CIVIL CASE COVER SHEET

Commonwealth of Kentucky – State Court System

(Use for initial pleading in every civil action filed in Kentucky Circuit or District Court)

1. COURT & CASE IDENTIFICATION

[// GUIDANCE: The Clerk will stamp the official case number and judge assignment. Complete every other field before filing.]

2. PARTY INFORMATION

[// GUIDANCE: Use full legal names; add additional parties on a separate sheet labeled “Attachment 2 – Additional Parties.”]

3. NATURE OF SUIT (Check ONE primary case type and all applicable sub-types)

A. TORT
☐ A-1 Auto Accident
☐ A-2 Premises Liability
☐ A-3 Product Liability
☐ A-4 Medical/Professional Malpractice
☐ A-5 Wrongful Death
☐ A-6 Other Personal Injury (specify): ____

B. CONTRACT
☐ B-1 Breach of Written Contract
☐ B-2 Breach of Oral Contract
☐ B-3 Debt Collection
☐ B-4 Insurance Coverage/Bad Faith
☐ B-5 U.C.C. / Commercial

C. REAL PROPERTY
☐ C-1 Boundary/Title Dispute
☐ C-2 Quiet Title / Ejectment
☐ C-3 Foreclosure
☐ C-4 Landlord–Tenant

D. CIVIL RIGHTS / EMPLOYMENT
☐ D-1 Discrimination (specify basis): _______
☐ D-2 Retaliation / Whistleblower
☐ D-3 Wage & Hour

E. OTHER CIVIL
☐ E-1 Declaratory Judgment
☐ E-2 Injunctive Relief
☐ E-3 Administrative Appeal (specify agency): ____
☐ E-4 Extraordinary Writ (Mandamus/Prohibition/Habeas)
☐ E-5 Other (describe with particularity): ______

[// GUIDANCE: Kentucky clerks rely upon this selection to assess filing fees and statistical reporting. Select the single best “primary” category, then mark any additional sub-categories that apply.]

4. AMOUNT IN CONTROVERSY

☐ $0 – $2,500
☐ $2,501 – $5,000
☐ $5,001 – $10,000
☐ $10,001 – $50,000
☐ Exceeds $50,000
Exact amount claimed (if liquidated): $[PLACEHOLDER]

[// GUIDANCE: This range governs the presumptive jurisdictional placement between District (< $5,000 in many matters) and Circuit Courts. Verify the current jurisdictional thresholds before filing.]

5. DEMAND FOR JURY TRIAL

☐ Jury trial demanded pursuant to CR 38
☐ Jury trial NOT demanded at this time

[// GUIDANCE: A jury demand must appear in the first pleading or be served within ten (10) days thereafter under Kentucky CR 38(B).]

6. RELATED OR COMPANION CASES

Is any related, re-filed, or companion case presently or previously pending in Kentucky or another jurisdiction?
☐ No
☐ Yes → List court, case number, and caption:
[PLACEHOLDER]

7. FEE SCHEDULE (FOR CLERK USE)

*Statutory citations vary; consult the most recent KRS §§ 23A.205 (Circuit) and 24A.170 (District) for current fee authority.

[// GUIDANCE: Fee amounts are periodically adjusted by the Administrative Office of the Courts (AOC) and by individual counties for local library or technology surcharges. Confirm current totals before submitting payment.]

8. CERTIFICATION & SIGNATURE

I hereby certify that the information provided on this Civil Case Cover Sheet is true and correct to the best of my knowledge and that this filing complies with the Kentucky Rules of Civil Procedure, the Kentucky Revised Statutes, and any applicable local rules.

[// GUIDANCE: An electronic signature (“/s/ Name”) is acceptable in e-filing counties pursuant to Kentucky CR 5.02(2).]

FILING INSTRUCTIONS (ATTORNEY USE ONLY – DO NOT FILE)

[// GUIDANCE: Remove this page before submitting to the Clerk.]

1. Venue Check
   • Circuit Court generally has original jurisdiction over civil matters exceeding the monetary limit set for District Court or seeking equitable relief.
   • District Court handles most matters in controversy not exceeding the statutory cap and certain statutory causes of action (e.g., forcible detainer).

2. Mandatory Electronic Filing
   • E-filing is mandatory in most Kentucky circuits. Register at https://kycourts.net and follow eFiling User Guide.
   • Upload this cover sheet as a separate lead document titled “Civil Case Cover Sheet.”

3. Summons Preparation
   • Prepare a separate summons for each defendant under CR 4.
   • Include accurate service addresses. The Clerk will issue and return signed summonses for service.

4. Fee Payment
   • Fee payment may be made via the eFiling portal (credit card or eCheck) or in person with cash, certified check, or money order.
   • If filing as a poor person, submit verified motion and affidavit (AOC-026). No fee is due upon approval.

5. Confidential Information
   • Do NOT include Social Security numbers, complete financial account numbers, or minor children’s names in pleadings.
   • Use the AOC-035 Privacy Redaction Cover Sheet where necessary.

6. Local Rules
   • Review any local practice rules for the filing county (often available on the circuit clerk’s website) for additional formatting, motion hour procedures, and scheduling orders.

[// GUIDANCE: This template is based on the Kentucky AOC’s standardized Civil Case Cover Sheet (form AOC-205). It is provided as a drafting aid and is not an official court form. Practitioners should confirm that no revisions to the official AOC form have occurred since this template was generated. Replace all bracketed [PLACEHOLDER] text with client-specific information before filing.]