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PI/PD - Complaint SAMPLE - California

SAMPLE Use the samples to help you complete the packet of blank forms. PI/PD - Complaint CM-010 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):FOR COURT USE ONLYTELEPHONE NO.:FAX NO.:ATTORNEY FOR (Name):SUPERIOR COURT OF California , COUNTY OFSTREET ADDRESS:MAILING ADDRESS:CITY AND ZIP CODE:BRANCH NAME:CASE NAME:CIVIL CASE COVER SHEETCASE NUMBER:Complex Case DesignationUnlimitedLimitedCounterJoinde r(Amount(AmountFiled with first appearance by defendantdemandeddemanded isJUDGE:(Cal. Rules of Court, rule )exceeds $25,000) $25,000 or less)DEPT.:Items 1-6 below must be completed (see instructions on page 2).1. Check one box below for the case type that best describes this case:Auto TortContractProvisionally Complex Civil LitigationAuto (22)Breach of contract/warranty (06)(Cal. Rules of Court, rules )Uninsured motorist (46)Rule collections (09)Antitrust/Trade regulation (03)Other PI/PD /WD (Personal Injury/PropertyInsurance coverage (18)Construction defect (10)Damage/Wrongful Death) TortOther contract (37)Mass tort (40)Asbestos (04)Real PropertySecurities litigation (28)Product liability (24)Eminent domain/InverseEnvironmental/Toxic tort (30)Medical malpractice (45)condemnation (14)Insurance coverage claims arising from theOther PI/PD /WD (23)Wrongful

To Plaintiffs and Others Filing First Papers. must complete and file, along with your first paper, the Civil Case Cover Sheet statistics about the types and numbers of cases filed. You must complete items 1 through 6 on the sheet. In item 1, you must check one box for the case type that best describes the case.

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