Superior Court of the District of Columbia CIVIL DIVISION- CIVIL ACTIONS BRANCH INFORMATION SHEET ________________________________________ vs ________________________________________ Name: (Please Print) Firm Name: Telephone No.: Six digit Unified Bar No.: 6 Person Jury Case Number: ____________________________________ Date: __________________________________________ One of the defendants is being sued in their official capacity. Relationship to Lawsuit Attorney for Plaintiff Self (Pro Se) Other: __________________ 12 Person Jury Other: ___________________________________ Calendar #:_______________________ Calendar#:_______________________ TYPE OF CASE: Non-Jury Demand: $____________________________ PENDING CASE(S) RELATED TO THE ACTION BEING FILED Case No.:______________________ Judge: __________________ Case No.:______________________ NATURE OF SUIT: A. CONTRACTS 01 Breach of Contract 02 Breach of Warranty 06 Negotiable Instrument 07 Personal Property 13 Employment Discrimination 15 Special Education Fees Judge: ___________________ (Check One Box Only) COLLECTION CASES 14 Under $25,000 Pltf. Grants Consent 17 OVER $25,000 Pltf. Grants Consent 27 Insurance/Subrogation Over $25,000 Pltf. Grants Consent 07 Insurance/Subrogation Under $25,000 Pltf. Grants Consent 28 Motion to Confirm Arbitration Award (Collection Cases Only) 16 Under $25,000 Consent Denied 18 OVER $25,000 Consent Denied 26 Insurance/Subrogation Over $25,000 Consent Denied 34 Insurance/Subrogation Under $25,000 Consent Denied B. PROPERTY TORTS 01 Automobile 03 Destruction of Private Property 02 Conversion 04 Property Damage 07 Shoplifting, D.C. Code § 27-102 (a) 05 Trespass C. PERSONAL TORTS 01 Abuse of Process 02 Alienation of Affection 03 Assault and Battery 04 Automobile- Personal Injury 05 Deceit (Misrepresentation) 06 False Accusation 07 False Arrest 08 Fraud 10 Invasion of Privacy 17 Personal Injury- (Not Automobile, 11 Libel and Slander Not Malpractice) 12 Malicious Interference 18Wrongful Death (Not Malpractice) 13 Malicious Prosecution 16 19 Wrongful Eviction 14 Malpractice Legal 20 Friendly Suit 15 Malpractice Medical (Including Wrongful Death) 21 Asbestos 16 Negligence- (Not Automobile, 22 Toxic/Mass Torts Not Malpractice) 23 Tobacco 24 Lead Paint SEE REVERSE SIDE AND CHECK HERE IF USED CV-496/June 2015 American LegalNet, Inc. www.FormsWorkFlow.com Information Sheet, Continued C. OTHERS 01 Accounting 02 Att. Before Judgment 05 Ejectment 09 Special Writ/Warrants (DC Code § 11-941) 10 Traffic Adjudication 11 Writ of Replevin 12 Enforce Mechanics Lien 16 Declaratory Judgment 17 Merit Personnel Act (OEA) (D.C. Code Title 1, Chapter 6) 18 Product Liability 24 Application to Confirm, Modify, Vacate Arbitration Award (DC Code § 16-4401) 29 Merit Personnel Act (OHR) 31 Housing Code Regulations 32 Qui Tam 33 Whistleblower II. 03 Change of Name 15 Libel of Information 06 Foreign Judgment/Domestic 19 Enter Administrative Order as 08 Foreign Judgment/International Judgment [ D.C. Code § 13 Correction of Birth Certificate 2-1802.03 (h) or 32-151 9 (a)] 14 Correction of Marriage 20 Master Meter (D.C. Code § Certificate 42-3301, et seq.) 26 Petition for Civil Asset Forfeiture (Vehicle) 27 Petition for Civil Asset Forfeiture (Currency) 28 Petition for Civil Asset Forfeiture (Other) 21 Petition for Subpoena [Rule 28-I (b)] 22 Release Mechanics Lien 23 Rule 27(a)(1) (Perpetuate Testimony) 24 Petition for Structured Settlement 25 Petition for Liquidation D. REAL PROPERTY 09 Real Property-Real Estate 12 Specific Performance 04 Condemnation (Eminent Domain) 10 Mortgage Foreclosure/Judicial Sale 11 Petition for Civil Asset Forfeiture (RP) 08 Quiet Title 25 Liens: Tax / Water Consent Granted 30 Liens: Tax / Water Consent Denied 31 Tax Lien Bid Off Certificate Consent Granted __________________________________ Attorney's Signature ______________________________ Date CV-496/ June 2015 American LegalNet, Inc. www.FormsWorkFlow.com