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The civil cover sheet and the information contained in it neither replace nor supplement the filing and service of pleadings or other documents as required by law. This form must 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 section 25.075, Florida Statutes. (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 on both the main category and subcategory lines.

             Condominium

             Contracts and indebtedness

             Eminent domain

             Auto negligence

             Negligence—other

                       Business governance

                         Business torts

                         Environmental/Toxic tort

                         Third party indemnification

                         Construction defect

                         Mass tort

                         Negligent security

                         Nursing home negligence

                        Premises liability—commercial

                         Premises liability—residential

             Products liability

             Real property/Mortgage foreclosure

                         Commercial foreclosure $0–$50,000

                         Commercial foreclosure $50,001–$249,999

                         Commercial foreclosure $250,000 or more

                         Homestead residential foreclosure $0–$50,000

                         Homestead residential foreclosure $50,001–$249,999

                         Homestead residential foreclosure $250,000 or more

                         Nonhomestead residential foreclosure  $0–$50,000

                         Nonhomestead residential foreclosure  $50,001–$249,999

                         Nonhomestead residential foreclosure  $250,000 or more

                         Other real property actions $0–$50,000

                         Other real property actions $50,001–$249,999

                         Other real property actions $250,000 or more

             Professional malpractice

                         Malpractice—business

                         Malpractice—medical

                         Malpractice—other professional

             Other

                         Antitrust/Trade regulation

                         Business transactions

                         Constitutional challenge—statute or ordinance

                         Constitutional challenge—proposed amendment

                         Corporate trusts

                         Discrimination—employment or other

                         Insurance claims

                         Intellectual property

                         Libel/Slander

                         Shareholder derivative action

                         Securities litigation

                         Trade secrets

                         Trust litigation

III. REMEDIES SOUGHT (check all that apply):

                         Monetary;

                         Nonmonetary declaratory or injunctive relief;

                         Punitive

IV. NUMBER OF CAUSES OF ACTION: [   ]

            (specify)                                                                                                                                                                                                                                                                                           

V. IS THIS CASE A CLASS ACTION LAWSUIT?

                                     yes

                                     no

VI. HAS NOTICE OF ANY KNOWN RELATED CASE BEEN FILED?

                                     no

                        __ yes If “yes,” list all related cases by name, case number, and court.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      

VII. IS JURY TRIAL DEMANDED IN COMPLAINT? 

                                     yes

                                     no

I CERTIFY that the information I have provided in this cover sheet is accurate to the best             of my knowledge and belief, and that I have read and will comply with the requirements             of Florida Rule of Judicial Administration 2.425.

            Signature                                                                   Fla. Bar #                                                                              Attorney or party                                                     (Bar # if attorney)

                                    (type or print name)                                                Date