Civil Information Sheet - Kansas

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For Office Use Only
CIVIL INFORMATION SHEET
The civil information sheet neither replaces nor supplements the filing and service of pleadings or other papers as
required by law. This form is required for use by the Clerk of the District Court for the purposes of initiating the civil
docket sheet.
This information will not be available to the public and this document will be stored in a separate
location from the case file and then destroyed within a reasonable time. A new case will not be accepted without a
cover sheet attached.
(THIS FORM MUST BE TYPED OR PRINTED LEGIBLY). This form can be found at
NATURE OF SUIT
(Click or mark in one circle only – If the case involves more than one of the following categories, indicate the
category having the highest dollar value)
CIVIL
If a CH. 61: $______________ (Judgment Demand Amount)
TORT
CONTRACT
REAL PROPERTY
STATE TAX
Asbestos Product Liability
Buyer Plaintiff
Eminent Domain
WARRANT
Automobile Tort
Employment Dispute - Discrimination
Mortgage Foreclosure
Intentional Tort
Employment Dispute - Other
Other Real Property
Legal Malpractice
Fraud
Medical Malpractice
Landlord/Tenant - Unlawful Detainer
MISCELLANEOUS
Other Professional Malpractice
Landlord/Tenant Dispute – Other
60-1507
Premises Liability
Seller Plaintiff (debt collection)
Habeas Corpus
Slander/Libel/Defamation
Other Contract
Other Writs
Tobacco Product Liability
Toxic/Other Product Liability
CIVIL APPEALS
OTHER CIVIL
Other Tort
Administrative Agency
Other Civil Appeal
SMALL CLAIMS
DOMESTIC
MARRIAGE DISSOLUTION/DIVORCE
PROTECTION FROM ABUSE
PROTECTION FROM STALKING
UIFSA
OTHER DOMESTIC RELATIONS
NON-DIVORCE SUPPORT, CUSTODY OR VISITATION
PATERNITY
PROBATE/ESTATE
GUARDIAN /CONSERVATOR
DETERMINATION OF DESCENT
ELDER ABUSE
ADOPTION
Conservatorship/Trusteeship
Guardianship – Adult
SEXUALLY VIOLENT PREDATOR
OTHER PROBATE / ESTATE
Guardianship - Minor
Guardian/Conservator – Adult
DECEDENT ESTATE
CARE AND TREATMENT
Guardian/Conservator - Minor
JURY DEMAND
YES (Check yes only if jury demand is included in petition or as a separate pleading)
NO
SUMMONS ATTACHED:
YES
NO
SERVICE BY:
PROCESS SERVER/ATTORNEY
SHERIFF IN STATE ____________
SHERIFF OUT OF STATE _____________
County
State
SHERIFF’S PROCESS FEE ATTACHED
YES
NO
PLAINTIFF / SUBJECT INFORMATION
DEFENDANT / OTHER PARTY INFORMATION
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
NAME:
NAME:
ADDRESS:
ADDRESS:
PHONE:
SEX:
PHONE:
SEX:
SSN:
DOB:
SSN:
DOB:
DL OR STATE ID NO:__________________________
DL OR STATE ID NO:_ _________________________
State and Number
State and Number
ALIAS NAMES USED:__________________________
ALIAS NAMES USED:
__________________________________________
ATTORNEYS
ATTORNEYS (if known)
(Firm Name, Address, Telephone Number and Supreme Court ID Number)
(Firm Name, Address, Telephone Number and Supreme Court ID Number)
FOR DOMESTIC CASES - NAME, DATE OF BIRTH AND SOCIAL SECURITY NUMBER OF EACH DEPENDENT CHILD:
(Name)
(Date of Birth)
(Social Security Number)
The requirement that Social Security numbers be included on domestic cases is mandatory, and authorized by the Supreme Court
and federal law. On non-domestic cases, the Social Security number is not mandatory. The number is used for purposes of
identification and may be disclosed as permitted by law. This form is not considered to be a public record.
07-01-12

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