SUPERIOR COURT CIVIL CASE INFORMATION STATEMENT (CIS) COUNTY: N K S CIVIL ACTION NUMBER: Caption: Civil Case Code: Civil Case Type: (S EE R EVERSE S IDE FOR C ODE AND T YPE ) M ANDATORY N ON - B INDING A RBITRATION (MNA) Name and Status of Party filing document: Document Type :( E . G .; C OMPLAINT ; A NSWER WITH COUNTERCL AIM ) J URY D EMAND : Y ES N O A TTORNEY N AME ( S ): A TTORNEY ID ( S ): F IRM N AME : A DDRESS : T ELEPHONE N UMBER : F AX N UMBER : E - M AIL A DDRESS : I DENTIFY ANY RELATED CASES NOW PENDING IN THE SUPERIOR COURT OR ANY RELATED CASES THAT H AVE BEEN CLOSED IN T HIS COURT WITHIN THE LAST TWO YEARS BY CAPTION AND CIVIL ACTION NU MBER INCLUDING JUDGE S INITIALS : E XPLAIN THE RELATIONS HIP ( S ): O THER UNUSUAL ISSUES THAT AFFECT C ASE M ANAGEMENT : (I F ADDITIONAL SPACE I S NEEDED , PLEASE ATTACH PAGE ) T HE P ROTHONOTARY WIL L NOT PROCESS THE CO MPLAINT , ANSWER , OR FIRST RESPONSIVE PLEADING IN THIS MA TTER FOR SERVICE UNT IL THE CASE INFORMATION STATEMENT ( CIS ) IS FILED . T HE FAILURE TO FILE T HE CIS AND HAVE THE PLEADING PROCESSED F OR SERVICE MAY RESULT IN THE DISMIS SAL OF THE CO MPLAINT OR MAY RESUL T IN THE ANSWER OR F IRST RESPONSIVE PLEA DING BEING STRICKEN . Revised 01/2019 American LegalNet, Inc. www.FormsWorkFlow.com SUPERIOR COURT CIVIL CASE INFORMATION STATEMENT (CIS) INSTRUCTIONS CIVIL CASE TYPE Please select the appropriate civil case code and case type (e.g., COD E - AADM and TYPE - Administrative Agency ) from the list below. Enter this information in the designated spaces on the Case Information Statement. APPEALS AADM - Administrative Agency ACER - Certiorari ACCP - Court of Common Pleas AIAB - Industrial Accident Board APSC - Public Service Commission AUIB - Unemployment Insurance Appeal Board COMPLAINTS CABT Abatement CASB Asbestos CAAA - Auto Arb Appeal CMIS - Civil Miscellaneous CACT - Class Action CCON Condemnation CCLD Complex Commercial Litigation Division (NCC ONLY) CDBT - Debt/Breach of Contract CDEJ - Declaratory Judgment CDEF - Defamation CEJM - Ejectment CATT - Foreign & Domestic Attachment CFJG - Foreign Judgment CFRD - Fraud Enforcement CINT - Interpleader CLEM - Lemon La w CLIB - Libel CMAL - Malpractice CMED - Medical Malpractice CPIN - Personal Injury CPIA - Personal Injury Auto CPRL - Products Liability CPRD - Property Damage CRPV - Replevin CSPD - Summary Proceedings Dispute CCCP - Transfer from CCP CCHA - Transfer from Chancery MASS TORT CABI Abilify Cases CBEN - Benzene Cases CHON - Honeywell Cases CMON - Monsanto Cases CPEL - Pelvic Mesh Cases CPLX - Plavix Cases CPPI - PPI Cases CTAL - Talc Cases CTAX - Taxotere Cases CXAR - Xarelto Cases INVOL UNTARY COMMITMENTS INVC - Involuntary Commitment MISCELLANEOUS MAGM - AG Motion - Civil/Criminal Investigations * MADB - Appeal from Disability Board * MAFF - Application for Forfeiture MAAT - Appointment of Attorney MGAR - Appointment of Guardianship M CED - Cease and Desist Order MCON - Civil Contempt/Capias MCVP - Civil Penalty MSOJ - Compel Satisfaction of Judgment MSAM - Compel Satisfaction of Mortgage MCTO - Consent Order MIND - Destruction of Indicia of Arrest * MESP - Excess Sheriff P roceeds MHAC - Habeas Corpus MTOX - Hazardous Substance Cleanup MFOR - Intercept of Forfeited Money MISS - Issuance of Subpoena MLEX - Lien Extension MMAN - Mandamus MWIT - Material Witness * MWOT - Material Witness - Out of State MRAT - Motion for Risk Assessment MROP - Petition for Return of Property MCRO - Petition Requesting Order MROD - Road Resolution MSEL - Sell Real Estate for Property Tax MSEM - Set Aside Satisfaction of Mortgage MSSS - Set Aside Sheriff's Sale MSET - Structure d Settlement MTAX - Tax Ditches MREF - Tax Intercept MLAG - Tax Lagoons MVAC - Vacate Public Road MPOS - Writ of Possession MPRO - Writ of Prohibition MORTGAGES MCOM - Mortgage Commercial MMED - Mortgage Mediation MORT - Mortgage Non - Mediation (Re s.) MECHANICS LIENS LIEN - Mechanics Lien * Not eFiled DUTY OF THE PLAINTIFF Each plaintiff/counsel shall complete the attached Civil Case Information Statement (CIS) and file with the complaint. DUTY OF THE DEFENDANT Each defendant/counsel shall c omplete the attached Civil Case Information Statement (CIS) and file with the answer and/or first responsive pleading. Revised 0 6 /201 9 American LegalNet, Inc. www.FormsWorkFlow.com