Civil Cover Sheet With Affirmation Pursuant To NRS 3.275

DISTRICT COURT CIVIL COVER SHEET WASHOE Case No. (Assigned by Clerk's Office) County, Nevada I. Party Information (provide both home and mailing addresses if different) Plaintiff(s) (name/address/phone): Defendant(s) (name/address/phone): Attorney (name/address/phone): Attorney (name/address/phone): II. Nature of Controversy (please select the one most applicable filing type below) Civil Case Filing Types Real Property Landlord/Tenant Unlawful Detainer (UD) Other Landlord/Tenant (LT) Title to Property Judicial Foreclosure (FC) Other Title to Property (OT) Other Real Property Condemnation/Eminent Domain (CD) Negligence Auto (VP) Premises Liability (SF) Other Negligence (NO) Malpractice Medical/Dental (MD) Legal (LG) Accounting (AG) Other Malpractice (MG) Construction Defect & Contract Construction Defect Chapter 40 (CQ) Other Construction Defect (CF) Contract Case Uniform Commercial Code (UN) Building and Construction (BC) Insurance Carrier (BF) Commercial Instrument (CI) Collection of Accounts (CT) Employment Contract (EC) Other Contract (CO) Civil Writ Torts Other Torts Product Liability (PL) Intentional Misconduct (IM) Employment Tort (WT) Insurance Tort (IN) Other Tort (TO) Other Real Property (RO) Probate Probate (select case type and estate value) Summary Administration (SU) General Administration (FA) Special Administration (SL) Set Aside (SE) Trust/Conservatorship (TN) Other Probate (OP) Estate Value Over $200,000 Between $100,000 and $200,000 Under $100,000 or Unknown Under $2,500 Judicial Review/Appeal Judicial Review Foreclosure Mediation Case (FO) Petition to Seal Records (PS) Mental Competency (MT) Nevada State Agency Appeal Department of Motor Vehicle (DM) Worker's Compensation (SI) Other Nevada State Agency (ON) Appeal Other Appeal from Lower Court (CA) Other Judicial Review/Appeal (AO) Other Civil Filing Civil Writ Writ of Habeas Corpus (HB) Writ of Mandamus (WM) Writ of Quo Warrant (WQ) Writ of Prohibition (WP) Other Civil Writ (WO) Other Civil Filing Compromise of Minor's Claim (CM) Foreign Judgment (FJ) Other Civil Matters (GC) Business Court filings should be filed using the Business Court civil coversheet. Date Signature of initiating party or representative Nevada AOC - Research Statistics Unit Pursuant to NRS 3.275 \ Rev 3.1 \ July 1, 2014 American LegalNet, Inc. www.FormsWorkFlow.com Form PA 201 Rev 3.1