SUPERIOR COURT OF THE DISTRICT OF COLUMBIA
Civil Division – Civil Actions Branch

GENERAL CIVIL CASE COVER SHEET
(To be completed and filed contemporaneously with the Complaint – D.C. SCR-Civ. R. 3 & 5)

Case No.: _____  (Clerk to assign)
Date Filed: _____

[// GUIDANCE: The Clerk will stamp the official case number and filing date. All other fields should be completed by filing counsel before submission.]

1. CASE CAPTION

Plaintiff(s):
1. [PLAINTIFF LEGAL NAME]   ☐ Individual  ☐ Business Entity
 Address: [STREET | CITY | STATE | ZIP]
 Telephone: [PHONE] E-Mail: [EMAIL]

2. [ADD ADDITIONAL PLAINTIFFS AS NEEDED]

• vs.-

Defendant(s):
1. [DEFENDANT LEGAL NAME]  ☐ Individual  ☐ Business Entity
 Address: [STREET | CITY | STATE | ZIP]
 Telephone: [PHONE] E-Mail: [EMAIL]

2. [ADD ADDITIONAL DEFENDANTS AS NEEDED]

2. ATTORNEY INFORMATION

Lead Counsel for Plaintiff  ☐ Pro Se
Name: [ATTORNEY NAME]  DC Bar No.: [BAR #]
Firm: [FIRM NAME]
Address: [STREET | CITY | STATE | ZIP]
Telephone: [PHONE] E-Mail: [EMAIL]

Lead Counsel for Defendant (if known):
Name: [ATTORNEY NAME]  DC Bar No.: [BAR #]
Firm: [FIRM NAME]
Address: [STREET | CITY | STATE | ZIP]
Telephone: [PHONE] E-Mail: [EMAIL]

[// GUIDANCE: Substitute “N/A – Unknown at filing” if opposing counsel is not yet identified.]

3. NATURE OF SUIT / CASE CATEGORY

(Check one primary category and one sub-type)

A. CONTRACT / COMMERCIAL
☐ 0101 Breach of Contract
☐ 0102 Breach of Warranty
☐ 0103 Negotiable Instrument
☐ 0199 Other Contract

B. REAL PROPERTY
☐ 0201 Quiet Title / Ejectment
☐ 0202 Construction & Development
☐ 0299 Other Real Property

C. TORT
☐ 0301 Motor Vehicle
☐ 0302 Medical Malpractice
☐ 0303 Other Professional Negligence
☐ 0304 Product Liability
☐ 0305 Personal Injury (other)
☐ 0306 Wrongful Death
☐ 0399 Other Tort

D. EQUITY / OTHER CIVIL
☐ 0401 Declaratory Judgment
☐ 0402 Injunction / Specific Performance
☐ 0499 Other Equitable Relief

E. STATUTORY / PUBLIC LAW
☐ 0501 FOIA / Public Records
☐ 0502 Administrative Appeal
☐ 0599 Other Statutory Action

[// GUIDANCE: These numerical codes mirror the Superior Court’s internal docketing codes. Select only one primary category to avoid mis-routing.]

4. RELIEF SOUGHT

1. Monetary Damages in the amount of $ [DEMAND]  ☐ Including Punitive damages
2. Non-Monetary Relief (specify): [DESCRIPTION]
3. Jury Demand pursuant to D.C. Code § 11-946   ☐ Yes ☐ No

[// GUIDANCE: Enter “TBD” if damages cannot yet be ascertained; amend when quantified.]

5. RELATED PENDING OR DISPOSED CASES

1. Case No.: [NUMBER]  Judge: [NAME]  ☐ Pending ☐ Disposed
2. Case No.: [NUMBER]  Judge: [NAME]  ☐ Pending ☐ Disposed
   ☐ I certify that, to the best of my knowledge, no related cases are pending in this Court.

[// GUIDANCE: SCR-Civ. R. 40-I requires disclosure of related matters to facilitate coordinated assignment.]

6. BASIS OF JURISDICTION

(Check all that apply)
☐ D.C. Code § 11-921 (General Civil)
☐ D.C. Code § 13-423 (Long-Arm Jurisdiction)
☐ Federal Question (28 U.S.C. § 1331) – Exercised Concurrently
☐ Diversity (28 U.S.C. § 1332) – Amount in Controversy exceeds $75,000

[// GUIDANCE: Identify any concurrent federal basis even if filing in Superior Court to preserve removal considerations.]

7. FILING FEE COMPUTATION

Statutory Filing Fee Category (D.C. Code § 15-101; D.C. Superior Court Fee Schedule, Rev. 07-2023)*

A. Base Civil Action Filing Fee   $ 120.00
B. Jury Demand Surcharge     $ 75.00
C. Motion for TRO/Prelim. Injunction $ 20.00
D. Other: [DESCRIPTION]     $ [AMOUNT]
Total Fee Paid: $ [CALC]  Receipt No.: [CLERK ENTRY]

*Fees subject to periodic revision by court order. Verify the current schedule at www.dccourts.gov before filing.

8. ATTORNEY CERTIFICATION

I, the undersigned, certify that:
1. The information provided herein is true and complete to the best of my knowledge.
2. I have complied with the service and filing requirements of the Superior Court Rules of Civil Procedure.
3. I acknowledge that intentional misclassification or omission may subject me to sanctions, including dismissal or disciplinary referral.

Date: ___   Signature: ______
Printed Name: [ATTORNEY NAME]  Bar No.: [BAR #]

OPTIONAL ADDENDA

Attach the following, as applicable:
1. Statement of Amount in Controversy (SCR-Civ. § V).
2. Corporate Disclosure Statement (SCR-Civ. 7.1).
3. Request for Initial Scheduling & Case Management Order.
4. Approved Fee Waiver or In Forma Pauperis Order.

[// GUIDANCE: File each addendum as a separate document, properly captioned, unless local civil rules permit consolidation.]

PRACTICAL FILING CHECKLIST

☐ Complete all placeholders and remove bracketed text.
☐ Use 1-inch margins, 12-pt Times New Roman, and double-spacing per LCvR 5.1.
☐ E-File via CaseFile Xpress or deliver a hardcopy with original ink signature.
☐ Submit one copy for Judge-in-Chambers if emergency relief is sought.
☐ Serve a file-stamped copy on each defendant in accordance with SCR-Civ. 4 within 60 days.

[// GUIDANCE: This template reflects current DC Superior Court practice as of August 2025. Always confirm rule amendments, administrative orders, and fee changes before use.]