New Case Information Sheet

10/1 CC7-1 TWENTY-THIRD JUDICIAL CIRCUIT NEW CASE INFORMATION SHEET Case No.: Plaintiff/Petitioner Defendant/Respondent File Stamp All Parties must be listed on new case filing sheet, or on an attached sheet following the same format as below. (PLEASE TYPE OR PRINT). 1.Case Type 2.Sub Case Type 3.Claim Amount 4.Jury (See reverse for codes) (See reverse for codes) (yes/no) 5.Return date/time (where return date summons is used) 6. 7.First named Plaintiff : Address:: : Phone #: 8.Additional Plaintiff/AKA/DBA/FKA/NKA/Other: Address: Phone #: 9.Additional Plaintiff/AKA/DBA/FKA/NKA/Other: Address: Phone #: 10. First named Defendant:Address: Phone #: 11.Additional Defendant/AKA/DBA/FKA/NKA/Other: Address: Phone #: 12.Additional Defendant/AKA/DBA/FKA/NKA/Other: Address: Phone #: State/Zip Code: State/Zip Code: State/Zip Code: State/Zip Code:State/Zip Code::::: : American LegalNet, Inc. www.FormsWorkFlow.com Law (L) ($50,001 & over) 0101 TORT $ DAMG AUTO-PROP 0102 TORT $ DAMG AUTO-PROP/PER INJ 0103 TORT $ DAMG AUTO-PER INJ 0104 TORT $ DAMG AUTO-PER INJ/DEATH 0105 TORT $ DAMG AUTO-DEATH 0106 TORT $ DAMG AUTO-OTHER 0107 CONTRACT 226 MONEY DAMAGES 0108 CONFESSION OF JUDGMENT 0109 226 POSS/$0110 226 POSS ONLY 0111 DISTRESS FOR RENT 0112 STAT ACT / STATE / RECR SUPPT 0113 ARBITRATION & AWARD 0114 DETINUE 0115 EJECTMENT 0116 REPLEVIN 0117 TROVER 0118 MALPRACTICE 226 MEDICAL 0119 MALPRACTICE 226 LEGAL 0120 MALPRACTICE 226 OTHER 0121 ALIENATION OF AFFECTION 0122 CLASS ACTION SUIT 0123 REGISTRATION OF FOREIGN JUDG 0130 OTHER (SPECIFY) 0131 CHANGE OF VENUE 226 TRANSFER LAW MAGISTRATE (LM) ($0 - $15,000) 0208 CONFESSION OF JUDGMENT 0210 226 POSS/$ 0211 DISTRESS FOR RENT 0214 DETINUE 0215 EJECTMENT 0216 REPLEVIN 0217 TROVER 0223 REGISTRATION OF FOREIGN JUDG LAW MAGISTRATE (LM) ($10,001 - $50,000) 0201 TORT $ DAMG AUTO-PROP 0202 TORT $ DAMG AUTO-PROP/PER INJ 0203 TORT $ DAMG AUTO-PER INJ 0204 TORT $ DAMG AUTO-PER INJ/DEATH 0205 TORT $ DAMG AUTO-DEATH 0206 TORT $ DAMG - OTHER 0207 CONTRACT 226 MONEY DAMAGES 0212 STAT ACT TRECR SUPPT 0213 ARBITRATION & AWARD 0218 MALPRACTICE 226 MEDICAL 0219 MALPRACTICE 226 LEGAL 0220 MALPRACTICE 226 OTHER 0221 ALIENATION OF AFFECTION 0222 CLASS ACTION SUIT 0223 REGISTRATION OF FOREIGN JUDG 0224 FORCE ENTRY/DETAINER 226 POSS ONLY 0230 OTHER (SPECIFY) 0231 CHANGE OF VENUE 226 TRANSFER SMALL CLAIMS (SC) ($0 - $10,000) 0301 CONTRACT 226 MONEY DAMAGES 0302 TORT $ DAMG AUTO 0303 TORT $ DAMG 226 OTHER 0304 COLLECTION OF TAXES 0305 REGISTRATION OF FOREIGN JUDG 0330 OTHER (SPECIFY) 0331 CHANGE OF VENUE 226 TRANSFER TAX (TX) 0401 RECOVER DELIN PERS PROP TAX 0402 RETAILERS OCCUPATION TAX 0403 PETITION FOR TAX REFUND 0404 TAX FORCLOSURE 0405 TAX INJUNCTION Rev 07/17 0406 ANNUAL TAX SALE 0407 SCAVENGER TAX SALE 0408 TAX OBJECTION 0409 TAX COMMISSION-REVIEW OF DECISION 0410 DRAINAGE ASSESSMENT 0411 SPECIAL ASSESSMENT 0412 FORCLOSURE LEIN SPEC ASSESSMENT 0413 SUIT RESTRAIN COLLECT SPEC ASSESS 0414 TAX DEED 0415 PETITION FOR RECOVERY 0416 REGISTRATION OF FOREIGN JUDGMENT 0417 SALE IN ERROR 0430 OTHER (SPECIFY) EMINENT DOMAIN (ED) 0501 CONDEMNATION 0530 OTHER (SPECIFY) MISCELLANEOUS REMEDIES (MR) 0601 JUD REVIEW OF ADM AGCY (not tax) 0602 JUD REVIEW 226 WORKERS COMP 0603 JUD REVIEW 226 UNEMPLOYMENT 0604 DECLARATORY JUDGMENT 0605 CORPORATION DISSOLUTION 0606 CHANGE OF NAME 0607 HABEAS CORPUS 0608 MANDAMUS 0609 PROHIBITION 0610 QUO WARRENTO 0611 ATTACHMENT/ORIGINAL ACTION 0612 NEEXEAT/ORIGINAL ACTION 0613 ESCHEAT 0614 LOST GOODS OR MONEY 0615 BURNT RECORDS 0616 ELECTION CONTEST 0617 DISCOVERY 0618 SEARCH WARRANT 0619 FORFEITURE/SEIZED PROP 0621 REGISTRATION OF FICTITIOUS RECORD 0622 SEX TRANSMISS DISEASE CONTROL ACT 0623 CONTAGIOUS/INFECTIOUS DISEASE 0624 REGISTRATION OF FOREIGN JUDGMENT 0625 PETN ISSUE FOREIGN SUBPOENA 0626 EAVESDROPPING/CRIM SURVEILLANCE 0627 DEMOLITION 0628 EXTRADITION 0629 RENDITION 0630 OTHER (SPECIFY) 0631 SEXUALLY VIOLENT PERSON 0632 BUILDING CODE VIOLATION 0633 STATEWIDE GRAND JURY CHANCERY (CH) 0701 INJUNCTION (EXCEPT TX OR D CASES) 0702 REAL ESTATE MORTGAGE FORCLOSURE 0703 MECHANIC LEIN FORCLOSURE 0704 FORCLOSURE SEC INT PERS PROPERTY 0705 PARTNERSHIP DISSOLUTION 0706 SPECIFIC PERFORMANCE 0707 PARTITION 0708 WILL CONTEST 0709 CONSTRUCT WILL 0710 CONSTRUCTION OF INTER VIVOS TRUST 0711 CONSTRUCTION OF TEST TRUST (P dispo) 0712 TRUST ADMINISTRATION 0713 QUIET TITLE 0714 COMPLAINT IN EQUITY 0715 ACCOUNTING 0716 RECEIVERSHIP 0717 RESCISSION OF CONTRACT 0718 CREDITOR222S COMPLAINT 0719 UNIFORM GIFT TO MINOR ACT 0720 SETTING ASIDE A DEED 0721 FORCLOSURE ON CONDO ASSESS 0722 INTERPLEADER 0723 REGISTRATION OF FOREIGN JUDGMENT 0724 STRUCTURE SETTLEMENT 0725 RES REAL ESTATE MORTG FORCLOSURE 0730 OTHER (SPECIFY) 0731 CHANGE OF VENUE 226 TRANSFER ADOPTION (AD) 0801 ADOPTION 0817 ADOPTION 226 UNBORN CHILD FAMILY (F) 0802 PUTATIVE FATHER 0803 PATERNITY 0804 PARENT & CHILD RELATIONSHIP 0806 RECIPROCAL NON-SUPPORT 0807 NEGLECT & REFUSAL TO SUPPORT 0808 CIVIL ACTION TO COMPEL SUPPORT 0809 URESA 226 INCOMING 0810 URESA 226 OUTGOING 0811 REGISTRATION OF FOREIGN JUDGMENT 0818 CONFIDENTIAL INTERMEDIARY 0821 PETITION FOR VISITATION 0830 OTHER (SPECIFY) 0831 CHANGE OF VENUE 226 TRANSFER 0904 PETITION FOR CUSTODY 1005 EMANCIPATION OF MINOR 1006 PETN FOR MARRIAGE LICENSE ORDER OF PROTECTION (OP) 0805 DOMENSTIC VIOLENCE ACT 0819 REGISTRATION OF FOREIGN JUDGMENT DIVORCE (D) 0901 DISSOLUTION 0902 INVALIDITY 0903 LEGAL SEPARATION 0906 SIMPLIFIED DISSOLUTION 0907 REGISTRATION OF FOREIGN JUDGMENT 0930 OTHER (SPECIFY) 0931 CHANGE OF VENUE 226 TRANSFER 0932 CIVIL UNION JUVENILE (J) 1002 SUPERVISION 1003 DEPENDENCY 1007 ADDICTED MINOR 1008 TRUANCY 1009 MINOR REQUIRE AUTHORITY INTERVENT 1010 TEMPORARY GUARDIAN 1030 OTHER (SPECIFY) JUVENILE ABUSE OR NEGLECT (JA) 1004 ABUSE OR NEGLECT MENTAL HEALTH (MH) 1101 PETITION FOR HOSPITALIZATION 1102 PETITION FOR DISCHARGE 1103 PETITION FOR RESTORATION 1104 AUTH EMERGENCY MED/DENTL TREAT 1105 AUTH PSYCHOTROPIC MEDICATION 1106 ADMINISTRATOR TO ADMIN TREATMNT 1130 OTHER (SPECIFY) MUNICIPAL CORPORATION (MC) 1301 PETN TO ORGANIZE MUNICIPAL CORP 1302 PETN TO DISOLVE MUNICIPAL CORP 1303 PETN TO CREATION DRAINAGE DIST 1304 PETN TO CHANGE OF GOVERNMENT 1330 OTHER (SPECIFY) CC7-2 American LegalNet, Inc. www.FormsWorkFlow.com