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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 eviction (33)above listed provisionally complex caseNon- PI/PD /WD (Ot)

domain, landlord/tenant, or harassment) Non-PI/PD/WD (Other) Tort foreclosure) Mechanics Lien Business Tort/Unfair Business Unlawful Detainer Other Commercial Complaint Practice (07) Commercial (31) Case (non-tort/non-complex) Civil Rights (e.g., discrimination, Residential (32) Other Civil Complaint false arrest) (not civil

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