Civil Case Cover Sheet (Chancery Court-Circuit Court) {022} | Pdf Fpdf Doc Docx | Tennessee

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Civil Case Cover Sheet (Chancery Court-Circuit Court) {022} | Pdf Fpdf Doc Docx | Tennessee

Last updated: 8/7/2006

Civil Case Cover Sheet (Chancery Court-Circuit Court) {022}

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Description

CIVIL CASE COVER SHEET Check one:  CHANCERY COURT  CIRCUIT COURT Docket N0._______________________________________________________ Date__________________________________________ Attorney of Record________________________________________________________________ ______ I. Origin  Original Proceeding  Case Reopened  Counter-claim  Cross-claim  3rd Party Claim  Intervening Claim  Answer/Initial Reponssive Pleading  O ther (Specify)_____________________________________________________________________ II. Type of Action (Check one ) Domestic Relations  361 Paternity  362 Legitimation  363 Adoption  364 Surrender  371 Divorce with minor children  372 Divorce without minor children  381 Order of Protection  391 Interstate Support-Incoming  392 Interstate Support-Outgoing  401 Other Domestic Relations (Specify)____________________________________________________________________________________________ ___ General Civil  461 Contract/Debt  462 Specific Performance  471 Damages/Torts  481 Real Estate Matter  491 Workers Compensation  501 Probate  511 Juvenile Court Appeal  512 General Sessions Appeal  513 Appeal from Admin. Hearing  571 Conservatorship  572 Guardianship  573 Trust  581 Miscellaneous General Civil (Specify)_____________________________________________________________________________________________ Other  541 Judicial Hospitalization Petition for: (Reopened Cases)  381 Order of Protection 382 Contempt  383 Residential Parenting/No Child Support  384 Residential Parenting/Child Support385 Child Support  387 Wage Assignment Hearing  551 Other____________________________________________________________________________________________ III. Total amount sued for $___________________________________ Specific type of damages or relief sought________________________________ _____ Statutory authority for suit, if any______________________________________________________________________________________________________ IV. Check one:  Affidavit to proceedin forma pauperi s Cost Bond Surety_______________________________________________________________ V. JURY DEMAND (Check YES only if demanded in complaint)  YES  NO VI. RELATED CASES (if any) Docket N0.___________________ Judge_____________________________________________________________________ Date filed_____________________Status____________________________________________________________________ VII. PLAINTIFF/PETITIONER INFORMATION (List additional parties on supplemental form.) 1. Name________________________________________________________________________________________________________________________________ L ast F irst M iddle  AKA  DBA  BNF___________________________________________________________________________________________________________ DOB______________________ Drivers License #____________________________________________________ _______________________________________________________________________________________ COMPANY NAME _______________________________________________________________________________________ ____________________________________________________________ _____________________ ADDRESS ATTORNEY BPR # _______________________________________________________________________________________ ______________________________________________________________________________________ CITY STATE ZIP ADDRESS _______________________________________________________________________________________ ______________________________________________________________________________________ EMPLOYER C ITY S TATE Z IP _______________________________________________________________________________________ ______________________________________________________________________________________ ADDRESS PHONE _______________________________________________________________________________________ CITY S TATE Z IP VIII. DEFENDANT/RESPONDENT INFORMATION (List additional parties on supplemental form.) 1. Name________________________________________________________________________________________________________________________________ L ast F irst M iddle  AKA  DBA  BNF___________________________________________________________________________________________________________ DOB______________________ Drivers License #____________________________________________________ ________________________________________________________________________________________ COMPANY NAME ________________________________________________________________________________________ ____________________________________________________________ _____________________ ADDRESS ATTORNEY BPR # ________________________________________________________________________________________ ______________________________________________________________________________________ CITY STATE ZIP ADDRESS ________________________________________________________________________________________ ______________________________________________________________________________________ EMPLOYER C ITY S TATE Z IP ________________________________________________________________________________________ ______________________________________________________________________________________ ADDRESS PHONE ________________________________________________________________________________________ CITY S TATE Z IP TYPE OF SERVICE REQUIRED  Out of County Sheriff________________________________  Publication (specify)______________________________________________________________  Local Sheriff  Other (specify)___________________________________________________________________  Secretary of State Special Instructions_________________________________________________________________  Comm. Of Ins. ________________________________________________________________________________ IX. ASSOCIATED PARTY (Uninsured Motorist Carrier) INFORMATION 1. Name_________________________________________________________Address________________________________________________________________ Type of Service (specify)__________________________________________________________________________________________________________________ Are additional plaintiffs or defendants listed on a separate sheetYE? S  NO [Form 022, Rev. 2002.08.05]

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