (PDF 43.98 KB)
Instructions for Police Departments After Court Hours (G.L. c. 258E) (PDF 18.77 KB)
Plaintiff's Affidavit in Support of Request for a Child Support Order (G.L. c. 209A) (PDF 40.06 KB)
Defendant's Affidavit in Connection with Request for a Child Support Order (G.L. c. 209A) (PDF 39.11 KB)
Plaintiff's Motion to Modify or Terminate Abuse Prevention Order (G.L. c. 209A) (PDF 38.23 KB)
Defendant's Motion to Modify or Terminate Abuse Prevention Order (G.L. c. 209A) (PDF 38.59 KB)
Translation of Affidavit (G.L. c. 209A or 258E) (PDF 33.69 KB)
Notice to Plaintiff Regarding Abuse Prevention Order (PDF 114.18 KB)
Notice to Defendant Regarding Abuse Prevention Order (PDF 80.43 KB)

Small claims

Multilingual Notice (PDF 199.97 KB)
Small Claims Information
This information is also available in Chinese, Haitian Creole, Khmer, Portuguese, Russian, Spanish & Vietnamese.
Small Claims in Massachusetts: What you need to know (PDF 315.12 KB)
This brochure is also available in Chinese, Haitian Creole, Khmer, Portuguese, Russian, Spanish & Vietnamese.
Statement of Small Claim and Notice of Trial (PDF 67.85 KB)
This form is also available in Chinese, Haitian Creole, Khmer, Portuguese, Russian, Spanish & Vietnamese.
Instructions for completing Statement of Small Claim and Notice of Trial
This information is also available in Chinese, Haitian Creole, Khmer, Portuguese, Russian, Spanish & Vietnamese.
Statement of Small Claims and Notice for E-Filing (select District Court, BMC and Housing Court divisions) (PDF 679.67 KB)
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Fillable Forms for E-Filing Important Information (PDF 32.34 KB)
Verification of Defendant's Address by Plaintiff (PDF 541.77 KB)
This form is also available in Chinese, Haitian Creole, Khmer, Portuguese, Russian, Spanish & Vietnamese. This form may not display properly in your browser. Please download the form and open it using Acrobat reader.
Small Claims Answer (PDF 47.37 KB)
This form is also available in Chinese, Haitian Creole, Khmer, Portuguese, Russian, Spanish & Vietnamese.
Small Claims Counterclaim (PDF 47.86 KB)
This form is also available in Chinese, Haitian Creole, Khmer, Portuguese, Russian, Spanish & Vietnamese.
Financial Statement of Judgment Debtor (PDF 247.8 KB)
This form is also available in Chinese, Haitian Creole, Khmer, Portuguese, Russian, Spanish & Vietnamese.
Agreement for Judgment and Payment Order (PDF 128.4 KB)
This form is also available in Chinese, Haitian Creole, Khmer, Portuguese, Russian, Spanish & Vietnamese.
Worksheet for Computing Amount of Wages Exempt from Attachment, Execution and Payment Orders (PDF 29.62 KB)
Defendant's Claim of Appeal (PDF 81.09 KB)
This form is also available in Chinese, Haitian Creole, Khmer, Portuguese, Russian, Spanish & Vietnamese.
Acknowledgment of Satisfaction of Judgment (PDF 14.69 KB)
This form is also available in Chinese, Haitian Creole, Khmer, Portuguese, Russian, Spanish & Vietnamese.
Acknowledgment of Satisfaction of Judgment in Counterclaim (PDF 14.91 KB)
This form is also available in Chinese, Haitian Creole, Khmer, Portuguese, Russian, Spanish & Vietnamese.
Notice of Transfer to Housing Court - District Court (PDF 896.21 KB)

District Court small claims supplemental forms

Appearance of Counsel (PDF 159.35 KB)
Appearance of Substitute Counsel (PDF 12.78 KB)
General Purpose Motion (PDF 246.5 KB)

District Court supplementary process

Supplementary Process Application and Summons (PDF 1.59 MB)
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Supplementary Process Application and Summons for Efiling Only (PDF 734.07 KB)
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