REQUEST TO CONFORM CASE INITIATION DATA ENTRY TO SUMMONS
JD-CL-96 New 1-09
COURT USE ONLY
Instructions to Person Making Request: This form may be used only to request that data incorrectly entered electronically be conformed to the information on the summons that was served. Instructions to Court Staff: Bring this form to the Chief Clerk or Chief Clerk's Designee.
Name of Case (First-named Plaintiff vs. First-named Defendant) Judicial District Address of Court Docket Number
The Plaintiff(s) respectfully represent(s) that the case initiation documents in the case named above were served on the defendant(s) on . After service on the defendant(s), the documents were filed with the Court electronically through e-filing. The data entered in the e-filing system does not conform to the data contained on the summons served on the defendant(s) as follows:
(Check all that apply) Case Type Return Date Name(s) of Plaintiff(s) Name(s) of Defendant(s) Data entered in the case management system Information contained on the summons served
The plaintiff(s) therefore request(s) that the incorrect data contained in the Court's case management system be changed to conform to the information on the summons.
Signed Print Name of Person Signing Juris Number Date Signed
I certify that a copy of the Request was mailed or delivered to the defendant(s) on:
Signed Address Print Name of Person Signing Telephone Number
Name and address of each Defendant this Request was mailed or delivered to:*
*If necessary, attach additional sheet with name of each Defendant served and the address where service was made.
Acted on as requested No action taken (reasons):
Notice sent to parties on (date): By: