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Fill and Sign the This Form Approved by the Judge of Civil District Court En Banc is

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Rev. 7/01 CLERK OF CIVIL DISTRICT COURT COVER SHEET The civil cover sheet and the information contained herein neither replace nor supplement the fili ng and service of pleadings or other papers as required by law. This form, approved by the Judge of Civi l District Court en banc is authorized for use by the Clerk of Court for the purpose of initiating the civil docket sheet. The plaintiff filing the suit must fill out this form. PLAINTIFFS (Name of first plaintiff listed) PARISH OF RESIDENCE OF FIRST LISTED PLAINTIFF DEFENDANTS (Name of first defendant listed) PARISH OF RESIDENCE OF FIRST LISTED DEFENDANT ATTORNEYS (Firm Name, Address, & Telephone No.) TO BE FILED IN BY CLERK’S OFFICE CASE NO. DIVISION JURY DEMAND (yes or no) PROBATE CONTRACT SPECIAL PROCEEDING TORTS- PERSONAL INJURY STATUS & DOMESTIC 110 Simple Possession (No Will) 115 Petition to Probate Will (with admin- istration) 120 Petition to Probate Will (without ad- ministration) 125 Petition to Search for Will 130 Other 210 Open Account 215 Breach of Contract 220 Suit on Note 225 Suit on Note with Fore- closure of Chattel Mortgage 230 Suit for Earned Wages 235 Suit for Accounting 240 Other 310 Injunction 315 Declaratory Judgment 320 Judicial Review Zoning 325 Mandamus (non-real estate) 330 Election Suit 335 Minor’s Settlement 340 Concursus 345 Petition for Discovery 350 Petition for Writ for Sequestration 355 Petition to Make Judgment Executory 360 Tax Suit 365 Petition to Become Notary 370 Other 410 Motor Vehicle 415 Motor Vehicle - Product Liability 420 Product Liability – Other 425 Medical Malpractice 430 Premises (liability for condition) 435 Marine 440 Intentional Tort 445 Defamation 450 Other 455 Asbestos 460 Class Action 510 Separation 515 Divorce 520 Annulment 525 Custody (not filed with separation or divorce) 530 Disavowment Of Paternity 535 Suit to Establish Paternity 536 Child Support 540 Name Change 545 Emancipation 550 Interdiction 555 Commitment 560 Petition to Appoint Curator 565 Partition of Community (separate Action) 570 Marital Agreement 575 Pet. To Make Judgment Executory (Domestic) 580 Other LABOR IMMOVABLE PROPERTY 610 Joint Petition for Workmen’s Compensation 615 Judicial Review 620 Workmen’s Compensation 625 Other 710 Suit on Note with Fore- closure of Mortgage 720 Suit to Rescind Sale Or for Refund Of Purchase Price 725 Suit for Specific Performance 730 Declaratory Judgment 735 Rent and/or Eviction 740 Expropriation 745 Mandamus to Cancel Mortgage 750 Other Check/Fill in if demanded in complaint:: Check if this is a CLASS ACTION under Demand $ RELATED CASE(S) IF ANY JUDGE CASE NO. CIVIL CASES ARE DEEMED RELATED IF PENDING CASE INVOLVED 1. Property included in an earlier numbered pending suit 2. Same issue of fact or grows out of the same 3. Validity or infringement of the same patent copyright or trademark Other

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