Annie Rebecca Elliott Fort Bend County District Clerk 301 Jackson Street Richmond, Texas 77469 Telephone 281-341-4509 Fax 281-341-4519 CIVIL CASE INFORMATION SHEET CAUSE NUMBER (FOR CLERK USE ONLY): _______________________________ COURT (FOR CLERK USE ONLY): ______________________ STYLED ____________________________________________________________________ (e.g., John Smith v. All American Insurance Co; In re Mary Ann Jones; In the Matter of the Estate of George Jackson) A civil case information sheet must be completed and submitted when an original petition or application is filed to initiate a new civil, family law, probate, or mental health case or when a post-judgment motion for modification or enforcement is filed in a family law case. The information should be the best available at the time of filing. This sheet, approved by the Texas Judicial Council, is intended to collect information that will be used for statistical purposes only. It neither replaces nor supplements the filings or service of pleading or other documents as required by law or rule. The sheet does not constitute a discovery request, response, or supplementation, and it is not admissible at trial. 1. Contact information for person completing case information sheet: Name: ___________________________ Email: __________________________ Address: ___________________________ Telephone: __________________________ City/State/Zip: ___________________________ Fax: __________________________ Signature: State Bar No: __________________________ Names of parties in case: Plaintiff(s)/Petitioner(s): _______________________________ _______________________________ _______________________________ Defendant(s)/Respondent(s): _______________________________ _______________________________ _______________________________ __________________________ Person or entity completing sheet is: Attorney for Plaintiff/Petitioner Pro Se Plaintiff/Petitioner Title IV-D Agency Other: _________________________ Additional Parties in Child Support Case: Custodial Parent: ____________________________ Non-Custodial Parent: ____________________________ Presumed Father: ____________________________ [Attach additional page as necessary to list all parties] 2. Indicate case type, or identify the most important issue in the case (select only 1): Civil Contract Debt/Contract Consumer/DTPA Debt/Contract Fraud/Misrepresentation Other Debt/Contract: _____________________ Foreclosure Home Equity—Expedited Other Foreclosure Franchise Insurance Landlord/Tenant Non-Competition Partnership Other Contract: ______________________ Employment Discrimination Retaliation Termination Workers’ Compensation Other Employment: ______________________ Family Law Injury or Damage Assault/Battery Construction Defamation Malpractice Accounting Legal Medical Other Professional Liability: _____________ Motor Vehicle Accident Premises Product Liability Asbestos/Silica Other Product Liability List Product: ____________________ Other Injury or Damage: _____________________ Real Property Eminent Domain/ Condemnation Partition Quiet Title Trespass to Try Title Other Property: ________________ Related to Criminal Matters Expunction Judgment Nisi Non-Disclosure Seizure/Forfeiture Writ of Habeas Corpus— Pre-indictment Other: ______________ Other Civil Administrative Appeal Antitrust/Unfair Competition Code Violations Foreign Judgment Intellectual Property Lawyer Discipline Perpetuate Testimony Securities/Stock Tortious Interference Other: ______________ Marriage Relationship Annulment Declare Marriage Void Divorce With Children No Children Other Family Law Enforce Foreign Judgment Habeas Corpus Name Change Protective Order Removal of Disabilities of Minority Other: _____________ Post-judgment Actions (non-Title IV-D) Enforcement Modification—Custody Modification—Other Title IV-D Enforcement/Modification Paternity Reciprocals (UIFSA) Support Order Parent-Child Relationship Adoption/Adoption with Termination Child Protection Child Support Custody or Visitation Gestational Parenting Grandparent Access Paternity/Parentage Termination of Parental Rights Other Parent-Child: __________________ American LegalNet, Inc. www.FormsWorkFlow.com Tax Tax Appraisal Tax Delinquency Other Tax Probate & Mental Health Probate/Wills/Intestate Administration Dependent Administration Independent Administration Other Estate Proceedings 3. Indicate procedure or remedy, if applicable (may select more than 1): Appeal from Municipal or Justice Court Declaratory Judgment Arbitration-related Garnishment Attachment Interpleader Bill of Review License Certiorari Mandamus Class Action Post-judgment Guardianship—Adult Guardianship—Minor Mental Health Other: ______________________ Prejudgment Remedy Protective Order Receiver Sequestration Temporary Restraining Order/Injunction Turnover 4. Has this case been previously filed, or does it relate to a case previously filed, in this county or in another county or state? □ NO □ YES, in another county or state; County____________ State_________ Cause #___________________ □ YES, in this county; Court; ____________ Cause #___________________ 5. Is a Pauper’s Oath/Affidavit of Indigency and an IOLTA Certificate being filed with this suit? □ YES, with Pauper’s Oath/Affidavit of Indigency □ YES, with Pauper’s Oath/Affidavit of Indigency and IOLTA Certificate □ NO American LegalNet, Inc. www.FormsWorkFlow.com Instructions for Completing the Texas Civil Case Information Sheet A civil case information sheet must be completed and submitted when an original petition or application is filed to initiate a new civil, family law, probate, or mental health case or when a post-judgment motion for modification or enforcement is filed in a family law case. The information should be the best available at the time of filing. If the original petition, application or post-judgment motion is e-filed, the case information sheet must not be the lead document. This sheet, approved by the Texas Judicial Council, is intended to collect information that will be used for statistical purposes only. It neither replaces nor supplements the filings or service of pleading or other documents as required by law or rule. The sheet does not constitute a discovery request, response, or supplementation, and it is not admissible at trial. The attorney or self-represented (pro se) plaintiff/petitioner filing the case or post-judgment motion should complete the sheet as follows: 1. Contact information a) Contact information for person completing case information sheet. Enter the following information: name; address; city, state, and zip code; email address; telephone number; fax number, if available; State Bar number, if the person is an attorney; and signature. b) Names of parties in the case. Enter the name(s) of the: plaintiff(s) or petitioner(s); defendant(s) or respondent(s); and in child support cases, additional parties in the case, including the: custodial parent; non-custodial parent; and presumed father. Attach an additional page as necessary to list all parties. c) Person or entity completing sheet is. Indicate whether the person completing the sheet, or the entity for which the sheet is being completed, is: an attorney for the plaintiff or petitioner; a pro se (self-represented) plaintiff or petitioner; the Title IV-D agency; or other (provide name of person or entity). 2. Case type. Select the case category that best reflects the most important issue in the case. You must select only one. American LegalNet, Inc. www.FormsWorkFlow.com 3. Procedure or remedy. If applicable, select any of the available procedures or remedies being sought in the case. You may select more than one. 4. Has this case been previously filed, or does it relate to a case previously filed, in this county or in another county or state? Select the proper check box and provide additional information if applicable. 5. Is a Pauper’s Oath/Affidavit or Indigency and an IOLTA Certificate being filed with this suit? Select the proper check box. American LegalNet, Inc. www.FormsWorkFlow.com