DISTRICT COURT CIVIL COVER SHEET WORKSHEET

(Nevada Form PA 201 shadow – District Court)

[// GUIDANCE: Use this to gather data before completing the official Nevada District Court Civil Cover Sheet.]

1. CAPTION

text
IN THE DISTRICT COURT OF THE STATE OF NEVADA
IN AND FOR THE COUNTY OF [COUNTY]

[PLAINTIFF/PETITIONER NAME], Plaintiff/Petitioner,
v. Case No.: [TBD BY CLERK]
[DEFENDANT/RESPONDENT NAME], Defendant/Respondent.

2. PARTIES & CONTACTS (worksheet)

• Plaintiff(s): [NAME / HOME ADDRESS / MAILING ADDRESS / PHONE / EMAIL]
• Defendant(s): [NAME / HOME ADDRESS / MAILING ADDRESS / PHONE / EMAIL]
• Additional parties: attach list if needed.
• Attorney: [NAME], NV Bar [NUMBER], Firm: [FIRM], Address: [ADDRESS], Phone: [PHONE], Email: [EMAIL]
• [ ] Self-represented party

3. NATURE OF CONTROVERSY (Form PA 201 categories)

• Landlord/Tenant: [ ] Unlawful Detainer [ ] Other L/T
• Real Property: [ ] Title to Property [ ] Judicial Foreclosure [ ] Other Real Property
• Torts: [ ] Auto Tort [ ] Premises Liability [ ] Product Liability [ ] Intentional Misconduct [ ] Employment Tort [ ] Insurance Tort [ ] Other Tort
• Probate: [ ] Summary Administration [ ] General Administration [ ] Special Administration [ ] Guardianship
• Construction Defect: [ ] Construction Defect
• Contract: [ ] Uniform Commercial Code [ ] Building & Construction [ ] Insurance Carrier [ ] Commercial Instrument [ ] Collection of Accounts [ ] Employment Contract [ ] Other Contract
• Civil Writs: [ ] Writ of Habeas Corpus [ ] Writ of Prohibition [ ] Writ of Mandamus [ ] Writ of Quo Warranto [ ] Other Civil Writ
• Judicial Review/Appeal: [ ] Review of Agency Determination [ ] Mental Competency [ ] NRS 233B (State Agency) [ ] Occupational License [ ] Other Judicial Review
• Other Civil Filing: [ ] Other Civil Filing
• Business Court: [ ] Business Court (use Business Court cover sheet)

4. CIVIL CASE FILING TYPE / AMOUNT BAND

• [ ] $300,000 or greater
• [ ] $25,001–$300,000
• [ ] $15,001–$25,000
• [ ] $10,001–$15,000
• [ ] $2,501–$10,000
• [ ] $2,500 or less

5. RELIEF

• 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 Nevada District Court Civil Cover Sheet (Form PA 201).

Date: [DATE]

____________________________________
[ATTORNEY NAME], NV Bar [NUMBER] / Pro Se
Attorney for [PARTY]
[// GUIDANCE: File the official Nevada District Court Civil Cover Sheet (Form PA 201) with the complaint. Business Court matters use the Business Court cover sheet.]***