COVER SHEET STATE OF ARKANSAS CIRCUIT COURT: CIVIL 1 /1/2017 The civil reporting form and the information contained herein shall not be admissible as evidence in any court proceeding or replace or supplement the filing and service of pleadings, orders, or other papers as required by law or Supreme Court Rule. This form is required pursuant to Administrative Order Number 8. Instructions are available at .gov. 1/1/2017 County: District: Filing Date: Judge: Division: Case ID: Type of case (select one that best describes the subject matter) Plaintiff Defendant Company/ Last Name Company/ Last Name Suffix Suffix First Name First Name DL/State ID DL/State ID Address Address City, State ZIP City, State ZIP Phone Phone Email Email Self - represented Self - represented DOB DOB Interpreter needed? Interpreter needed? Attorney of Record: Bar #: For the: Email Address: Related Case(s): Judge: Case ID(s): Manner of filing (choose one): American LegalNet, Inc. www.FormsWorkFlow.com