Confidential Cover Sheet False Claims Action {MC-060}

CONFIDENTIAL ATTORNEY (Name, state bar number, and address): FOR COURT USE ONLY MC­060 TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR: PLAINTIFF FAX NO. (Optional): OTHER (specify): SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PLAINTIFF: DEFENDANT: [UNDER SEAL] [UNDER SEAL] CASE NUMBER: CONFIDENTIAL COVER SHEET­FALSE CLAIMS ACTION INSTRUCTIONS: This civil action is brought under the False Claims Act, Government Code section 12650 et seq. The documents filed in this case are under seal and are confidential pursuant to Government Code section 12652(c). This Confidential Cover Sheet must be affixed to the caption page of the complaint and to any other paper filed in this case until the seal is lifted. You should check with the court to determine whether papers filed in False Claims Act cases must be filed at a particular location. 1. The document to which this cover sheet is affixed is: a. Complaint for damages for violation of the False Claims Act Civil Case Cover Sheet (form 982.2(b)(1)) b. c. Motion for an extension of time to intervene Affidavit or other document in support of the motion for an extension of time d. Order extending time to intervene (specify date order expires): e. Other order (describe): f. Seal to expire on (date): UNLESS: (1) Motion to extend time is pending; or (2) Extended by court order g. h. Notice from the Attorney General of additional prosecuting authority that may have access to the file Other (describe): 2. This Confidential Cover Sheet and the attached document must each be separately file-stamped by the clerk of the court. Date: Page 1 of 1 Form Adopted for Mandatory Use Judicial Council of California MC-060 [Rev. January 1, 2007] CONFIDENTIAL COVER SHEET FALSE CLAIMS ACTION Gov. Code, § 12652(c); Cal. Rules of Court, rules 2.570-2.573 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkflow.com