Civil Case Cover SheetCal. Super. - 6th Dist.February 4, 2021‘ CM-010I ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, Slale Bar numbel. and address] FOR COURT USE OMY ._ Your LogalName: QWQ’\S&\ g" ?OCWQLO Your Address: ‘6 c)(b T Y ‘-\ Q 8w Wm” gon ) (2482‘ ’9; l TELEPHONE NO. FAX NO. momwoamm; Self-Represented F L E D. Santa Clara ’"’§$§§Ti‘§3§;§‘1°9‘%"fi"8fifi°fl¥§€§ueet FEB - 4 2021 MAILING ADDRESS 191 North First Street CITYANDzlpcooE San Jose, CA 95113 BRANCH NAME Civil Courthouse cASE NAME: PmWE \) S - 20.89 Lu CIVIL CASE COVER SHEET Complex Case Designation CAse Nuns 8 a 6Unlimited D Limited 51 C H 00 9 _ (Amount (Amount D Counter D Joinder JUDGE demanded demanded is Filed with first appearance by defendant exceeds $25,000) $25,000 or less) (Cal. Rules of Court. rule 3.402) DEPT. Items 1-6 below mus! be completed (see instructions on page 2)A 1. Check one box below for the case type that best describes this case: Auto Tort Contract Provlslonally 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 (03) Other collections (09) Construction defect (1 0) Other PIIPDNVD (Personal InjuryIProporty DamageIWrongful Death) Tort Asbestos (04) Insurance coverage (18) Mass tort (40) Other contract (37) Secun‘lies litigation (28) EnvironmentallToxic ton (30)Pmdum “abimy (24) Real Pmpeny Insurance coverage claims arising from the Medical malpractice (45) D Eminent domain/Inverse above listed provisionauy complex case Other PI/PDNVD (23) condeTuTation (14):” types (41) Wrong eviction ( )Non'PIIPPIWD (Othernbn. . Other real property (26) Enforcement of Judgment Busmess tort/unfalr busmess pracnce (07) D Enforcement ofjudgmem (20) Civil rights (08) Unlawful Detalner Defamation (13) Commercial (31) Mlscellanoous Civil Complaint Fraud (16) Residential (32) a RICO (27)Intellectual property (1 9) Drugs (38) Other complaint (not specified above) (42) Szafiszgziglggagfifigé) Judlclal Review Miscellaneous Cile Petition Asset forfeiture (05) Partnership and corporate governance (21) Employment Petition re: arbitration award (11) a 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 postjudgment judicial supervision 3‘ Remedies sought (check allthat apply): a. D monetary b. nonmonetary; declaratory orinjunctive relief c. D punitive 4. Number of causes of actionfiecify): 5. 6 This case D is is not a class action suit. If there are any known related cases, file and serve a notice of related case.(You Date: g/g/azoal (- Cég gem; mdpw ’ 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, 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 o! F A ted! M ndal . Cd. Rd ?Coufl. n10 2.30. 3.220. 3100-3403 3.740; ggfiw?gags U“ c .9ML C'V'L CASE COVER SHEET cségmmmimmmmmbad.m 9V» Y ~ 7] h [mum "INS"! wwwcoumn cagov flA/J/n /Fd/ 2-444 CM-01 0 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 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. 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 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 this form means that it will be exempt from the general otime-for-service requirements and case management rules, unless a defendant files a responsive pleading. A rule 3.740 c case will be subject to the requirements for service and obtaining a judgment in rule 3.740. lex cases only. parties must also use the Civil Case Cover Sheet to designate whether theTo Parties in Complex Casean com fie case is complex under rule 3.400 of the California Rules of Court. this must be indicated bycase is complex. If a plaintiff believes t lecflons 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 Jounder 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 Ton Auto (22)-Personal lnjury/Propeny DamageNVrongful Death Uninsured Motorist (46) (if the case involves an uninsured motorist claim subject to arbitration, check this item instead of Auto) Other PIIPDIWD (Personal Injury! Property Damage/Wrongful Death) Tort Asbestos (04) Asbestos Property Damage Asbestos Personal lnjury/ Wrongful Death Product Liability (not asbestos or toxic/envimnmental) (24) Medical Malpractice (45) Medical Malpractice- Physicians 8. Surgeons Other Professional Health Care Malpractice Other PI/PDNVD (23) Premises Liability (e.g.. slip and fall) Imentional Bodily InjurylPDNVD (e.g.. assault. vandalism) Intentional lnfliction of Emotional Distress Negligent lnfliction of Emotional Distress Other PIIPD/WD Non-PIIPDIWD (Other) Tort Business Tort/Unfair Business Practice (07) Civil Rights (e.g.. discn‘minalion. 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 (not medical or legal) Other Non-Pl/PD/WD Tort (35) Employment Wrongful Termination (36) Other Employment (1 5) CASE TYPES AND EXAMPLES Contract Breach of Contract/Warranty (06) Breach of RentallLease Contract (no! unlawful detainer or wrongful eviction) Contract/Warranty Breach~$eller Plaintiff (not fraud or negligence) Negligent Breach of Contract! Warranty Other Breach of Contractharranty Collections (e.g.. money owed. open book accounts) (09) Collection Case-SelIer Plaintiff Other Promissory Note/Collections Case Insurance Coverage (no! 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 (no! eminent domain, landlord/tenant, or foreclosure) Unlawful Detainer 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 Limiled Coun Case Matter Writ-Other Limited Court Case Review Other Judicial Review (39) Review of Health Officer Order Notice of AppeaI-Labor Commissioner Appeals Provlslonally Complex Clvll thlgatlon (Cal. Rules of Court Rules 1400-3403) Antitrust/Trade Regulation (03) Construction Defect (10) Claims Involving Mass Tort (40) Securities Litigation (28) EnvironmentaI/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 Administrative Agency Award (not unpaid taxes) Petition/Certification of Entry of Judgment on Unpaid Taxes Other Enforcement of Judgment Case Mlscollaneous Civil Complaint RICO (27) Other Complaint (not specified above) (42) Declaratory Relief Only Injunctive Relie! Only (non- harassment) Mechanics Lien Other Commercial Complaint Case (non-ton/non-complex) Other Civil Complaint (non-tort/non-complex) Miscellaneous CIvII Petltlon Partnership and Corporate Governance (21) Other Petition (not specified above) (43) Civil Harassment Workplace VioIence EIder/Dependent Adult Abuse Election Contest Petition for Name Change Petition for Relief from Late Claim Other Civil Petition CM-O1O (Rev. July 1. 2007] L . ““3"m¢#,_# BSEIM film" CIVIL CASE COVER SHEET Pug. 2 o! 2