Disclosure Statement (Civil)

IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA ) ) ) ) ) ) Plaintiff(s), ) ) v. ) ) _________________________________ ) _________________________________ ) _________________________________ ) _________________________________ ) _________________________________, ) ) Defendant(s)/ ) Third-Party Plaintiff(s), ) ) v. ) ) _________________________________ ) _________________________________ ) _________________________________ ) _________________________________ ) _________________________________, ) ) Third-Party Defendant(s). ) ____________________________________) _________________________________ _________________________________ _________________________________ _________________________________ _________________________________, Civil Action No. ________________ DISCLOSURE STATEMENT PURSUANT TO Fed. R. Civ. P. 7.1 (Civil Action) Pursuant to Rule 7.1 of the Federal Rules of Civil Procedure, ____________________, (type of party) who is ________________________________________, makes the following disclosure: (name of party) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 1. Is the party a non-governmental corporate party? 9 YES 2. 9 NO If the answer to Number 1 is "yes," list below any parent corporation or state that there is no such corporation: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 3. If the answer to Number 1 is "yes," list below any publicly-held corporation that owns 10% or more of the party's stock or state that there is no such corporation: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ The undersigned party understands that under Rule 7.1 of the Federal Rules of Civil Procedure, it must promptly file a supplemental statement upon any change in the information that this statement requires. __________________________________ Signature of Counsel for Party Date: ___________________ Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com