The civil cover sheet and the information contained in it neither replace nor supplement the filing and service of pleadings or other documents as required by law. This form must be filed by the plaintiff or petitioner with the Clerk of Court for the purpose of reporting uniform data pursuant to section 25.075, Florida Statutes. (See instructions for completion.)
_______________________________________________________________
I. CASE STYLE
(Name of Court)_________________ .
Plaintiff _____________ Case # _________________
Judge _____________________
vs.
Defendant ____________________
__________________________________________________________
II. AMOUNT OF CLAIM
Please indicate the estimated amount of the claim, rounded to the nearest dollar. The estimated amount of the claim is requested for data collection and clerical processing purposes only. The amount of the claim shall not be used for any other purpose.
_____ $8,000 or less
_____ $8,001 – $30,000
_____ $30,001- $50,000
_____ $50,001- $75,000
_____ $75,001-$100,000
_____ over $100,000.00
III. TYPE OF CASE (If the case fits more than one type of case, select the most definitive category.) If the most descriptive label is a subcategory (is indented under a broader category), place an x on both the main category and subcategory lines.
CIRCUIT CIVIL
______ Condominium
______ Contracts and indebtedness
______ Eminent domain
______ Auto negligence
______ Negligence-other
______ Business governance
______ Business torts
______ Environmental/Toxic tort
______ Third party indemnification
______ Construction defect
______ Mass tort
______ Negligent security
______ Nursing home negligence
______ Premises liability-commercial
______ Premises liability-residential
______ Products liability
___ Real property/Mortgage foreclosure
_____ Commercial foreclosure
_____ Homestead residential foreclosure
_____ Non-homestead residential foreclosure
_____ Other real property actions
______ Professional malpractice
______ Malpractice-business
______ Malpractice-medical
______ Malpractice-other professional
______ Other
______ Antitrust/Trade regulation
______ Business transactions
______ Constitutional challenge-statute or ordinance
______ Constitutional challenge-proposed amendment
______ Corporate trusts
______ Discrimination-employment or other
______ Insurance claims
______ Intellectual property
______ Libel/Slander
______ Shareholder derivative action
______ Securities litigation
______ Trade secrets
______ Trust litigation
COUNTY CIVIL
______ Civil
______ Real Property/Mortgage foreclosure
______ Replevins
______ Evictions
______ Residential Evictions
______ Non-residential Evictions
______ Other civil (non-monetary)
IV. REMEDIES SOUGHT (check all that apply):
______ Monetary;
______ Nonmonetary declaratory or injunctive relief;
______ Punitive
V. NUMBER OF CAUSES OF ACTION: [ ]
(Specify) _____________________________________________________
_____________________________________________________________
VI. IS THIS CASE A CLASS ACTION LAWSUIT?
___ yes
___ no
VII. HAS NOTICE OF ANY KNOWN RELATED CASE BEEN FILED?
_____ no
__ yes If “yes,” list all related cases by name, case number, and court. ___
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
VIII. IS JURY TRIAL DEMANDED IN COMPLAINT?
___ yes
___ no
I CERTIFY that the information I have provided in this cover sheet is accurate to the best of my knowledge and belief, and that I have read and will comply with the requirements of Florida Rule of Judicial Administration 2.425.
Signature _________________ Fla. Bar #/__________________
Attorney or party (Bar # if attorney)
_____________________________________________________________
(type or print name) Date.