Civil Case Cover SheetCal. Super. - 6th Dist.January 27, 2021ATTORNEY OR PARTV WITHOUT ATTORNEY (Name, Stale Ba! NUMDEI, 5nd address)? FOR COURT USE ONLY ‘- YourtegaIN-Ime: Phuons N,u\|€n ' I V YourAddress: Q9! 3/ mdn: T Avg . ‘ gQM )0“ , (fl (jglng « C , TELEPHONENO. ““5 ”97‘ )H FAXNo. momevroamame; Self-Represented I L ESUPERIOR count or CALIFORNIA, coum'v or Santa Clara STREET ADDRESS 191 North First Street MAILINGADDRESS 191 North First street JAN 2 7 2021 CITVANDZIP cone san Jose, CA 95113 BRANCH NAME Civil Courthouse Clef o he Court K. NGUYEN CASE NAME: '_ ' , ' Superior Cou pt ounty o! Santa ClaraNkkk‘ftN \/’\.- PAN 3v DEPUTY CIVIL CASE COVER SHEET Complex Case Designation cAse NUMBER \ Unlimited D Limited D Counter D Joinder 2 1 c H 00 98 2 4(Amount (Amount GEdemanded demanded is Filed with first appearance by defendant JUD exceeds $25,000) $25.000 or less) Qal. Rules of Court, rule 3.402) DEPT. Items 1-6 below mus! be completed (see instmctions on page 2). 1 . Check one box below for the case type that best describes this case: Auto Tort Contract Provisionally Complex Civil Litigation a Auto (22) Breach of contract/warranty (06) Cal. Rules of Court, rules 3.400-3.403)Uninsured motorist (46) Rule 3.740 collections (09) Antitrust/Trade regulation (O3) Other collections (09) Construction defect (10) Other Pl/PD/WD (Personal InjurylProperty Insurance coverage (1 8) Mass tort (40)Damageiwrongfu' Death) Tort Other contract (37) Securities litigation (28) Asbestos (04) . . . .. Envnronmental/Toxm tort (30) Product Ilablhty (24) Real Property . . . . . . . Insurance coverage claims ansmg from the Medical malpractice (45) D Eminent domaIn/lnverse above listed rovisiona" com lex case Other PI/PD/WD (23) condemnation (14) types (41 ) p y p Non-PI/PD/wo (Other) Tort W'°”9f“' swam" (33) _. . . . Other real property (26) Enforcement of Judgment Business tort/unfalr busmess practice (07) D Eq‘orcement of .ud mem (20) Civil rights (08) Unlawful Detainer ' J g Defamation (13) Commercial (31) Miscellaneous Civil Complaint Fraud (16) Residential (32) RICO (27) Intellectual property (19) Drugs (38) Other complaint (not specified above) (42) gzgzsjloonrgllrpegmg‘:rfigg Judicial Review Miscellaneous Civil Petition Asset forfeiture (05) - Partnership and corporate governance (21) Employment Petition re: arbitration award (1 1) 53 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 couds issues that will be time-consuming to resolve in other counties, states, or countries, or in a federal court c. D Substantial amount of docutnemary evidence f. D Substantial postjudgment judicial supervision Remedies sought (check all thatapp/y): a. a monetary b.m nonmonetary; declaratory or injunctive relief c. D punitive Number of causes of action s ecify): This case D is fl is not a class action suit. If there are any known related cases, file and serve a notice of related case.(You may use form CM-O15.) ' .x /fi, Dt: O'1ILU’lL'li (4/ae ?lwonra Nguyen ’ ‘(SI/E 7m f .__ _ __._ _ ,._.___ _________ .A~_ _, 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. rule 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. 99.5.“ Pug. 1 of F ted! M dt U . CLRI OfC n I 2. ,. ,400-3. ,740; fififikym}? ?aariziéfig se L .3M CIVIL CASE COVER SHEET a 33.15stanggfdsnivleiudlaceaFAfizmoiniastrauonfiti33.10 I 9V. y . ] n ESE.“ ”Rusw WWWCOUIflnfO.CI.OOV ‘fiuzzzu/M/L \ I l. - I 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 Sheel contained on statistics about the types and numbers o cases filed. You must complete items 1 throug age 1. This information will be used to compile 6 on the sheet. ln 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 Ic 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. oowed in a sum stated to be certain 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. The identification of a case as a rule 3.740 collections case on th:s form means that it will be exempt from the- enefal tlme-for-service requirements and case management rules, unless a defendant files a responsive pleading. A rule 3.740 co lectlons case will be subject to the requirements for service and obtaining a judgment in rule 3.740. To Parties in Complex Cases. In com Iex cases only. parties must also use the Civil Case Cover Sheet to designate whether the case is complex. lf a plaintiff believest 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 Iaintiff designates a case as complex. the cover sheet must be sewed with the complaint on all parties to the action. A defendant may Ile and serve no later than the time of its first appearance a joinder in the plaintiff's 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)-Persona| Injury/Propedy DamageNVrongful Death Uninsured Motorist (46) (if the case involves an uninsured motorist claim subject to arbitration, check (his item instead of Auto) Other Pl/PDNVD (Personal lnjuryi Property DamageNVrongful Death) Tort Asbestos (O4) Asbestos Property Damage Asbestos Personal lnjuryl Wrongful Death Product Liability (not asbestos or toxic/environmental) (24) Medical Malpractice (45) Medical Malpractice- Physicians & Surgeons Other Professional Health Care Malpractice Other PI/PD/WD (23) Premises Liability (e.g., slip and fall) Intentional Bodily lnjury/PDNVD (e.g.. assault. vandalism) Intentional lnfliction of Emotional Distress Negligent lnfliction of Emotional Distress Other PI/PD/WD Non-PllPD/WD (O(her) Tort Business Ton/Unfair Business Practice (O7) Civil Rights (e.g.. discrimination, false arrest) (not civil harassment) (08) Defamation (e.g.. slander. libel) (13) Fraud (16) Intellectual Property (19) Professional Negligence (25) Legal Malpractice Other Professional Malpractice (nor medical or legal) Other Non-Pl/PDNVD Tort (35) Employment Wrongful Termination (36) Other Employment (1 5) a _ ammu BSEIIW FIRMS" CM-OlO [Rem July 1‘ 2007] CASE TYPES AND EXAMPLES Contract Breach of Contract/Warranty (06) Breach of ReMal/Lease Contract (not unlawful detainer or wrongful eviction) Contract/Warranty Breach-Seller Plaintiff (not fraud or negligence) Negligent Breach of Contract/ Warranty Other Breach of Contract/Warranty Collections (e.g., money owed, open book accounts) (09) Collection Case-Seller Plaintiff Other Promissory Note/Collections Case Insurance Coverage (no! provisionally complex) (18) Auto Subrogation Other Coverage Other Contract (37) Contractual Fraud Other Contract Dispute Real Property Eminent Domain/Inverse Condemnation (14) Wrongful Eviction (33) Other Real Property (e.g., quiet tide) (26) Writ of Possession of Real Property Mortgage Foreclosure Quiet Title Other Real Property (not eminent domain, Iand/ord/tenant, or foreclosure) Unlawful Detalner 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 Writ-Other Limited Court Case Review Other Judicial Review (39) Review of Health Officer Order Notice of Appeal-Labor Commissioner Appeals CIVIL CASE COVER SHEET Provisionally Complex Civil Litigation (Cal. Rules of Court Rules 3.400-3.403) Antitrust/Trade Regulation (03) Construction Defect (1 O) Claims Involving Mass Tort (40) Securities Litigation (28) EnvironmentallToxic Tort (30) Insurance Coverage Claims (an'sing from provisionally complex case type listed above) (41.) Enforcement of Judgment Enforcement of Juogment (20) Abstract of Judgment (Out of County) Confession of Judgment (non- domestlc re'ations) Sister State Judgment Administrative Agency Award (not unpaid (axes) Petition/Cemfication of Entry of Judgment on Unpaid Taxes Other Enforcement of Judgment Case Miscellaneous Civil Complaint RICO (27) Other Complaint (not specified above) (42) Declaratory Relief Only Injunctive Relief Only (non- harassment) Mechanics Lien Other Commercial Complaint Case (non-ton/non-complex) Other Civil Complaint (non~tor1/non-complex) Miscellaneous Civil Petition Partnership and Corporate Governance (21) Other Petition (not specified above) (43) Civil Harassment Workplace Violence EIder/Dependent Adult Abuse Election Contest Petition for Name Change Petition for Relief from Late Claim Othet Civil Petition Pngl 2 of 2