Civil Case Cover Sheet

Cal. Super. - 6th Dist.January 25, 2021

' ' CM~010 LATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar numbel, and address) FOR COURT USE OMY Your Legal Name: CIOOMDS \Zcqe 5 YourAddress: €33 N (yup'LOJ foq fiAygL/LQS/33TELEPHONE NO, mama ma (Name) Self-Represented summon COURT 0F cAuronmA, COUNTY 0F Santa Clara I L E STREET ADDRESS 191 North First Street MAILING ADDRESS 191 North First Street CITYANDZIPCODE san Jose, CA 95113 JAN 2 5 2021 amen NAME Civil Courthouse CASE NAME: ae\ e 5 T . Superigclgu Io hgxgosgrfcfavmeunw l V‘» A 0n mes av n- CIVIL CASE COVER SHEET Complex Case Designation CASENWBER v F 91f? ' Unlimited D leited D Count D J i d 2 1 00(Amount (Amount er ° n 9r demanded demanded is Filed with first appearance by defendant JUDGE exceeds $25,000) $25000 or less) (Cal. Rules of Court, rule 3.402) DEPT, Items 1-6 below mus! be completed (see Instructions on page 2). 1. Check one box below for the case type that best describes this case: Auto Ton Contract Provlslonally Complex Civil Litigation B Auto (22) Breach of contrachan'anty (06) Cal. Rules of Court, rules 3400-3403)Uninsured motorist (46) Rule 3.740 collections (09) Antitrustfrrade regulation (03) Other collections (09) Construction defect (10)0mm PIIPDMD (Penon‘I Inluwlpromny Insurance coverage (18) Mass ton (40)Damagdwmngfu' om") 7°" Other contract (37) Securities Im anon 28 Asbestos (04) E . g .( ) . H nvuronmentallToxnc tort (30) Product llablllty (24) Real Property . . . . . . . Insurance coverage claims ansmg from the Medical malpractice (45) D Eminent domalnllnverse above listed provisionaw complex case Other PI/PD/WD (23) 33ndermation (14)” types (41) rong u eviction( )"on'P'IPPMD (omen.Ton. . Other real property (26) Enforcement of Judgment Busmess tort/uniatr busmess practice (07) D Enforcement ofjudgmem (20) Civil rights (08) Unlawful Detalner Defamation (13) Commercial (31) MlscelIaneous Clvll Complain! Fraud (16) Residential (32) a RICO (27)Intellectual property (19) Drugs (38) Other complaint (not specified above) (42) PrOfeSSional negugence (25) Judlclal Review Mlscellaneous Clvll Petltlon ome' non'Pl/PD/WD m" (35) Asset forfeiture (05) a Partnership and corporate governance (21)Employment Petition re: arbitration award (1 1) Other petition (no! specified above) (43) Wrongful termination (36) Writ of mandate (02) Other employment (1 5) 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. a Large number of witnessesb. Extensive motion practice raising difficult or novel e. 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 postjudgmentjudicial supervision 3. Remedies sought (check all that apply): a. D monetary b. nonmonetary; declaratory or injunctive relief c. D punitive 4. Number of causes of action s 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: \O\ \ ?ADS \ZM‘VS ’ (Sllggficsos @%?6S o Plaintiff must file this cover sheet with the first paper filed in the action or proceeding (except small claims cases or cases filed o File this cover sheet in addition to any cover sheet required by local court rule. o 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 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. NOTICE under the Probate Code. Family Code, or Welfare and Institutions Code). (Cal. Rules of Court, rule 3.220.) Failure to file may result in sanctions. other parties to the action or proceeding. Page 1 o! Fonn torum Use . I CIVIL CASE COVER SHEET cu. R es Com rues 2.30. 3.220. 3.4004403 3.7mwfiwflgag} film Elm.” gm. gums o1Man Amsgg‘y’ggbstg‘ 3&0 {14,‘(44A I‘m “A CM-010 INSTRUCTIONS ON HOW TO COMPLETE THE COVER SHEET To Plaintiffs and Others Filing First Papers. If you are filing a first paper (for example, a complaint) in a civil case, you must complete and file, along with your first pa er, the Civil Case Cover Sheet contained on gage 1. This information will be used to compile statistics about the types and numbers o cases filed‘ You must complete items 1 throug 6 on the sheet. In item 1, you must check one box for the case pe that best describes the case. If the case fits both a general and a more specific type of case listed in item 1, check the more speci c one. If the case has multiple causes of action, check the box that best indicates the primary cause of action. To assist you in completing the sheet, examples of the cases that belong under each case type in item 1 are provided below. A cover sheet must be filed only with your initial paper. Failure to file a cover sheet with the first paper filed in a civil case may subject a party, its counsel, or both to sanctions under rules 2.30 and 3.220 of the California Rules of Court. To Parties in Rule 3.740 Collections Cases. A "collections case" under rule 3.740 is defined as an action for recovery of money owed in a sum stated to be cenain that is not more than $25,000, exclusive of interest and attorney's fees, arising from a transaction in which property, services, or moneg was acquired on credit. A collections case does not include an action seeking the following: (1) tort damages, (2 punitive damages, ( ) recovery of real property, (4) recovery of personal property. or (5) a prejudgment writ of attachment. he identification of a case as a rule 3.740 collections case on this form means that it will be exempt from the general time-for-service requirements and case management rules, unless a defendant files a responsive pleading. A rule 3.740 co lections case will be subject to the requirements for service and obtaining a judgment in rule 3.740. To Parties In Complex Casean comfilex cases only, parties must also use the Civil Case Cover Sheet to designate whether the case is complex. If a plaintiff believes t e case is complex under rule 3.400 of the California Rules of Court, this must be Indicated by completing the appropriate boxes in items 1 and 2. If a plaintiff designates a case as complex, the cover sheet must be served with the complaint on all parties to the action. A defendant may file and serve no later than the time of its first appearance a joinder in the plaintiffs designation, a counter-designation that the case is not complex, or, if the plaintiff has made no designation, a designation that the case is complex. Auto Tort Auto (22)-Personal Injury/Propeny Damagerongful Death Uninsured Motorist (46) (if (ha case involves an uninsured motorist claim subject to arbitration, check this item instead of Auto) Other PI/PD/WD (Personal Injury] Property Damage/Wrongful Death) Ton Asbestos (04) Asbestos Property Damage Asbestos Personal Injury/ Wrongful Death Product Liability (not asbestos or toxic/envimnmenral) (24) Medical Malpractice (45) Medical Malpractice- Physicians 8. Surgeons Other Professional Health Care Malpractice Other Pl/PD/WD (23) Premises Liability (e.g.. slip and fall) Intentional Bodily InjuryIPDNVD (e.g., assaun, vandalism) Intentional lnfliction of Emotional Distress Negligent lnfliction of Emotional Distress Other PI/PD/WD Non-PllPD/WD (Other) Ton Business Tort/Unfair Business Practice (07) Civil Rights (e.g‘. discrimination. false arrest) (no! civil harassment) (08) Defamation (e.g., slander. libel) (13) Fraud (16) Inteliectual Property (19) Protessional Negligence (25) Legal Malpractice Other Professional Malpractice (not medical or legal) Other Non-PI/PDMID Ton (35) Employment Wrongful Termination (36) Other Employment (1 5) cM-mo [Ru Jay 1. 2007] c”) mm FllflS'N CASE TYPES AND EXAMPLES Contract Breach of Contractharranty (06) Breach o! RentalILease Contract (nor unlawful detainor or wrongful eviction) Contract/Warranty Breach-Seller Plaintiff (not fraud or negligence) Negligent Breach 01 Contract! Warranty Other Breach of ContracUWarranty Collections (e.g., money owed, open book accounts) (09) Collection Case-Seller Plaintiff Other Promissory Note/Colleclions Case Insurance Coverage (not provisionally complex) (18) Auto Subrogation Other Coverage Other Conlract (37) Contractual Fraud Other Contract Dispute Real Propetty Eminent Domain/lnverse Condemnation (14) Wrongful Eviction (33) Other Real Property (e.g., quiet tine) (26) Wn't of Possession of Real Propeny Mortgage Foreclosure Quiet Title Other Real Property (not eminent domain, landlord/tenant, or foreclosure) Unlawful Detalnor Commercial (31) Residential (32) Drugs (38) (if the case involves illegal drugs, check this item; otherwise. report as Commercial or Residential) Judicial Review Asset Forfeiture (05) Petition Re: Arbitration Award (1 1) Writ of Mandate (02) Writ-Administrative Mandamus Writ-Mandamus on Limited Court Case Matter Wril-Other Limited Court Case Review Other Judicial Review (39) Review of Health Officer Order Notice of Appeal-Labor Commissioner Appeals CIVIL CASE COVER SHEET Provlsionally Complex Clvll Litigation (Cal. Rules of Court Rules 3400-3403) AntitrusUTrade Regulation (03) Construction Defect (10) Claims Involving Mass Ton (40) Securities Litigation (28) Environmental/Toxic Ton (30) Insurance Coverage Claims (arising fmm provisionally complex case type listed above) (41) Enforcement of Judgment Enforcement of Judgment (20) Abstract of Judgment (Out of County) Confession of Judgment (non- domestic relations) Sister State Judgment Admini_strative Agency Award (not unpaid taxes) Petition/Cenification of Entry of Judgment on Unpaid Taxes Other Enforcement of Judgment Case Mlscellaneous Clvll Complaint RICO (27) Other Complaint (no! specified above) (42) Declaratory Relief Only Injunctive Relief Only(non- harassment) Mechanics Lien Other Commercial Complaint Case (non-ton/non-comp/ex) Othef Civil Complaint (non-tort/non-complex) Miscellaneous Clvll Petition Partnership and Corporate Governance (21) Other Petition (not specified above) (43) Civil Harassment Workplace Violence Elder/Dependent Adult Abuse Election Contest Petition for Name Change Petition for Relief from Late Claim Other Civil Petition Pan. 2 of 2