Civil Case Cover SheetCal. Super. - 6th Dist.January 28, 2021ATTORNfiY OR PAR“ WI rHOUT ATTORNEY (Name State Bar number. and amass) FOR COURT USE ONLY- YourLogalNune: Nykm‘ Conswb U (lsqu C t YourAddress: 5854 thV anxlt #3 son Tats '01.‘ I TELEPHONE NO FAX NO ATTORNEY FOR (Name) SEIf-Repfesented I L ESUPERIOR COURT or CALIFORNIA. COUNTY 0F Santa Clara STREET ADDRESS 191 North First Street MAILINGADDREss 191 North First street JAN 2 8 2021 K NGUYHI cmmozw coca san Jose, CA 95113 amen NAME Civil Courthouse o'er the Court CASE NAME: Superb: Cou o! County d Santa Gare - DEPUTY«Wagja M mm Comudo ”Y 8 2 9CIVIL CASE COVE SHEET 1Complex Case Designation cAsE nu s1 c H 00 9m Unlimited D Limited M2 (Amount (Amount D Counter D Joinder demanded demanded is Filed with first appearance by defendant JUDGE exceeds $25,000) $25.000 or less) (Cal. Rules of Court, rule 3.402) Dem. 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 Tort Contract Provlslonally Complex Civil Llugatlon Auto (22) Breach of contractMarranty (06) Cal. Rules of Court. rules 3.400-3.403) Uninsured motorist (46) Rule 3.740 collections (09) Antitrust/Trade regulation (03) Other PI/PDMD (Personal wmy/Pmpom Other collections (09) Constructlon defect (10) Insurance coverage (18) Mass ton (40) DamageNVrongful Death) Tort ‘ . . _ . - Other contract (37) Securmes litigation (28) Asbestos (04) E . . . . . nvcronmental/Toxnc ton (30) Productllablllty(24) Real Property . . . . . , , Insurance coverage claims ansmg from the Medical malpractuce ‘45) D Eminent domaIn/lnverse above listed rovisiona" com [ex case Other PI/PD/wo (23; condemnation (14) p y p Wron fuleviction (33) types (41) Non-PI/PD/wo (Other) Tort 9 . . . Other real property (26) Enforcement of JudgmentBusmess tort/unfalr busmess practice (07) D Enforcement 0f .ud ment (20) Civil rights (03) Unlawful Detainer J 9 Defamation (13) Commercial (31) Miscellaneous Civil Complaint Fraud (16) Residential (32) RICO (27) Intellectual property (19) Drugs (38) Other complaint (not specified above) (42) gizfeerszlofiapl|rsgxlgvgfgéigg Judicial Review Miscellaneous Civll Petition Asset forfeiture (05) 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 (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. Large number of witnesses b. Extensive motion practice raising difficult 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 coun c. a 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 actionsecify). 5. This case D is 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 foam C -015.) t Date: U , L 1 . . ac? ~ 7,02, I 9 "O WWW) ’ ' (_ V7 __. V_ I / W ]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. 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 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. Pug. 1 ol Mfgfgfmmt: U WH- CIV'L CASE COVER SHEET ca' Hmwmfiflfingggy SEIIIM M" m u n pVFfiU/Mli Ilanlh 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 t pe tha‘ 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 owed 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 propetty, or (5) a prejudgment writ of attachment. The identification of a case as a rule 3.740 collections case on this form means that it will be exempt frcm the eneral 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 Cases. In com lex cases only, parties must also use the Civil Case Cover Sheet to designate whether the case is complex. If 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 ?laintiff designates a case as complex, the cover sheet must be served with the Icomplaint on all parties to the action. A defendant may le 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 lnjury/Property DamageNVrongful Death Uninsured Motorist (46) (if the case involves an uninsured motorist claim subject to arbilration, check this item instead of Auto) Other PIIPDNVD (Personal Injury] Propetty DamageNVrongful Death) Tort Asbestos (04) Asbestos Property Damage Asbestos Personal Injury/ Wrongful Death Product Liability (no! asbestos or toxic/environmental) (24) Medical Malpractice (45) Medical Malpractice- Physicians & Surgeons Other Professional Health Care Malpractice Other PIIPDNVD (23) Premises Liability (e.g., slip and fall) Intentional Bodily lnjury/PDNVD (e.g., assault, vandalism) Intentional lnfliction of Emofional Distress Negligent lnfliction of Emotional Distress Other PIIPDNVD Non-PI/PDNVD (Other) Tort 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) Intellectual Property (19) Professional Negligence (25) Legal Malpractice Other Professional Malpractice CASE TYPES AND EXAMPLES Contract Breach of Contract/Warranty (06) Breach of Rental/Lease Contract (not unlawful detainer or wrongful eviction) ContracVWarranty Breach-Seller Plaintiff (no! 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 (not provisionally complex) (1 8) Auto Subrogation Other Coverage Other Contract (37) Contractual Fraud Other Contract Dispute Real Property Eminent Domain/lnverse Condemnation (14) Wrongful Eviction (33) Other Real Property (e.g.. quiet title) (26) Writ of Possession of Real Propeny Mortgage Foreclosure Quiet Title Other Real Property (not eminent domain, Iandlord/fenanl, or foreclosure) Unlawful Detainer Commercial (31) Residential (32) Drugs (38) (if (he case involves illegal drugs, check this item; otherwise, report as Commercial 0! Residential) Judicial Review Asset Forfeiture (05) Petition Re: Arbitration Award (1 1) Writ of Mandate (02) Writ-Administrative Mandamus Writ-Mandamus on Limited Coun Provlsionally Complex Civil Litigation (Cal. Rules of Court Rules 3.4006403) Antitrust/Trade Regulation (03) Construction Defect (10) Claims Involving Mass Tort (40) Securities Litigation (28) Environmental/Toxic Tort (30) Insurance Coverage Ciaims (an'sing from provisionally complex case type listed above) (41) Enforcement of Judgment Enforcement of Judgment (20) Abstract of Judgment (Out of County) Confession of Judgment (non- domeslic relations) Sister State Judgment Administrative Agency Award (not unpaid faxes) Petition/Certification 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-tort/non-complex) Other Civil Complaint (non-tort/non-comp/ex) Miscellaneous Civil Petition Partnership and Corporate Governance (21) Other Petition (not specified above) (43) Civil Harassment Workplace Violence EIder/Dependent Adult Abuse Election Contest Case Matter - . nouned-Ca/w/e 8/ . . . Petltlon for Name Change omer {Jon-PI/PID/wo Tgrtias) wr'figfihei; “med CW“ case Petitggifmm Relief "0m Late Employment Other Judicial Review (39) - - - - Wrongful Termination (36) Review of Health Officer Order Other CW" Petmon Other Employment (1 5) Notice of Appeal-Labor Commissioner Appeals cmmolRev. July 1, 2007] CIVIL CASE COVER SHEET PagozovzWm»