Free Attorney or Party Without Attorney (Name and Address) - California

For Court Use Only

SUPERIOR COURT OF CALIFORNIA
County of Sacramento 720 Ninth Street, Room 102 Sacramento, CA 95814-1380 (916) 874-5522--Website www.saccourt.ca.gov
Attorney or Party Without Attorney (Name, State Bar # and Address):

Telephone No.: E-Mail Address: Attorney for (Name): Plaintiff: Defendant:

Fax No.:

Designation Statement Counter Designation Statement Telephone Conference (California Rule of Court 3.670 and Local Rule 9.10) Plaintiff Defendant Cross-Complainant Cross-Defendant

Case Number:

Hearing Date: _________8:30 a.m. (If applicable) Assigned Dept: ___________

NOTE: Do not complete this form unless requesting or opposing Class II or Class III designation.
This case is is not Complex under rule 1800 of the California Rules of Court. If case is Complex, mark the factors requiring exceptional judicial management: a. Large number of separately represented parties. b. Extensive motion practice raising difficult or novel issues that will be time-consuming to resolve. c. Substantial amount of documentary evidence. d. Large number of witnesses. e. Coordination with related actions pending in one or more courts in other counties, states or countries, or a federal court. f. Substantial post-judgment judicial supervision

State whether you believe this action should be designated as: Class I Class II Class III

Designation Statement CV\E-113 (Rev 02.13.09) Local Form Adopted for Mandatory Use Page 1 of 5

Superior Court of California, County of Sacramento Case Management

Plaintiff: Defendant:

Case Number:

Indicate each of the following categories that applies to this action: Tort - Personal Injury Motor Vehicle Personal Injury/Property Damage Non-Motor Vehicle Personal Injury/Property Damage Medical Malpractice Products Liability Other (specify)___________________________________________ Tort - Other Defamation Wrongful Discharge Fraud Bad Faith Other Malpractice (Attorney, Architect, Accountant, etc.) Other (specify)___________________________________________

Civil - Other Injunction Declaratory Relief Eminent Domain Unlawful Detainer Construction Litigation Multi-part Business Litigation Contract 1) Type of Contract__________________________________________ (Note, Construction, Purchase/Sale, Franchise, etc) 2) Relief Sought____________________________________________ (e.g. Rescission, Restitution, Reformation, Specific Performance) Other (specify) _________________________________________________
Length of Trial ­ Preliminary Assessment

Number of days: ______________ Jury Non-jury Number of witnesses to be called: ____________

Designation Statement CV\E-113 (Rev 02.13.09) Local Form Adopted for Mandatory Use Page 2 of 5

Superior Court of California, County of Sacramento Case Management

Plaintiff: Defendant:
Number of Parties:

Case Number:

Number of plaintiffs: ______________ Number of defendants: _____________ Are cross-complaints filed or likely to be filed? Number of cross-complaints: ____________

Yes

No

Availability for Service:

Are all defendants or cross-defendants available for service? Yes No If not, explain why not __________________________________________________ _____________________________________________________________________ _____________________________________________________________________

Extent of Discovery:

1. Describe the discovery you expect to conduct and that you expect to be conducted by adverse parties: Number of depositions to be taken: ____________ Number of sets of interrogatories: _____________ 2. Requests for admissions, production, etc.: Describe the extent of discovery you expect regarding experts: Number of expert witnesses to be deposed: ___________ State whether you expect to conduct depositions outside the Sacramento Area, and if so, where:___________________________________ Estimate total time for completion of all described discovery: ____________________
Amount in Controversy:

State the amount of relief sought: ________________ State whether there is a prayer for punitive damages and the amount sought: _________________________. Other remedies sought: _________________________________________________ ____________________________________________________________________
__________________________________________________________________________
Designation Statement CV\E-113 (Rev 02.13.09) Local Form Adopted for Mandatory Use Page 3 of 5

Superior Court of California, County of Sacramento Case Management

Plaintiff: Defendant:
Law and Motion:

Case Number:

Estimate the nature and extent of law and motion, including motions to change venue, quash service, attack pleadings, or for summary judgment:

Appellate or Writ Proceedings:

If you anticipate that intermediate appellate or writ proceedings will be filed during the course of this action, describe such proceedings:

Complexity of Substantive and Procedural Issues:

If you believe that any issues in this action are unusually complex, are issues of first impression, or involve a split of appellate authority, describe such issues:

If pending cases in the appellate courts may affect the decision of this court during the pendency of this case before trial, describe the appellate cases and why they will affect the decision in this case

Pendency of Other Actions:

If there are other actions or proceedings pending in this court or any other court or agency that may affect the prosecution of this action (Examples: bankruptcy, other actions on the same subject that may be consolidated, other actions that may be coordinated with this action, other actions or claims in arbitration, receiverships, declaratory relief actions regarding coverage, etc.), describe each such action and the parties affected.

Designation Statement CV\E-113 (Rev 02.13.09) Local Form Adopted for Mandatory Use Page 4 of 5

Superior Court of California, County of Sacramento Case Management

Plaintiff: Defendant:
Other Matters:

Case Number:

State any other matters that you believe would affect the classification of this case

Dated

Signature of attorney or party without attorney

Designation Statement CV\E-113 (Rev 02.13.09) Local Form Adopted for Mandatory Use Page 5 of 5