Civil Cover Sheet

GENERAL CIVIL & DOMESTIC RELATIONS CASE FILING WORKSHEET

(Georgia statewide case filing information form shadow worksheet – v1.1.20)

1. CAPTION & COURT SELECTION

☐ SUPERIOR COURT   ☐ STATE COURT   OF [COUNTY], GEORGIA

General Civil and Domestic Relations Case Filing Information – Worksheet

Case No.: [TBD BY CLERK]      Date Filed: [DATE]

Plaintiff/Petitioner: [NAME(S)]
Defendant/Respondent: [NAME(S)]

2. PARTY INFORMATION

• Plaintiff/Petitioner(s): [NAME / ADDRESS / PHONE / EMAIL]
• Defendant/Respondent(s): [NAME / ADDRESS / PHONE / EMAIL]
• Additional parties: attach list if needed.

3. ATTORNEY OR SELF-REPRESENTED PARTY

• Name / Bar No.: [ATTORNEY NAME], GA Bar [NUMBER] (or “Pro Se”)
• Firm: [LAW FIRM NAME]
• Address: [STREET, CITY, STATE ZIP]
• Phone/Email: [PHONE] | [EMAIL]
• Attorney for: [PLAINTIFF/DEFENDANT/PETITIONER/RESPONDENT]
• ☐ Self-represented party

4. CASE TYPE (CHECK ONE PRIMARY) – STATEWIDE FORM CATEGORIES

General Civil

• ☐ Automobile Tort
• ☐ Civil Appeal
• ☐ Contempt/Modification/Other Post-Judgment
• ☐ Contract
• ☐ Garnishment
• ☐ General Tort
• ☐ Habeas Corpus
• ☐ Injunction/Mandamus/Other Writ
• ☐ Landlord/Tenant
• ☐ Medical Malpractice Tort
• ☐ Product Liability Tort
• ☐ Real Property
• ☐ Restraining Petition
• ☐ Other General Civil

Domestic Relations

• ☐ Adoption
• ☐ Contempt
• ☐ Non-payment of support
• ☐ Dissolution/Divorce/Separate Maintenance
• ☐ Family Violence Petition
• ☐ Modification
• ☐ Custody/Parenting Time/Visitation
• ☐ Paternity/Legitimation
• ☐ Support – IV-D
• ☐ Support – Private
• ☐ Other Domestic Relations

5. RELATED ACTIONS

• ☐ Yes (list case number(s)/court(s)): [DETAILS]
• ☐ No

6. INTERPRETER & ACCOMMODATIONS

• Interpreter needed: [YES/NO] – Language: [SPECIFY]
• Disability accommodation needed: [YES/NO] – Describe: [SPECIFY]

7. AMOUNT IN CONTROVERSY (OPTIONAL WORKSHEET DETAIL)

• Monetary relief: $[AMOUNT] (exclusive of fees/costs)
• Non-monetary / equitable relief: [DESCRIBE]

8. JURY DEMAND

• ☐ Jury requested
• ☐ Non-jury

9. SERVICE & SPECIAL NOTES

• Service addresses and method (sheriff/process server/certified mail): [DETAILS]
• Out-of-state or special service issues: [DETAILS]

10. CERTIFICATION & SIGNATURE

I certify that the information provided is accurate and complies with the redaction requirements of OCGA § 9-11-7.1.

Date: [DATE]

____________________________________
[ATTORNEY NAME], GA Bar [NUMBER] / Pro Se
Attorney for [PLAINTIFF/DEFENDANT/PETITIONER/RESPONDENT]