Summit County Court of Common Pleas Civil Division NEW CASE DESIGNATION FORM Primary Plaintiff: For Official Use Only: Case No: vs Primary Defendant: Judge: Jury Demanded? Refiled Case? Previous Case Number: Previous judge: Torts PCOM Personal Injury LCOM LMCO Product Liability Legal Malpractice MMCO Medical Malpractice DMCO Dental Malpractice WDCO Wrongful Death Real Property PTCO QTCO FCOM Partition Quiet Title Foreclosure - Enter required parcel information below Money CGCO CBCO PNCO Cognovit Note Creditor's Bill Promissory Note Miscellaneous BACO BLCO Breach of Agreement Breach of Lease BCOM Breach of Contract BWCO Breach of Warranty DCOM Declaratory Judgment FORJ INCO RPCO SCOM AARB DICO CCLA UCSV WCAS AAPP Foreign Judgment Injunction Replevin Subrogation Arbitration Discrimination Sex Offender Classification Consumer Sales Practice Violation Workers Compensation Asbestos Appeal Administrative Appeal MCOM Money Due Parcel Number: Parcel Address: City: Other State: Zip: WCOM Workers Compensation Attorney Information: Attorney Name: Firm Name: Address: Address: City: Phone: CV Form 001 Address Change? Attorney Signature s/ State: Zip: Supreme Court Number American LegalNet, Inc. www.FormsWorkFlow.com Rev 1.4 20131002