STATE OF NORTH CAROLINA County Name Of Petitioner 1 Name Of Petitioner 2 Name Of Petitioner 3 File No. In The General Court Of Justice Superior Court Division SPECIAL PROCEEDINGS ACTION COVER SHEET Rule 5(b), Rules of Practice For Superior and District Courts VERSUS Name Of Respondent 1 Name And Address Of Attorney Or Party If Not Represented (complete for initial appearance or change of address) Summons Submitted Yes No Attorney Bar No. Name Of Respondent 2 Initial Appearance in Case Yes No Name Of Firm Change of Address Summons Submitted Name Of Respondent 3 Telephone No. Counsel for FAX No. Summons Submitted Yes No All Petitioners All Respondents Only (List party(ies) represented) APPLICATION (check appropriate box) Adoption (ADOP) Appointing Guardian Ad Litem (AGAL) Amend (AMND) Add Additional Party (ADOP) Attorney Fees (ATFE) No Motion Fee Assessed If Sole Claim Boundary Settlement (BNDR) Cartway (CART) Change Of Venue (CHVN) Compel (CMPL) Condemnation - Private Condemnor/Mill (CNDM) Continue (CNTN) Costs (COST) No Motion Fee Assessed If Sole Claim Determine Owner Surplus Funds (DOSF) Decedent Estate - Sell Land To Create Assets (PESE) Decedent's Estate - Sell Personal Property (SLPS) Dismiss (Involuntary) (DISM) Drainage - Individual/Corporation (DRNG) Drainage District - Establishment (DRDS) Extension Of Time (EXTM) Foreclosure (FORE) Date Incompetency (INCM) Land Registration - Torrens Act (TORR) Legitimation (LGMT) Lis Pendens (LISP) Minor's Estate - Disburse Funds (DFND) Minor's/Incompetent Person's Estate Sale/Lease/Mortgage (MIES) Motor Vehicle Lien G.S. 44A (MVLN) Name Change (NAME) Partition (PART) Restoration To Competency (RTCO) Sterilization (STRL) To Determine Heirs (TDHE) Transfer Of Title (TOTL) Voluntary Dismissal (VOLD) Year's Allowance - Spouse/Child (SSCA) Other (specify and list separately) Signature Of Attorney/Party All filings in special proceedings shall include as the first page of the filing a cover sheet summarizing the critical elements of the filing in a format prescribed by the Administrative Office of the Courts, and the Clerk of Superior Court shall require a party to refile a filing which does not include the required cover sheet. For subsequent filings the filling party must include either a Special Proceedings (AOC-SP-550), Motion (AOC-CV-752), or Court Action (AOC-CV-753) cover sheet. (Over) American LegalNet, Inc. www.FormsWorkFlow.com NOTE: AOC-SP-550, Rev. 1/14 © 2014 Administrative Office of the Courts No. Additional Petitioner(s) No. Additional Respondent(s) Summons Submitted Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No No No No No No No No No No No No AOC-SP-550, Side Two, Rev. 1/14 © 2014 Administrative Office of the Courts American LegalNet, Inc. www.FormsWorkFlow.com