STATE OF RHODE ISLAND – SUPERIOR COURT

CIVIL CASE COVER SHEET (INTAKE WORKSHEET)

[// GUIDANCE: This mirrors the RI Superior Court Civil Case Cover Sheet (SC-223 / Superior-3). Check the latest “Nature of Proceeding” options, fee bands, and note if this is a District Court appeal.]

1. CAPTION

text
STATE OF RHODE ISLAND
SUPERIOR COURT

[PLAINTIFF NAME], PLAINTIFF
v. Case No.: [TBD BY CLERK]
[DEFENDANT NAME], DEFENDANT

2. PARTY INFORMATION

• Plaintiff(s): [NAME / ADDRESS / PHONE / EMAIL]
• Defendant(s): [NAME / ADDRESS / PHONE / EMAIL]
• Additional parties: attach list if needed.
• Plaintiff ID # (if used): [ID]
• Defendant ID # (if used): [ID]
• [___] District Court appeal

3. ATTORNEY OR SELF-REPRESENTED PARTY

• Name / Bar No.: [ATTORNEY NAME], RI Bar [NUMBER]
• Firm: [LAW FIRM NAME]
• Address: [STREET, CITY, STATE ZIP]
• Phone/Email: [PHONE] | [EMAIL]
• ☐ Self-represented (Pro Se)

4. NATURE OF PROCEEDING (CHECK ONE PRIMARY)

• Personal Injury / Wrongful Death
• ☐ Auto Tort
• ☐ Other Personal Injury
• ☐ Wrongful Death
• Property Damage
• ☐ Auto Property Damage
• ☐ Other Property Damage
• Contract Damages
• ☐ UCC / Commercial
• ☐ Insurance / Coverage
• ☐ Collections / Money Owed
• ☐ Other Contract
• Professional Malpractice
• ☐ Medical Malpractice
• ☐ Legal Malpractice
• ☐ Other Professional Malpractice
• Civil Rights / Other Torts
• ☐ Civil Rights
• ☐ Product Liability
• ☐ Other Tort
• Employment
• ☐ Employment / Discrimination / Wage
• Administrative / Appeals
• [___] District Court Appeal
• ☐ Administrative Appeal / Statutory Review
• Other Civil (not listed above)
• ☐ Other: [DESCRIBE]
  [// GUIDANCE: Mirror the latest SC-223 “Nature of Proceeding” options and use only one primary selection.]

5. AMOUNT IN CONTROVERSY

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

6. JURY DEMAND

• ☐ Jury requested
• ☐ Non-jury

7. RELATED CASES

• Related case numbers/courts: [LIST OR "NONE"]
• Prior appeals/arbitrations: [LIST OR "NONE"]

8. SERVICE & SPECIAL NOTES

• Service addresses and method (sheriff/process server/certified mail): [DETAILS]
• Interpreter or accommodation needed: [YES/NO - LANGUAGE/ACCOMMODATION]

9. SIGNATURE

text
Date: [DATE]

____________________________________
[ATTORNEY NAME], RI Bar [NUMBER] / Pro Se
Attorney for [PLAINTIFF/DEFENDANT]
[// GUIDANCE: Confirm any updated SC-223 categories, fee impacts, or local supplements, and ensure “one primary” box is checked on the official form.]