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Designation Form To Indicate Category Of Case For Assignment To Appropriate Calendar Form. This is a Pennsylvania form and can be use in USDC Eastern Federal.
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Tags: Designation Form To Indicate Category Of Case For Assignment To Appropriate Calendar, CIV 609, Pennsylvania Federal, USDC Eastern
UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF PENNSYLVANIA — DESIGNATION FORM to be used by counsel to indicate the category of the case for the purpose of
assignment to appropriate calendar.
Address of Plaintiff:
Address of Defendant:
Place of Accident, Incident or Transaction:
(Use Reverse Side For Additional Space)
Does this civil action involve a nongovernmental corporate party with any parent corporation and any publicly held corporation owning 10% or more of its stock?
(Attach two copies of the Disclosure Statement Form in accordance with Fed.R.Civ.P. 7.1(a))
Yes
Does this case involve multidistrict litigation possibilities?
Yes
9
No
No
9
9
9
RELATED CASE, IF ANY:
Case Number:
Judge
Date Terminated:
Civil cases are deemed related when yes is answered to any of the following questions:
1. Is this case related to property included in an earlier numbered suit pending or within one year previously terminated action in this court?
9
9
Yes
No
2. Does this case involve the same issue of fact or grow out of the same transaction as a prior suit pending or within one year previously terminated
action in this court?
Yes
9
No
9
3. Does this case involve the validity or infringement of a patent already in suit or any earlier numbered case pending or within one year previously
terminated action in this court?
Yes
9
No
9
No
9
4. Is this case a second or successive habeas corpus, social security appeal, or pro se civil rights case filed by the same individual?
Yes
9
U
CIVIL: (Place
in ONE CATEGORY ONLY)
A. Federal Question Cases:
B. Diversity Jurisdiction Cases:
9 Indemnity Contract, Marine Contract, and All Other Contracts
2. 9 FELA
3. 9 Jones Act-Personal Injury
4. 9 Antitrust
5. 9 Patent
6. 9 Labor-Management Relations
7. 9 Civil Rights
8. 9 Habeas Corpus
9. 9 Securities Act(s) Cases
10. 9 Social Security Review Cases
11. 9 All other Federal Question Cases
1.
1.
2.
3.
4.
5.
6.
7.
8.
9.
9
9
9
9
9
9
9
9
9
Insurance Contract and Other Contracts
Airplane Personal Injury
Assault, Defamation
Marine Personal Injury
Motor Vehicle Personal Injury
Other Personal Injury (Please specify)
Products Liability
Products Liability — Asbestos
All other Diversity Cases
(Please specify)
(Please specify)
ARBITRATION CERTIFICATION
(Check appropriate Category)
, counsel of record do hereby certify:
I,
9
Pursuant to Local Civil Rule 53.2, Section 3(c)(2), that to the best of my knowledge and belief, the damages recoverable in this civil action case
exceed the sum of $150,000.00 exclusive of interest and costs;
9
Relief other than monetary damages is sought.
DATE:
Attorney-at-Law
Attorney I.D.#
NOTE: A trial de novo will be a trial by jury only if there has been compliance with F.R.C.P. 38.
I certify that, to my knowledge, the within case is not related to any case now pending or within one year previously terminated action in this court
except as noted above.
DATE:
Attorney-at-Law
CIV. 609 (6/08)
Attorney I.D.#
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