Form Scca / 234 Civil Action Cover Sheet

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STATE OF SOUTH CAROLINA
)
)
IN THE COURT OF COMMON PLEAS
COUNTY OF
)
______________________________
)
____________________________________________
)
CIVIL ACTION COVERSHEET
Plaintiff(s) )
)
CP -
-
__________-
______
__________
vs.
)
)
____________________________________________
)
Defendant(s) )
(Please Print)
SC Bar #:
_______________________________
____________________________________
Telephone #:
_______________________________
Submitted By:
Fax #:
_______________________________
_________________________________________
Address:
Other:
_______________________________
_____________________________________________________
E-mail:
_______________________________
_____________________________________________________
NOTE: The coversheet and information contained herein neither replaces nor supplements the filing and service of pleadings or other papers as
required by law. This form is required for the use of the Clerk of Court for the purpose of docketing. It must be filled out completely, signed,
and dated. A copy of this coversheet must be served on the defendant(s) along with the Summons and Complaint.
(
DOCKETING INFORMATION
Check all that apply)
*
If Action is Judgment/Settlement do not complete
JURY TRIAL demanded in complaint.
NON-JURY TRIAL demanded in complaint.
This case is subject to ARBITRATION pursuant to the Court Annexed Alternative Dispute Resolution Rules.
This case is subject to MEDIATION pursuant to the Court Annexed Alternative Dispute Resolution Rules.
This case is exempt from ADR. (Proof of ADR/Exemption Attached)
NATURE OF ACTION
(Check One Box Below)
Contracts
Torts - Professional Malpractice
Torts – Personal Injury
Real Property
Constructions (100)
Dental Malpractice (200)
Assault/Slander/Libel (300)
Claim & Delivery (400)
Debt Collection (110)
Legal Malpractice (210)
Conversion (310)
Condemnation (410)
Employment (120)
Medical Malpractice (220)
Motor Vehicle Accident (320)
Foreclosure (420)
General (130)
Previous Notice of Intent Case #
Premises Liability (330)
Mechanic’s Lien (430)
20____-CP-_____-_____________
Breach of Contract (140)
Products Liability (340)
Partition (440)
Other (199)
Personal Injury (350)
Possession (450)
_____________________
Notice/ File Med Mal (230)
Wrongful Death (360)
Building Code Violation (460)
Other (299)
Other (399)
Other (499)
_______________________
_________________________
_______________________
Inmate Petitions
Administrative Law/Relief
Judgments/Settlements
Appeals
PCR (500)
Reinstate Drv. License (800)
Death Settlement (700)
Arbitration (900)
Mandamus (520)
Judicial Review (810)
Foreign Judgment (710)
Magistrate-Civil (910)
Habeas Corpus (530)
Relief (820)
Magistrate's Judgment (720)
Magistrate-Criminal (920)
Other (599)
Permanent Injunction (830)
Minor Settlement (730)
Municipal (930)
___________________
Forfeiture-Petition (840)
Transcript of Judgment (740)
Probate Court (940)
Forfeiture-Consent Order (850)
Lis Pendens (750)
SCDOT (950)
Other (899)
Transfer of Structured Settlement
Worker’s Comp (960)
Payment Rights Application (760)
Zoning Board (970)
_______________________
Public Service Commission (990)
Confession of Judgment (770)
Special/Complex /Other
Petition for Workers
Employment Security Commission
Compensation Settlement
(991)
Approval (780)
Environmental (600)
Pharmaceuticals (630)
Automobile Arb. (610)
Unfair Trade Practices (640)
Other (799)
Other (999)
___________________________
Medical (620)
Foreign Subpoenas (650)
___________________________
Other (699)
Motion to Quash Subpoena
____________________
in Out-of-County Action
Sexual Predator (510)
(660)
Submitting Party Signature: ___________________________
Date: _______________
Note:
Frivolous civil proceedings may be subject to sanctions pursuant to SCRCP, Rule 11, and the South Carolina Frivolous
Civil Proceedings Sanctions Act, S.C. Code Ann. §15-36-10 et. seq.
SCCA / 234 (04/2012)
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