CIVIL CASE COVER SHEET WORKSHEET
(Kentucky AOC-104 shadow worksheet – District/Circuit Court)
[// GUIDANCE: Use this to gather data before completing the official AOC-104. eFiling captures this information electronically; paper filings must attach AOC-104.]
1. CAPTION
text
COMMONWEALTH OF KENTUCKY
COURT OF JUSTICE [ ] DISTRICT COURT [ ] CIRCUIT COURT
COUNTY OF [COUNTY]
Civil Case Cover Sheet (AOC-104) – Worksheet
Case No.: [TBD BY CLERK]
[PLAINTIFF/PETITIONER NAME], Plaintiff/Petitioner,
v.
[DEFENDANT/RESPONDENT NAME], Defendant/Respondent.
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], KY Bar [NUMBER] (or “Pro Se”)
- Firm: [LAW FIRM NAME]
- Address: [STREET, CITY, STATE ZIP]
- Phone/Email: [PHONE] | [EMAIL]
- Attorney for: [PLAINTIFF/PETITIONER/DEFENDANT/RESPONDENT]
- [ ] Self-represented party
4. CASE TYPE (SELECT ONE – AOC-104 CATEGORIES)
[// GUIDANCE: Choose the single primary case type from the AOC-104 list.]
- Domestic Relations / Family
- Tort (injury)
- Consumer / Commercial
- Real Property
- Probate / Estate
- Employment
- Business / Commercial
- Miscellaneous Civil
- Other Civil: [DESCRIBE]
5. AMOUNT / RELIEF (WORKSHEET)
- Monetary relief: $[AMOUNT] (exclusive of fees/costs)
- Non-monetary / equitable relief: [DESCRIBE]
6. JURY DEMAND
- [ ] Jury requested
- [ ] Non-jury
7. RELATED CASES
- [ ] Yes (list case number(s)/court(s)): [DETAILS]
- [ ] No
8. SERVICE & SPECIAL NOTES (WORKSHEET)
- Service addresses and method (sheriff/process server/certified mail): [DETAILS]
- Interpreter needed: [YES/NO] – Language: [SPECIFY]
- Accommodation needed (ADA/disability): [YES/NO] – Describe: [SPECIFY]
9. CERTIFICATION & SIGNATURE
text
I certify that the information provided is accurate for completion of the Kentucky Civil Case Cover Sheet (AOC-104).
Date: [DATE]
____________________________________
[ATTORNEY NAME], KY Bar [NUMBER] / Pro Se
Attorney for [PARTY]
[// GUIDANCE: File the official AOC-104 (or provide the required information via eFiling) with the initial pleading in District or Circuit Court. One case type must be selected.]***