Civil Case Cover SheetCal. Super. - 6th Dist.March 2, 2021CM-01 0 _ATTORNEY 0R PARTY WITHOUT ATTORNEY (Name. Slale Bar number. and address): FOR COURT USE ONLY Tiega-Noel Varlack, SBN 248203 ¥2a§|€KclkVLCfigal Sgwces S ' 207 ll d CA 94544 EleCtronically Filed . Inton venue Lute , i a war , - TELEPHONENO. (5 I 0)397-2008 y mo; (5 1 0)397~2997 2y S"p°“°’ cw” °f CA! ATTORNEY FORrName): Shawn Robertson "ounty Of santa Clara! SUPERIOR COURT 0F CALIFORNIA‘COUNTY 0F 3n 3/2/2021 2:47 PM smemonaess: '9' N- FH'St Street Reviewed By: D Harris MAILNGADDRESS: l9] N. First Street CITYAND ZIP cone: San Jose, 95| l3 _ vase #21CV378994 BRANCH NAME Downtown Superior Court Envelope: 5946902 CASE NAMEC Robertson v‘ Lucille Salter Packard Children's Huspilul 211 Stanford: el ul. CIVIL CASE COVER SHEET Complex Case Designation CASE NUMBEE1 CV378994 Unlimited D Limited I (Amount (Amount E Counter E Jomder . demanded demanded is Filed with first appearance by defendant JUDGE exceeds $25.000) $25,000 or less) (Cal. Rules of Court. rule 3.402) DEPT: Items 1-6 below must be completed (see instructions on page 2). 1. Check one box below for the case type that best describes this case: DamageNVrongful Death) Tort Asbestos (04) Product liability (24) Medical malpractice (45) Insurance coverage (1 8) Mass tort (40) Other contract (37) D Securities litigation (28) Auto Tort ComraCl Provisionally Complex Civil Litigation Auto (22) D Breach of contracuwarramy (05) (Cal. Rules of Court, rules 3.400-3.403) Uninsured motorist (46) E Rule 3‘740 collections (09) E Antitrust/Trade regulation (03) Other PIIPDIWD (Personal InjurylProperty E Othercollections (09) D Construction defect (10)D Real Property Environmental/Toxic tort (30) Eminent domainllnverse I Insurance coverage claims arising from theE Other Pl/PDIWD (23) condemnat'on (14) above listed provisionally complex case Non-PI/PDIWD (Other) Tort D Wrongful eviction (33) types (41)D Business tomunfai, business practice (07) D Other real property (26) Enforcement of JudgmentE Civil rights (08) Unlawful Detainer E Enforcement of judgment (20)E Defamation (13) D CommefCial (31) Miscellaneous Civil ComplaintB Fraud (15) D Residential (32) D RICO (27)a 'melleCtua' Pmpedy (19) E DTUQS (38) Other complaint (not specified above) (42)B Professionalnegligence (25) Judicial Review Miscellaneous Civil Petitiona Other non'P'IPD/WD ton (35) E Asset forfeiture (05) Partnership and corporate governance (21) Employment Petition re: arbitration award (1 1) D Other petition (not specified above) (43)Q Wrongful termination (36) E Writ of mandate (02)D Other employment (15) D Otherjudicial review (39) 2. This case D is is not complex under rule 3.400 ofthe California Rules of Court. lfthe case is complex, mark the factors requiring exceptional judicial management: a.E Large number of separately represented parties d.D Large number of witnesses b.D Extensive motion practice raising difficult or novel e.D 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. E Substantial postjudgmentjudicial supervision Remedies sought (check all that apply): a.- monetary b.- nonmonetary; declaratory 0r injunctive relief c. .punitive Number of causes of action (spech‘y): 6 This case D is m 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.) DatezJanuary 25 ,2021 .[Vicga-Nocl Varlack t PgVW’O-QU (TYPE OR PRINT NAME) (SIGNATURE OF PARTY 0R ATTORNEY FOR PARTY) 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. - Unless this is a collections case under rule 3.740 or a complex case. this cover sheet will be used for statistical purposes onl . age 1 o! 2 Form Adopted for Mandalory Use Cal. Rules of Cuuvl. rules 2.30. 3.220, 3400-1403. 3.740: Judicial Council of California CIVIL CASE COVER SH EET Cal. Standards olJudicial Administration. std. 3.10 CM-010 [Rem July 1. 2007] www.courtmfo.ca.gov 9‘1“?” INSTRUCTIONS ON HOW TO COMPLETE THE COVER SHEET CM 01o 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 paper, the Civil Case Cover Sheet contained on page 1. This information will be used to compile statistics about the types and numbers of cases filed. You must complete items 1 through 6 on the sheet. In item 1, you must check one box for the case type 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 specific 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 attomey’s fees, arising from a transaction in which property, services. or money was acquired on credit. A collections case does not include an action seeking the following: (1) tort damages. (2) punitive damages, (3) 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 time-for-service requirements and case management rules, unless a defendant files a responsive pleading. A rule 3.740 collections case will be subject to the requirements for service and obtaining a judgment in rule 3.740. To Parties in Complex Cases. In complex cases only, parties must also use the Civil Case Cover Sheet to designate whether the case is complex. If a plaintiff believes the 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 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)-Personal Injury/Property Damage/Wrongful Death Uninsured Motorist (46) (if the case involves an uninsured motorist claim subject to arbitration, check this item instead ofAuto) Other PIIPDIWD (Personal Injury! Property DamageIWrongful Death) Tort Asbestos (04) Asbestos Property Damage Asbestos Personal Injury/ Wrongful Death Product Liability (not asbestos or toxic/environmental) (24) Medical Malpractice (45) Medical Malpractice- Physicians & Surgeons Other Professional Health Care Malpractice Other Pl/PDNVD (23) Premises Liability (e.g.. slip and fall) Intentional Bodily Injury/PD/WD (e.g.. assault. vandalism) Intentional lnfliction of Emotional Distress Negligent lnfliction of Emotional Distress Other Pl/PD/WD Non-PIIPDIWD (Other) Tort Business TortlUnfair Business Practice (07) Civil Rights (e.g., discrimination, false arrest) (not civil harassment) (08) Defamation (e.g., slander. libel) 13 Fraud (1 6) Intellectual Property (19) Professional Negligence (25) Legal Malpractice Other Professional Malpractice (not medical or legal) Other Non-PI/PDNVD Tort (35) Employment Wrongful Termination (36) Other Employment (1 5) CM-mo (Rev. July 1. 2007] CASE TYPES AND EXAMPLES Contract Breach of ContracWVarranty (06) Breach of Rental/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 (not provisionally complex) (1 8) Auto Subrogation Other Coverage Other Contract (37) Contractual Fraud Other Contract Dispute Real Property Eminent Domain/Inverse Condemnation (14) Wrongful Eviction (33) Other Real Properly (e.g., quiet title) (26) Writ of Possession of Real Property Mortgage Foreclosure Quiet Title Other Real Property (not eminent domain, Iandlord/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 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) AntitrustlTrade Regulation (03) Construction Defect (10) Claims Involving Mass Tort (40) Securities Litigation (28) Environmental/Toxic Tort (30) Insurance Coverage Claims (arising 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- domestic relations) Sister State Judgment Administrative Agency Award (not unpaid taxes) Petition/Cerlification of Entry of Judgment on Unpaid Taxes Otheé Enforcement of Judgment ase Miscellaneous Civil Complaint RICO (27) Other Complaint (not specified above) (42) Declaratory Relief Only lnjunctive Relief Only {nan- harassment) Mechanics Lien Other Commercial Complaint Case (non-lort/non-complex) Other Civil Complaint (non-tort/non-complex) Miscellaneous Civil 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 Page 2 of 2
