Civil Cover Sheet

Form 1.997 Civil Cover Sheet The civil cover sheet and the information contained herein neither replace nor supplement the filing and service of pleadings or other papers as required by law. This form shall be filed by the plaintiff or petitioner for the use of the Clerk of Court for the purpose of reporting judicial workload data pursuant to Florida Statutes section 25.075. (See instructions for completion). I. CASE STYLE (Name of Court) Plaintiff Case #: Judge: vs. Defendant II. 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 in both the main category and subcategory boxes. 037 Condominium 037 Contracts and indebtedness 037 Eminent domain 037 Auto negligence 037 Negligence227other 037 Business governance 037 Business torts 037 Environmental/Toxic tort 037 Third party indemnification 037 Construction defect 037 Mass tort 037 Negligent security 037 Nursing home negligence 037 Premises liability227commercial 037 Premises liability227residential 037 Products liability 037 Real property/Mortgage foreclosure 037 Commercial foreclosure $0 - $50,000 037 Commercial foreclosure $50,001 - $249,999 037 Commercial foreclosure $250,000 or more 037 Homestead Rresidential foreclosure $0 - $50,000 037 Homestead residential foreclosure $50,001 - $249,999 037 Homestead residential foreclosure $250,000 or more 037 Nonhomestead residential foreclosure $0 - $50,000 037 Nonhomestead residential foreclosure $50,001 -$249,999 037 Nonhomestead residential foreclosure $250,000 or more 037 Other real property actions $0 - $50,000 037 Other real property actions $50,001 - $249,999 037 Other real property actions $250,000 or more 037 Professional malpractice American LegalNet, Inc. www.FormsWorkFlow.com 037 Malpractice227business 037 Malpractice227medical 037 Malpractice227other professional 037 Other 037 Antitrust/Trade regulation 037 Business transactions 037 Constitutional challenge227statute or ordinance 037 Constitutional challenge227proposed amendment 037 Corporate trusts 037 Discrimination227employment or other 037 Insurance claims 037 Intellectual property 037 Libel/Slander 037 Shareholder derivative action 037 Securities litigation 037 Trade secrets 037 Trust litigation 10 III. REMEDIES SOUGHT (check all that apply): 037 monetary; 037 nonmonetary declaratory or injunctive relief; 037 punitive IV. NUMBER OF CAUSES OF ACTION: [ ] (specify) V. IS THIS CASE A CLASS ACTION LAWSUIT? 037 yes 037 no VI. HAS NOTICE OF ANY KNOWN RELATED CASE BEEN FILED? 037 no 037 yes If yes, list all related cases by name, case number, and court. VII. IS JURY TRIAL DEMANDED IN COMPLAINT? 037 yes 037 no I CERTIFY that the information I have provided in this cover sheet is accurate to the best of my knowledge and belief. Signature Fla. Bar # Attorney or party (Bar # if attorney) (type or print name) Date American LegalNet, Inc. www.FormsWorkFlow.com