Civil Case Cover SheetCal. Super. - 6th Dist.January 12, 2021- Your Legal Name:WLax m [rt 1.ATTORNEY 0R PARTY WITHOUT ATTORNEY (Name. State Bar number, and addless): r FOR COURT USE ONLY Your Address: 921 kvo’fida EJRM q San 7059a €57.39 TELEPHONE N0. FAX NO.: moanev ma mm; Self-Represented I SUPERIOR COURT 0F CALIFORNIA cougmr 0F Santa Clara STREEV ADDRESS 191 North first street JAN 1 2 2021 MAILING ADDRESS 191 North Flrst Street cmrANo ZIP CODE san Jose, CA 951 1 3 same“ NAME Civil Courthouse Court u ‘y o! Santa 018m CASE NAME ‘A . ‘ , av Gmfazm’ Kamlrc VSArml/e flmU/sz CIVIL CASE COVER SHEET Complex Case Designation use ~u~ua :m Unlimited D Limited D Count r D J I d 2 1 CH 00 98 12(Amount (Amount ° ° n er V demanded demanded is Filed with first appearance by defendant JUDGE exceggs $25.000) $25.000 or less) (Cal. Rules of Court rule _3.402) ospr- Items 1-6 below must be completed (see instructions on page 2) 1. Check one box bélow for the case type that best describes this case: Auto Tort Contract Provisionally Complex Clvll Litigatlon Auto (22) Breach of contractlwarranty (06) Cal. Rules of Court, rules 3.400-3.403) Uninsured motorist (46) Rule 3.740 collections (09) Antitrust/Trade regulation (03) Other PUPDMD (Personal Injurylpmpeny Other collections (09) Constructlon defect (10) Insurance coverage (18) Mass tort (40)Damage/Wrongful Death) Ton . , . ‘ . Other contract (37) Secuntles litigation (28) ASbeStos (04) Environmental/Toxic ton (30) Product liability (24) Real Property Insurance coverage claims arising from the above listed provisionally complex case types (41) Medical malpractice (45) D Eminent domain/lnverse Other Pl/PDNVD (23) condemnation (14) Wrongful eviction (33)Non-PllPD/WD (Other) Tort Business tort/unfair business practice (07) Other real prOpeny (26) aorcefmem 0' Juggmem Civil rights (08) Unlawful Detalner En orcemem 0 IUdgmem (20) Defamation (13) Commercial (31) Miscellaneous Clvll Complalnt Fraud (16) Residential (32) RICO (27) Intellectual property (19) Drugs (38) Other complaint (not specified above) (42) Professional negligence (25) Judlclal Review Mlscellaneous Clvll Petition Other non'PI/PD/WD ton (35) Asset forfeiture (05) B Partnership and corporate governance (21)Employment Petition re: arbitration award (1 1) Other petition (not specified above) (43) Wrongful termination (36) Writ of mandate (02) Other employment (15) Other judicial review (39) 2. This case D is m is not complex under rule 3.400 of the California Rules of Court. If the case is complex. mark the factors requiring exceptional judicial management a. Large number of separately represented parties d. B Large number of witnessesb. Extensive motion practice raising difficuIt or novel Coordination with related actions pending in one or more courts issues that will be time-consuming to resolve in other counties. states. or countries, or in a federal court c D Substantial amount of documentary evidence f. Substantial postjudgment judicial supervision 3. Remedies sought (check all (hat apply): a. D monetary b. nonmonetary; declaratory or injunctive relief c D punitive 4. Number of causes of actions ecify). 5. This case D is fl is not a class action suit. 6. If there are any known related cases. file and serve a notice of related case. (You may use form CM-015.) Date. l/Q/ao Q" \ _ ’MAV ‘ )V NOTICE o Plaintiff must file this cover sheet with the first paper filed in the action or proceeding (except small claims cases or cases filed under the Probate Code. Family Code. or Welfare and Institutions Code). (Cal. Rules of Court. mle 3.220.) Failure to file may result in sanctions. File this cover sheet in addition to any cover sheet required by local court rule. If this case is complex under rule 3.400 et seq. of the California Rules of Court, you must serve a copy of this cover sheet on all other parties to the action or proceeding. o Unless this is a collections case under rule 3.740 or a complex case. this cover sheet will be used for statistical purposes only. Pogo 1 d Mwmnéa Use mm“ CIVIL CASE COVER SHEET Cal. Races o(CougdsmgleS&Iaéznghawfig .740;3m amnw “m“"”W-Wo