it - MUJFIQAIEB
The JS—44 civil cover sheet and the information contained herein neither replace nor supplement the tiling and service of pleadings or other papers as required bylaw, except
as provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is required for the use of the Clerk of Court for the
purpose of initiating the civil docket sheet. (SEE INSTRUCTIONS ON THE REVERSE OF THE FORM.)
l.(a) PLAINTIFFS DEFENDANTS
Layne Drexel Harleysville Insurance Co.
io) COUNTY oe RESIDENCE oe FIRST LISTED RLAINTIFF ___ OOONTY OF RESPFNCE OF *"R§T '·'S,TEO OEFENOANT ——-
(EXCEPT IN Us PLAINTIFF CASES) _ _ I N UO '°'—A'N 'FF PASES ONLY) _
Harleysville, Montgomery County, Pennsylvania
New Castle
NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF THE
TRACT OF LAND INVOLVED
(c) ATTORNEYS (FIRM NAME, ADDRESS, AND TELEPHONE NUMBER) ATTORNEYS (IF KNOWN)
Kathleen M. Miller, Esquire William M. Kelleher, Esquire
Robert K. Beste, III, Esquire Ballard Spahr Andrews & Ingersoll, LLP
Smith, Katzenstein & Furlow, LLP 919 N. Market Street, 12"` Floor
800 Delaware Avenue, 7"‘ Floor Wilmington, DE 19801
P.O. Box 410
Wilmington, DE 19899
II. BASIS OF JURISDICTION (pLAce AN x IN oNe eox oitwi III. CITIZENSHIP OF PRINCIPAL PARTIES (PLACE AN x IN oNE cox i=oR PLAINTIFF
(For Diversity Cases Only) AND ONE BOX FOR DEFENDANT)
[I 1U.S. Government I] 3 Federal Question DEF DEF
PIOINNN (UO G¤v¤r¤ms¤I NO) O PONY) Citizen of This State I'] I [III Incorporated or Principal Place EI 4 III 4
I;] 2 U.S. Government W 4 Diversity 0f Busiiisss in This Stats
Defandant (lndlgatet Cmzenshlp OT Citizen of Another State I] 2 I] 2 Incorporated and Principal Place I:] s E 5
Pames In Nam NI) of Business in Another State
Citizen or Subject ofa [II 2 I] ci Foreign Nation I;] s III o
Foreign Country
IV. NATURE OF SUIT (PLAceANxiiv oiveeox orvtvi
CONTRACT TORTS ` FORFEITUREIPENALTY BANKRUPTCY OTHER STATUTES
I] 110 Insurance PERSONAL INJURY PERSONAL INJURY I;] 610 Agnculture I] 422 Appeal [1 400 State Reapportionment
I:] 120 Manne I] 310 Airplane [I 362 Personal Injury- I;] 620 Other Food& Drug 28 USC 158 I] 410 Antitrust
I] 130 Miller Act EI 315 Airplane Product Med Malpractice I] 625 Drug Related I] 423 Withdrawal I] 430 Banks and Banking
I] 140 Negotiable Instrument Liability I] 365 Personal Injury - Seizure of 28 USC 157 I] 450 Commerce/ICC Rates/etc.
I] 150 Recovery of Over-payment& I] 320 Assault, Libel & Product Liability Property 21 USC EI 460 Deportation
Enforcement of Judgment Slander EI 368 Asbestos Personal I] 630 Liquor Laws PROPERTY RIGHTS I,] 470 Racketeerlnfluenced and
[I 151 Medicare Act I] 330 Federal Injury Product I] 640 R.R4&`I'rucI· _ Corrupt Organizations
I] 152 Recovery of Defaulted Employers} Liability I] 650 Airline Regs. EI 820 OOOYNQNIS [I 810 Selective Service
Student Loans (Excl. Liability PERSONAL PROPERTY lj 660 Occupational D 830 patent [I 850 Securities/Commodities/
Veterans) [I 340 Marine I] 370 Other Fraud Safety/Health D 840 Trademark Exchange
I] 153 Recovery of Over- I:] 345 Marine Product [I 371 Truth in Lending lj 690 Other I] 875 Customer Challenge 12
payment of Veterarrs Liability I] 380 Other Personal SOCIAL SECURITY USC 3410
Benefits EI 350 Motor Vehicle Property LAB R EI 891 Agricultural Acts
[I 160 Stockholders Suits I] 355 Motor Vehicle Damage D HOF . L EOST d d E g;`6;153:g)(923) I] 892 Economic Stabilization Act
E 190 Other Contract Product Liability [I 385 Property Damage axda Or an at S D 863 DTWC/DIWW [I 893 Environmental Matters
I] 195 Contract Product Liability I] 360 Other Personal Product Liability D 720 L b /M F R I F (4O5(g)) I;] 894 Energy Allocation Act
'"I“')’ Ei iso Lgbg;/Mggti RZSOIIIIIZ EI 864 ssio Tiiie xvi U 8:3 §rss¤i~?mf<;jl¤f
EI 210 Lario Condemnation ON"- RIGHTS D 510 M<>li¤¤sl¤ I/seats Dis¢I¤s¤is ACI JUSUCF ` ` `
I] 220 Foreclosure El 441 Voting Semence U 740 Railway LONG" Act FEDERAL TAX SUITS I] 950 Constitutionalily of State
I] 230 Rent Lease & Ejectment I3 442 EmPI0Ym€m Habsas C<>FP¤$i D 790 Omg L3b°' EI gyg Taxes (U_S_ Statutes
III 240 T¤rtst¤ Land U 443 H°¤$*09/ I:) 530 G€“€'a* '—*“9a"°“ Riaintiri or EI ssc Other Statutory Actions
ij 245 Tori produc; Liabiiiiy Accommodations I] 535 Death Penalty III 791 Emp. RSI- INC. Sssufiiy Dekndam) `
ij 230 Aii Oihgy Reai Pi-Opgqy E 444 Welfare [I 540 lviandamus& Act U 871 |RS_T-md
I] 440 Other Civil Rights Other pany 26
Ei 550 Civil Rights USC 7666
I] 555 Piison Condition _.
V. ORIGIN (r·LAceANxiNoNeaox0uLv)
I] 1 Original Proceeding Q2 Removed from State I] 3 Remanded from I] 4 Reinstated or I] 5 Transferred from I] 5 Multidistnct IE] 7 Appeal to Distnct
Court Appellate Court Reopened another district (specify) Litigation Judge from
Ma istrate Jud ment
VI. CAUSE OF ACTION (CITE THE U.S. CIVIL STATUTE UNDER WHICH YOU ARE FILING AND WRITE BRIEF STATEMENT OF CAUSE. DO NOT CITE JURISDICTIONAL
STATUTES UNLESS DIVERSITYI
28 U.S.C. Section 1332(A)(1); Removal from state court pursuant to 28 U.S.C. Sections 1441, 1446
VII. REQUESTED IN I] CHECK IF THIS IS A CLASS ACTION DEMAND $ Check YES only if demanded in complaint.
COMPLAINT: UNDER F.R.C.P. 23 JURY DEMAND: EI Yes El No
VIII. RELATED CASE(S) (See instructions):
IF ANY JUDGE DOCKET NUMBER
DATE SIGNA RNEY OF RECORD
_._;j;. ____
FOR OFFICE USE ONLY
RECEIPT # AMOUNT APPLYING IFF JUDGE MAG. JUDGE _
DE_DOCS_A #5008 v1
United States Free Forms
Canada Free Forms
United Kingdom Free Forms
Australia Free Forms