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Fill and Sign the Family Law Case Management Statement Dissolution of Form

Fill and Sign the Family Law Case Management Statement Dissolution of Form

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PETITIONER’S (or ATTORNEY’S) NAME & ADDRESS: ____________________________________________________________ ______________________________ ______________________________ PETITIONER P.I.N.#: ________Telephone No: _________FOR COURT USE ONLYCASE NUMBER: COUNTY WHERE CASE FILED:CASE NAME: ______________________________NATURE OF THE CASE: CHECK the BOX to the LEFT of the ONE case category that most accurately describes your PRIMARY CASE . If you are making more than one type of claim, check the one that involves the largest amount of damages or the one you consider most important. LAW: Contract/Commercial ClaimDOMESTIC RELATIONSEQUITYDebt collection (LA-C1)Dissolution-children involved (CD-DC)Mortgage foreclosure (EQ-EM)Employment-related claim (LA-C3)Dissolution-no children (CD-DN)Other real property claim (EQ-ER)Other contract/commercial claim (LA-C9)Modification-children involved (CD-MC)Other equity (EQ-EO)Modification-no children (CD-MN)LAW: Tort-Personal Injury (P.I.)§ 236 - Domestic abuse (DA-DA)OTHER CIVIL ACTIONSMotor vehicle accident (LA-T2)§ 234 - Foster care (DR-D1)Administrative appeal to dist. ct. (CV-V1)Premises liability/slip & fall (LA-T3)§ 252A - Support action (DR-D2)Change of name (CN-CN)Malpractice: medical or dental (LA-T1)§ 252A.18 - Foreign support (DR-D3)Distress warrant (CV-V2)Products liability (toxic chem./subst.) (LA-T8)§ 252B.11 - Cost recovery (DR-D4)Foreign judgment entry (CV-V3)Products liability (not toxic substance) (LA-T4)§ 252C - Administrative Order (DR-D5)Lien (LN - IE, IH, IM or IO)Wrongful death (LA-T7)§ 252D - Income withholding (DR-D6)Post conviction relief (PC-PC)Other negligent/intentional P.I. (LA-T9)§ 252E - Medical support (DR-D7)Seized property/forfeiture (SP-SP)§ 252F/ § 600B – Paternity (DR-D8)Transcript of judgment (TJ-TJ)LAW: Tort-Other damages (no P.I.)§ 252K - UFISA (DR-R1)Other civil action (CV-V9)Professional malpractice-no P.I. (LA-T5)§ 598B – Out of state custody (DR-R2)Fraud/business tort (LA-C2)§ 600 - Adoption (AT-AT)Other tort - property/financial damages (LA-T6)Other domestic relations action (DR-D9) FOR COURT USE ONLY ________________________________________ ________________________________________TYPE OR PRINT NAME SIGNATURE DATE: _________________ *NOTE TO PETITIONER/PLAINTIFF:This cover sheet MUST accompany each civil petition EXCEPT: small claims, probate, or mental health commitment actions.DO NOT SERVE THIS COVER SHEET ON THE DEFENDANT(S). This cover sheet is for statistical purposes only. It shall have no legal affect on the validity of the claims or statute of limitations.

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