General Civil Case Filing Information Form (Non-Domestic) gasccc-03 Court Superior State CHATHAM County _____________________ STCV Docket # ____________________ Date Filed _____________ MM-DD-YYYY Plaintiff(s) __________________________________ Defendant(s) __________________________________ Last Last First Middle I. Suffix Prefix Maiden First Middle I. Suffix Prefix Maiden __________________________________ __________________________________ Last Last First Middle I. Suffix Prefix Maiden First Middle I. Suffix Prefix Maiden __________________________________ __________________________________ Last Last First Middle I. Suffix Prefix Maiden First Middle I. Suffix Prefix Maiden __________________________________ __________________________________ Last Last First Middle I. Suffix Prefix Maiden No. of Plaintiffs _______ First Middle I. Suffix Prefix Maiden No. of Defendants _______ Plaintiff/Petitioner's Attorney Pro Se __________________________________ Last First Middle I. Suffix Bar # _________________ Check Primary Type (Check only ONE) If Tort is Case Type: (Check no more than TWO) Contract/Account Auto Accident Wills/Estate Premises Liability Real Property Medical Malpractice Dispossessory/Distress Other Professional Negligence Personal Property Product Liability Equity Other Specify ___________________________ Habeas Corpus ________________________________________ Appeals, Reviews Post Judgment Garnishment, Attachment, or Other Relief Are Punitive Damages Pleaded? Yes No Non-Domestic Contempt Tort (If tort, fill in right column) Other General Civil Specify _________________ 15. General Civil Case Filing Information Form (Non-Domestic) 09-05 American LegalNet, Inc. www.FormsWorkFlow.com