Civil Cover Sheet

CIVIL CASE REPORTING COVER SHEET WORKSHEET

(Louisiana Civil Case Reporting / Civil Case Cover Sheet shadow – LA. R.S. 13:4688; Rule 9.6)

1. CAPTION

____ JUDICIAL DISTRICT COURT
PARISH OF [PARISH], STATE OF LOUISIANA

Civil Case Reporting / Civil Case Cover Sheet – Worksheet

[PLAINTIFF/PETITIONER NAME],                      Plaintiff/Petitioner,
v.                                                 Suit No.: [TBD BY CLERK]
[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], LA 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. NATURE OF LITIGATION (SELECT PRIMARY)

• ☐ Contract / Business / Commercial
• ☐ Tort – motor vehicle
• ☐ Tort – other personal injury/property damage
• ☐ Medical malpractice
• ☐ Legal malpractice
• ☐ Products liability
• ☐ Employment (discrimination, wage, restrictive covenant)
• ☐ Real property / immovable property (quiet title, boundary, possessory)
• ☐ Foreclosure
• ☐ Agency/Administrative appeal
• ☐ Declaratory judgment / injunctive relief
• ☐ Other Civil: [DESCRIBE]

Briefly describe the nature of the litigation: [TEXT]

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

I certify that the information provided is accurate for completion of the Louisiana Civil Case Reporting / Civil Case Cover Sheet.

Date: [DATE]

____________________________________
[ATTORNEY NAME], LA Bar [NUMBER] / Pro Se
Attorney for [PARTY]