Free Circuit & Associate Civil Filing Form - Missouri

IN THE CIRCUIT COURT OF ST. LOUIS COUNTY, MISSOURI CIRCUIT CIVIL/ASSOCIATE CIVIL FILING INFORMATION SHEET INSTRUCTIONS FOR COMPLETING THE CIRCUIT CIVIL/ASSOCIATE CIVIL FILING INFORMATION SHEET:
As part of our reporting requirements to the Missouri Supreme Court and the Office of the State Court Administrator, you are required to complete and submit this information sheet at the time you file your cause of action. Your cause of action will not be accepted and/or processed unless it is accompanied by this information sheet at the time of filing. The person, or attorney, filing the cause of action should the complete the form as follows:
You must provide the following information below for the purpose of initiating case processing. SSN is required if the party is a person; exception can only be granted if the information is not reasonably available. Type or neatly print in black ink. Plaintiff(s)/Defendant(s): Enter the full names (last, first, middle initial) of plaintiff(s) and defendant(s). If the plaintiff or defendant is a: Corporation ­ Include the full name of the corporation. Government Agency ­ Use only the full name or standard abbreviations. Government Official ­ Identify the Agency and then the official, giving both title and name. NOTE: If there are multiple counts in the petition that are considered in two or more categories, it is the responsibility of the filing party to choose the one appropriate Case Type code. The assignment of the case is subject to review by the Presiding Judge. Based on that review, the case may be reassigned.

CASE HEADING:___________________________________vs_______________________________________ 1st Plaintiff 1st Defendant Fill in the two-letter Case Type code from the back of this form here: (one code only). Does this case result from the alleged REFUSAL to take a Blood or Breathalyzer test? PARTIES (attach a separate sheet to include additional parties) YES
Circle one

NO

Party Type: Last Name: Middle Name: City: DOB:

(i.e. Plaintiff,etc.) First Name: Address: __________________________________________ State: SSN: required Zip:

Party Type: Last Name: Middle Name: City: DOB:

(i.e. Plaintiff, Defendant, etc.) First Name: Address: __________________________________________ State: SSN: required
___

Zip:

Attorney of Record Filing Action

Bar #

Firm

Address/City/State/Zip Code

Phone Number

Fax Number

E-mail address

Signature of Person Filing

CCCDT222 ­ JIS

Revised 02/09

CASE TYPES LIST
CATEGORY & CASE TYPE DESCRIPTION CONTRACT Breach of Contract Promissory Note Specific Performance Suit on Account Contract - Other AC Contract - BULK ADMINISTRATIVE REVIEW Chapter 536 State Agency Review Drivers License Revocation Review (302.311 RSMo) Trial De Novo of DOR Decision Refused Breathalyzer (302.750/577.041 RSMo) Limited Driving Privileges (302.309 RSMo) Other Administrative Review SATOP Review (302.540/577.041 RSMo) TORTS AC Tort - BULK Employment Discrimination (213.111 RSMo) Public Accommodation (213.111 RSMo) Asbestos Personal Injury - Federal Employee Liability Act Personal Injury - Malpractice
Personal Injury ­ Product Liability

COURT FILED IN CASE TYPE CODE ASSOCIATE CIRCUIT CM CA CN CB CO CC CP CD CQ CE CR ASSOCIATE CIRCUIT IN IO IP IQ IR IS IT ASSOCIATE CIRCUIT TZ TO TP TQ TR TS TT TU TV TW TX TY TJ TK TA TB TC TD TE TF TG TH TI

Personal Injury - Vehicular Personal Injury - Other Property Damage Wrongful Death Other Tort REAL ESTATE AC Landlord - BULK Rent and Possession Unlawful Detainer Appl. to Enforce Mechanics Lien Eminent Domain/Condemnation - State Eminent Domain/Condemnation - Other Exception Foreclosure Partition Quiet Title Other Real Estate Action EXTRAORDINARY REMEDY Declaratory Judgment Habeas Corpus Injunction Other Extraordinary Remedy Show Cause to Enforce Jury Service Temporary Restraining Order
CCCDT222 ­ JIS

ASSOCIATE CIRCUIT R4 R1 R2 RS RA RB RC RD RE RG RH RK

RW RY RZ R3

ASSOCIATE CIRCUIT EO EA EP EB EQ EC ER ED ET EU EF EG

CATEGORY & CASE TYPE COURT FILED IN DESCRIPTION CASE TYPE CODE MISCELLANEOUS CIVIL ASSOCIATE CIRCUIT Action Against Garnishee YA XA CAFA Forfeit (513.600 - 513.640 RSMo) YB XB Common Law Lien Petition (428.115 RSMo) YC XC Contempt YD XD Establishment of Charter YE XE Examination of Judgment Debtor YF XF Expungement/Correction of Arrest Record YG XG Out of State Witness YH XH Registration of Foreign Judgment (Excluding Domestic Relations) YI XI Replevin YJ XJ Revival of Judgment YK XK Delinquent City License Fee YL XL Delinquent City Tax YM XM Delinquent County License Fee YN XN Delinquent County Tax YO XO Delinquent Sales Tax YP XP Delinquent State Taxes YQ XQ Personal Property Taxes YR XR Tax Action Other YZ XZ Other Miscellaneous Action Y2 X1 Trial De Novo XS Small Claims Trial De Novo XT Will Contest (473.083 RSMo) XU Small Claims Certified XV Motion, Rules 24.035 or 29.15 XW Pro Forma Decree of Incorporation XY Transcript Judgment NA Mechanics Lien ND Contraband Destruction Order NE Foreign/Non-Case Document NF Search Warrant/Investigative Subpoena NZ Owner/Lienholder Petition for Property Release YU SMALL CLAIMS ASSOCIATE Small Claims Under $100 YV Small Claims Over $100 YW Petition for Revocation of Conceal Carry Endorsement (571.117 RSMo) YX Appeal of Denial of Conceal Carry Endorsement (571.114 RSMo) YZ

Revised 02/09