District Of Columbia > Statewide > Superior Court > Small Claims and Conciliation Branch
Information Sheet - District Of Columbia
| Information Sheet Form. This is a District Of Columbia form and can be used in Small Claims and Conciliation Branch Superior Court Statewide . |
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SUPERIOR COURT OF THE DISTRICT OF COLUMBIA CIVIL DIVISION SMALL CLAIMS AND CONCILIATION BRANCH INFORMATION SHEET Case No: Plaintiff vs Date: Defendant _________________________________ Name: (please print) Relationship to Lawsuit Attorney for Plaintiff Firm Name, if applicable ___________________________________________ Telephone No: 6 Digit Unified Bar No. Do you need an interpreter for your case? AMOUNT IN CONTROVERSY: Case No: NATURE OF SUIT: (Check One Box Only) A. CONTRACTS a claim based on an agreement between parties made either orally or in writing Debt Suit Personal Property Unpaid Wages Breach of Contract Breach of Warranty Loan Services Rendered Home Improvement Contract Negotiable Instrument Rent Due Security Deposit Oral Yes Self (Pro Se) Other: No If yes, what type: $500.01 - $2,500 Case No: $2,500.01 - $5,000 $1 -$500 PENDING CASE(S) RELATED TO THE ACTION BEING FILED: B. PROPERTY TORTS a claim for an injury or wrong committed on the property of another Automobile Property Damage Assault and Battery Automobile Harassment Conversion Destruction of Property False Witness Personal Injury Fraudulent Misrepresentation Shop Lifting Trespass Libel and Slander Negligence Slip and Fall G. SUBROGATION a claim filed by one person in the place of another H. COLLECTION- a claim filed by a seller or lender to collect a consumer debt Yes No American LegalNet, Inc. www.FormsWorkFlow.com C. PERSONAL TORT a claim for an injury or wrong committed on the person of another D. UNIFORM ARBITRATION ACT an action based on an arbitration agreement E. FOREIGN JUDGMENT- a judgment, decree or order filed from another jurisdiction F. MEDICAL MALPRACTICE a claim against a healthcare provider for professional misconduct Have you given notice of intention to file your lawsuit 90 days prior to filing? CV-3046/Rev. Nov. 07
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