Civil Case Form - Alaska Judicial Council
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Complete Both Sides
of Civil Cases
Confidential
Attorneys/parties must submit the information contained in this form upon the resolution (whether by dismissal,
settlement, final judgment, etc.) of most civil cases in Alaska state courts. See AS 09.68.130;
Civil Rule 41(a)(3); Appellate Rule 51 1(e). Complete all the information on both sides of this page. The only
excluded civil case types are:
1.
divorce and dissolution;
2.
adoption, custody, support, visitation, and emancipation of children;
3.
children-in-need-of-aid cases under 47.10 or delinquent minors cases
under 47.12;
4.
domestic violence protective orders under AS 18.66.100-18.66.180;
5.
estate, guardianship, and trust cases filed under AS 13;
6.
small claims under AS 22.15.040;
7.
forcible entry and detainer (FED) cases;
8.
administrative appeals; and
9.
motor vehicle impound/forfeiture actions under municipal ordinance.
The information collected in this form is confidential and will be used only to compile statistics and
summaries in a manner that does not allow the identification of particular cases or parties.
AS 09.68.130(b).
Trial Court Case Number
Case Name
______ - ______ - ____________CI
_____________________________________
V. _____________________________________
Case Type (check all applicable)
Date Filed:
Relief Sought
____/____/____
F Medical Malpractice
F Property Damage - Auto
F Compensatory: Actual
F Legal Malpractice
F Property Damage - Other
F Compensatory: Non-Economic
Date Disposed:
F Other Malpractice
F Employment
F Punitive
____/____/____
F Personal Injury - Auto
F Debt
F Costs/Attorney Fees
F Personal Injury - Premises
F Injunctive Relief
F Other Business Dispute
F Personal Injury - Product
F Real Estate
% of Judgment Covered
Total Judgment/Settlement
F Personal Injury - Other
F Other Civil
by Liability Insurance
$
______________________
%
__________
Disposition
Disposition After?
$
Non-Economic Award
__________
(pick one):
(check all applicable)
$
Punitive Award
__________
F Dismissed
F Bench Trial
Declaratory Relief Award? FYes
F No
F Settlement
F Jury Trial
F Judgment
F Appeal Filed
Appeal #
_____________
Send the completed form to:
This form may be filled in and submitted on the Council's
Alaska Judicial Council
Internet home page at
510 L Street, Suite 450
Call the Council at (907) 279-2526 for copies of the form.
Anchorage, AK 99501
E-mail postmaster@ajc.state.ak.us with questions.
AJC01
Issued 9/98: Revised 2/14
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