Fillable Louisiana Civil Case Reporting Form printable pdf download

Louisiana Civil Case Reporting Form

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LOUISIANA CIVIL CASE REPORTING

Civil Case Cover Sheet - LA. R.S. 13:4688 and

Part G, §13, Louisiana Supreme Court General Administrative Rules

This civil case cover sheet shall be completed by counsel for the petitioner, counsel’s authorized

representative, or by the self-represented litigant (if not represented by counsel) and submitted with the

original petition filed with the court. The information should be the best available at the time of filing.

This information does not constitute a discovery request, response or supplementation, and is not

admissible at trial.

Suit Caption:

vs.

Court: ___________________________

Docket Number: _____________________

Parish of Filing:____________________ Filing Date: _________________________

Name of Lead Petitioner’s Attorney: ________________________________________

Name of Self-Represented Litigant:__________________________________________

Number of named petitioners: _____

Number of named defendants: ____

Type of Lawsuit: Please check the categories which most appropriately apply to this suit

(no more than 3 categories should be checked):

__Auto: Personal Injury

__ Auto: Property Damage

__Auto: Wrongful Death

__ Auto: Uninsured Motorist

__Asbestos: Property Damage

__ Asbestos: Personal Injury/Death

__Product Liability

__ Premise Liability

__Intentional Bodily Injury

__ Intentional Property Damage

__Intentional Wrongful Death

__ Unfair Business Practice

__Business Tort

__ Fraud

__Defamation

__ Professional Negligence

__Environmental Tort

__ Medical Malpractice

__ Intellectual Property

__ Toxic Tort

__ Legal Malpractice

__ Other Tort (describe below)

__ Other Professional Malpractice

__ Redhibition

__ Maritime

__ Class action (nature of case)

__ Wrongful Death

______________________________________

__General Negligence

Please briefly describe the nature of the litigation in one sentence of additional detail:

___________________________________________________________________________

Following the completion of this form by counsel, counsel’s representative, or by the self-represented

litigant, this document will be submitted to the Office of the Judicial Administrator, Supreme Court of

Louisiana, by the Clerk of Court.

Name, address and contact information of person completing form:

Name ________________________________Signature______________________________________

Address ____________________________________________________________________________

Phone number:________________________E-mail address:__________________________________

Louisiana Civil Case Reporting Form

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