General Civil Case Cover Sheet

STATE OF HAWAIʻI

CIRCUIT COURT OF THE _____ CIRCUIT

GENERAL CIVIL CASE COVER SHEET

(Civil Information Sheet Required by Haw. R. Civ. P. 3(g))

[COURT CLERK’S STAMP AREA]

SECTION 1 – COURT & CASE IDENTIFICATION

1.1 Case Number: _________________________ (to be completed by Clerk)
1.2 Judge (if known): _______________________
1.3 Filing Date: ____ / ____ / 20____    Time: __________ a.m./p.m.
1.4 Type of Initial Pleading (check one):
• ☐ Complaint  • ☐ Petition  • ☐ Other: __________________

SECTION 2 – PARTY & ATTORNEY INFORMATION

2.1 PLAINTIFF(S)
• Name(s): __________________________________________________________
• Mailing Address: _________________________________________________
• Phone: _____________________  E-Mail: ___________________________

2.2 DEFENDANT(S)
• Name(s): _________________________________________________________
• Mailing Address: ________________________________________________
• Phone: _____________________  E-Mail: __________________________

2.3 ATTORNEY FOR PLAINTIFF
• Name: ______________________________________ Bar No.: ____________
• Firm: _____________________________________________________________
• Office Address: _________________________________________________
• Phone: _____________________  E-Mail: __________________________

SECTION 3 – NATURE OF SUIT / CASE CATEGORY

(Check ONE primary category and ONE sub-category that best describes the dominant claim. If multiple distinct claims, check “Other – Multiple”.)

A. TORT
☐ 01 Motor Vehicle  ☐ 02 Premises Liability  ☐ 03 Products Liability
☐ 04 Medical/Professional Malpractice  ☐ 05 Wrongful Death
☐ 06 Intentional Tort (e.g., assault, defamation)
☐ 07 Other Tort (specify): __________________________________________

B. CONTRACT
☐ 11 Assumpsit / Breach of Contract   ☐ 12 Collections
☐ 13 Insurance Coverage        ☐ 14 Construction
☐ 15 U.C.C./Commercial Transaction  ☐ 16 Other Contract (specify): ______

C. REAL PROPERTY
☐ 21 Foreclosure  ☐ 22 Quiet Title  ☐ 23 Condemnation / Eminent Domain
☐ 24 Partition  ☐ 25 Land Court / Title Registration
☐ 26 Other Real Property (specify): __________________________________

D. COMPLEX / SPECIAL PROCEEDINGS
☐ 31 Class Action  ☐ 32 Mass Tort  ☐ 33 Shareholder Derivative
☐ 34 Complex Business Litigation  ☐ 35 Other Complex: _______________

E. STATUTORY / ADMINISTRATIVE
☐ 41 Administrative Agency Appeal (specify agency): ___________________
☐ 42 Declaratory / Injunctive Relief (non-tort)
☐ 43 Election Contest  ☐ 44 Environmental / Land Use
☐ 45 Other Statutory (specify): ______________________________________

F. OTHER CIVIL
☐ 51 Miscellaneous Civil Action    ☐ 52 Foreign Judgment
☐ 53 Enforcement of Administrative Order  ☐ Other – Multiple: __________

SECTION 4 – JURY DEMAND & CASE COMPLEXITY

4.1 Jury Demand:  ☐ Yes  ☐ No  (If “Yes,” jury fee must be paid per fee schedule.)
4.2 Estimated Trial Length: ______ days
4.3 Does the case involve more than 200 documentary exhibits, more than 10 expert witnesses, or novel/complex issues of law?
  ☐ Yes  ☐ No

SECTION 5 – RELATED OR CONSOLIDATED CASES

5.1 Prior or pending Hawaiʻi state cases involving the same parties, transactions, or issues:
• Case No.: ____________________ Court: ____________________________
• Case No.: ____________________ Court: ____________________________
☐ Additional related cases listed in attached addendum.

SECTION 6 – DEMAND / RELIEF SOUGHT

6.1 Monetary Relief: $ ________________________ (exclusive of interest & costs)
6.2 Non-Monetary Relief (brief description): __________________________________
6.3 Estimated Value of Real Property (if applicable): $ ______________________

SECTION 7 – FILING FEE CALCULATION WORKSHEET (OPTIONAL)

Item (reference current Judicial Fee Schedule)      Amount ($)
• Initial Complaint / Petition Filing Fee:       ☐
• Jury Demand Fee (if applicable):         ☐
• Additional Parties (>12) Fee:           ☐
• Exhibit Copy / Certification Fees:        ☐
TOTAL FEES PAID:               ☐

SECTION 8 – CERTIFICATION & SIGNATURE

I certify that to the best of my knowledge, information, and belief formed after reasonable inquiry:
(a) This cover sheet is complete and accurate;
(b) The case category selected above is the most specific and appropriate; and
(c) I will promptly notify the court and all parties of any corrections or amendments needed.

Date: ____ / ____ / 20____    Signature: _______________________________
Printed Name: ___________________________________ Title: ☐ Attorney  ☐ Self-Represented

SECTION 9 – CLERK’S OFFICE USE ONLY

• Fee Receipt No.: _______________________ Amount Received: $ __________
• Date Entered in JIMS: ____ / ____ / 20____
• Initials of Receiving Clerk: __________

ATTORNEY CHECKLIST

• Verify compliance with Hawaiʻi Rules of Civil Procedure, especially Rule 3(g).
• Confirm the correct Circuit (First – Oʻahu; Second – Maui; Third – Hawaiʻi; Fifth – Kauaʻi).
• Cross-check filing fees and electronic service addresses before submission.
• Maintain a copy of the filed cover sheet bearing the Clerk’s file stamp for your records.

© 2025 [LAW FIRM / AUTHOR NAME]. All rights reserved. This template is provided solely for use by licensed attorneys. No legal advice is rendered, and no attorney-client relationship is created.