Fill and Sign the Cover Sheet for Filing Civil Actions Virginias Judicial System Form

FORM CC-1416 (MASTER) PAGE ONE 07/16 COVER SHEET FOR FILING CIVIL ACTIONS Case No. ............................................................................. COMMONWEALTH OF VIRGINIA (CLERK’S OFFICE USE ONLY) ........................................................................................................................................................................................................................... Circuit Court ............................................................................................................................... v./ In re: ...................................................................................................................... PLAINTIFF(S) DEFENDANT(S) ............................................................................................................................... ...................................................................................................................... I, the undersigned [ ] plaintiff [ ] defendant [ ] attorney for [ ] plaintiff [ ] de fendant hereby notify the Clerk of Court that I am filing the following civil action. (Please indicate by checking box that most clos ely identifies the claim being asserted or relief sought.) GENERAL CIVIL Subsequent Actions [ ] Claim Impleading Third Part y Defendant [ ] Monetary Damages [ ] No Monetary Damages [ ] Counterclaim [ ] Monetary Damages [ ] No Monetary Damages [ ] Cross Claim [ ] Interpleader [ ] Reinstatement (other than divorce or driving privileges ) [ ] Removal of Case to Federal Co urt Business & Contract [ ] Attachment [ ] Confessed Judgment [ ] Contract Action [ ] Contract Specific Performance [ ] Detinue [ ] Garnishment Property [ ] Annexation [ ] Condemnation [ ] Ejectment [ ] Encumber/Sell Real Estate [ ] Enforce Vend or’s Lien [ ] Escheatment [ ] Establish Boundaries [ ] Landlord/Tenant [ ] Unlawful Detainer [ ] Mechanics Lien [ ] Partition [ ] Quiet Title [ ] Termination of Mineral Rights Tort [ ] Asbestos Litigation [ ] Compromise Settlement [ ] Intentiona l Tort [ ] Medical Malpractice [ ] Motor Vehicle Tort [ ] Product Liability [ ] Wrongful Death [ ] Other General Tort Liability ADMINISTRATIVE LAW [ ] Appeal/Judicial Review of Decision of (select one) [ ] ABC Board [ ] Board of Zoning [ ] Comp ensation Board [ ] DMV License Suspension [ ] Employee Grievance Decision [ ] Employment Commission [ ] Local Government [ ] Marine Resources Commission [ ] School Board [ ] Voter Registration [ ] Other Administrative Appeal DOMESTIC/FAMILY [ ] Ad option [ ] Adoption – Foreign [ ] Adult Protection [ ] Annulment [ ] Annulment – Counterclaim/Responsive Pleading [ ] Child Abuse and Neglect – Unfounded Complaint [ ] Civil Contempt [ ] Divorce (select one) [ ] Complaint – Contested * [ ] Complaint – Uncontested* [ ] Counterclaim/Responsive Pleading [ ] Reinstatement – Custody/Visitation/Support/Equitable Distribution [ ] Separate Maintenance [ ] Separate Maintenance Counterclaim WRITS [ ] Certiorari [ ] Habeas Corpus [ ] Mandamus [ ] Proh ibition [ ] Quo Warranto PROBATE/WILLS AND TRUSTS [ ] Accounting [ ] Aid and Guidance [ ] Appointment (select one) [ ] Guardian/Conservator [ ] Standby Guardian/Conservator [ ] Custodian/Successor Custodian (UTMA) [ ] Trust (select one) [ ] Impre ss/Declare/Create [ ] Reformation [ ] Will (select one) [ ] Cons true [ ] Contested MISCELLANEOUS [ ] Amend Death Certificate [ ] Appointment (select one) [ ] Church Trustee [ ] Conservator of Peace [ ] Marriage Celebrant [ ] Approval of Transfer of Structured Settlement [ ] Bond Forfeiture Appeal [ ] Declaratory Judgment [ ] Declare Death [ ] Driving Privileges (select one) [ ] Reinstatement pursuant to § 46.2 -427 [ ] Restor ation – Habitual Offender or 3 rd Offense [ ] Expungement [ ] Fire arms Rights – Restoration [ ] Forfeiture of Property or Money [ ] Freedom of Information [ ] Injunction [ ] Interdiction [ ] In terrogatory [ ] Judgment Lien -Bill to Enforce [ ] Law Enforcement/Public Official Petition [ ] Name Change [ ] Referendu m Elections [ ] Sever Order [ ] Taxes (select one) [ ] Correct Erroneous State/Local [ ] Delinquent [ ] Vehicle Confiscation [ ] Voting Rights – Restoration [ ] Other (please specify) ............................................................................ ...................................................................... ____________________________________________________ ________________ DATE [ ] PLAINTIFF [ ] DEFENDANT [ ] ATTORNEY FO R [ ] PLAINTIFF [ ] DEFENDANT ............................................................................................................................................ PRINT NAME ............................................................................................................................................ ADDRESS/TELEPHONE NUMBER OF SIGNATOR ............................................................................................................................................ ............................................................................................................................................ EMAIL ADDRESS OF SIGN ATOR (OPTIONAL) *“Contested” divorce means any of the following matters are in dispute: grounds of divorce, spousal support and maintenance, child custody and/or visitation, child support, property distr ibution or debt allocation. An “Uncontested” divorce is filed on no fault grounds and none of the above issues are in dispute. [ ] Damages in the amount of $ ............................................................... are claimed. FORM CC -1416 (MASTER) PAGE TWO 10/17 Civil Action Type Codes (Clerk’s Office Use Only) Accounting .......................................................................... ACCT Adoption ............................................................................... ADOP Adoption – Foreign .......................................................... FORA Adult Protec tion .................................................................. PROT Aid and Guidance .................................................................. AID Amend Death Certificate ................................................... ADC Annexation ........................................................................ ANEX Annulment ........................................................................... ANUL Annulment – Counterclaim/Responsive Pleading .. ACRP Appeal/Judicial Review ABC Board .................................................................... ABC Board of Zoning ........................................................ ZONE Comp ensation Board .............................................. ACOM DMV License Suspension ............................................. JR Employment Commission ........................................ EMP Employment Grievance Decision .......................... GRV Local Government ................................................... GOVT Marine Resources ....................................................... MAR School Board ..................................................................... JR Voter Registration .................................................... AVOT Other Administrative Appeal ............................... AAPL Appointment Conservator of Peace .................................................. COP Church Trustee .......................................................... AOCT Custodian/Su ccessor Custodian (UTMA) ...... UTMA Guardian/Conservator .............................................. APPT Marriage Celebrant ................................................. ROMC Standby Guardian/Conservator ........................... STND Approval of Transfer of Structured Settlement .............. SS Asbestos Litigation .................................................................. AL Attachment .............................................................................. ATT Bond Forfeiture Appeal ...................................................... BFA Child Abuse and Negl ect – Unfounded Complaint .. CAN Civil Contempt ................................................................... CCON Claim Impleading Third Party Defendant – Monetary Damages/No Monetary Damages ........... CTP Complaint – (Miscellaneous) .......................................... COM Compromise Settlement ................................................. COMP Condemnation ................................................................... COND Confessed Judgment ................................................................ CJ Contract Action .................................................................. CNTR Contract Specific Performance ....................................... PERF Counterclaim – Monetary Damages/No Monetary Damages ................................................................................. CC Cross Claim ......................................................................... CROS Declaratory Judgment ...................................................... DECL Declare Death ..................................................................... DDTH Detinue ...................................................................................... DET Divorce Complaint – Contested/Uncontested ...................... DIV Counterclaim/Responsive Pleading ................... DCRP Reinstatement – Custody/Visitation/Support/ Equitable Distribution ............................................ CVS Driving Privileges Reinstatement pursuant to § 46.2 -427 ................ DRIV Restoration – Habitual Offender or 3 rd Offense ................................................................... REST Ejectment ........................................................................... EJET Encumber/Sell Real Estate ............................................... RE Enforce Vendor’ s Lien ................................................ VEND Escheatment ........................................................................ ESC Establish Boundaries .................................................... ESTB Expungement .................................................................. XPUN Forfeiture of Property or Money .............................. FORF Freedom of Information .................................................. FOI Garnishment .................................................................. GARN Injunction ............................................................................... INJ Intentional Tort ................................................................ ITOR Interdiction ....................................................................... INTD Interpleader ....................................................................... INTP Interrogatory ..................................................................... INTR Judgment Lien – Bill to Enforce ............................... LIEN Landlord/Tenant ................................................................... LT Law Enforcement/Public Official Petition ............... LEP Mechanics Lien ............................................................ MECH Medical Malpractice ...................................................... MED Motor Vehicle Tort ........................................................... MV Name Change ....................................................................... NC Other General Tort Liability ..................................... GTOR Partition ............................................................................. PART Permit , Unconsti tutional Grant/Denial by Locality LUC Petition – (Miscellaneous) ............................................. PET Product Liability ........................................................... PROD Quiet Title .............................................................................. QT Referendum Elections .................................................. ELEC Reinstatement ( Other than divorce or driving privileges) ..................................................................... REIN Removal of Case to Federal Court ............................. REM Restore Firearms Rights – Felony ............................ RFRF Restore Firearms Rights – Review .......................... RFRR Separate Maintenance ...................................................... SEP Separate Maintenance – Counterclaim/Responsive Pleading ........................................................................ SCRP Sev er Order ...................................................................... SEVR Sex Change ......................................................................... COS Taxes Correct Erroneous State/Local ........................ CTAX Delinquent .............................................................. DTAX Termination of Mineral Rights .................................... MIN Trust – Impress/Declare/Create ................................ TRST Trust – Reformation ...................................................... REFT Uniform Foreign Country Money Judgments ....... RFCJ Unlawful Detainer .............................................................. UD Vehicle Confiscation ...................................................... VEH Voting Rights – Restoration ...................................... VOTE Will Construction ........................................................... CNST Will Contested ................................................................ WILL Writs Certiorari ...................................................................... WC Habeas Corpus ........................................................ WHC Mandamus .................................................................. WM Prohibition .................................................................... WP Quo Warranto ........................................................ WQW Wrongful Death .................................................................. WD