Civil Case Cover SheetCal. Super. - 6th Dist.April 2, 2021- Your Current Name: Ellery Susan Carlsofl ATTORNEY OR PARTY WITHOUTATTORNEY (Nam, Shfs Barnumber. and addmss}: Street Address: 5637 Calmor Ave. #2 City. State. Zip: San Jose, CA 95123 TELEPHONE No.: (408) 375-7962 FAX No.: ATTORNEY FOR (Name): Self-Represented SUPERIOR COURT OF CALIFOR CO NTV OF smEmDDRESS 191 Nonfl'firstlétreet MAILING Aonngss; 191 North First Street crrv AND zIP oonE: San Jose, CA 951 13 BRANCH NAME Civil Division “I me Court a Cou'nw clSm Clam . 'EPUTY CASE NAME. Name and Gender Change of. Ellery Susan Carlson _ :Ll Avn_ MART‘NEZ CIVIL CASE COVER SHEET Complex Case Designation cAsE Munnami a a c ? 9m Unlimited a Limited D Counter Jam“, 1 W 3 F; 3 3(Amount (Amount JUDGE. demanded demanded is Filed with first appearance by defendant ' exceeds $25,000) $25,000 or less) (Cal. Rules of Court, rule 3.402) nan: Items 1-6 below must be completed (see instructions on page 2). . Check one box below for the case type that best describes thls case: Auto Tort Contract ‘ Provlslonally Complex Clvln thlgatlon .1' Auto (22) I“ Breach of oontracI/warranly (06) Cal. Rules of Court, rules 3.400-3.403) Uninsured motorist (46) Rule 3.740 collections (09) AntitrustlTrade regulation (03) mher PWD’WD (Personal inluwlpmpeny Other collections (09) Construction defect (1 0) , Insurance coverage(18) Masston(4o)Damage’wmng'mpeamh" - Othercontracusn Securitieslitigationme) Asms'os (M) Environmentall'l'oxic tort (30) quuc' "ab'my (2.4) Real P I "y 7 Insurance coverage cl'aims an'sing from the Medical malpractice (45) - Eminent domainllnverse above Med provisional”, complex case Other PI/PD/WD (23) condemnation (1 4) types (41) Non-PUPDIWD (Other) Tort wmngfu' “mm“ (33) Oiher real properly (26) Enforcement of Judgment Business torl/unfalr business practice (07) - Enfomemem of.Judgment (20) Civil nghts (08) _ Unlawful Detalner Defamation (1 3) Commercial (51) Mlsoellaneous Clvll Complalnt Fraud (1 6) Residential (32) RICO (27) Intellectual property (1 9) Drugs (38) Other complaint (not specified above) (42) ' Professional negligence (25) Judicial Revlew Miscellaneous Clvll Petltlon Other non'Pl/PD/WD ton (35) Asset forfeiture (05) Partnership and corporate govemance (21) Employment Petition re: arbitration award (11) Other petition (not specified above) (43) Wrongful terminafion (36) Writ of mandate (02) , Other employment (1 5) Other judicial review (39) 99".“? 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. fl 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 court c. a Substantial amount of documentary evidence f. Substantial postjudgment judiclal supervision- Remedies sought (check all thatapply): a.a monetary b. nonmonetary declaratory or Injunctlve relief c. Ipunitive Number of causes of actionsecify): This case a is 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-015.) I Date: ' g Ellery Susan Carlson P (TYPE OR PRINT NAME) (SIGNATURE OF PARTY 0-H ATTORNEY FOR PARTY) a Plaintiff must file this cover sheet with the first paper filed in the action or proceeding (except small claims cases or cases filed a File this cover sheet in addition to any cover sheet required by local court rule. e If this wuss is complex under rule 3.400 et seq. of the California Rules of Court, you must serve a copy of this cover sheet on alfl 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. NOTHCE under the Probate Code. Family Code, or Welfare and Institutions Code). (Cal. Rules of Court, rule 3.220.) Failure to file may result in sancflons. other parties to the action or proceeding. Page 1 cl 2 Efiz‘ifi‘wfl'°”§a@"mm .m-mnmanx - CIVIL CASE COVER SHEET eat. n&?&%gkmxu%udlaod .(kdmrnfagfifw 3%0, aB-Sflmfl FHRMS" ' ‘ WWW-ooumv canov VERN