CIVIL INFORMATION SHEET
The civil information sheet neither replaces nor supplements the filing and service of pleadings or other papers as
required by law. This form is required for use by the Clerk of the District Court for the purposes of initiating the civil
docket sheet. This information will not be available to the public and this document will be stored in a separate
location from the case file and then destroyed within a reasonable time. A new case will not be accepted without a
cover sheet attached. (THIS FORM MUST BE TYPED OR PRINTED LEGIBLY). This form can be found at
www.kscourts.org
.
NATURE OF SUIT
(Click or mark in one circle only – If the case involves more than one of the following categories, indicate the
category having the highest dollar value)
CIVIL If a CH. 61: $______________ (Judgment Demand Amount)
TORT CONTRACT REAL PROPERTY STATE TAX
Asbestos Product Liability Buyer Plaintiff Eminent Domain WARRANT
Automobile Tort Employment Dispute - Discrimination Mortgage Foreclosure
Intentional Tort Employment Dispute - Other Other Real Property
Legal Malpractice Fraud
Medical Malpractice Landlord/Tenant - Unlawful Detainer MISCELLANEOUS
Other Professional Malpractice Landlord/Tenant Dispute – Other 60-1507
Premises Liability Seller Plaintiff (debt collection) Habeas Corpus
Slander/Libel/Defamation Other Contract Other Writs
Tobacco Product Liability
Toxic/Other Product Liability CIVIL APPEALS OTHER CIVIL
Other Tort Administrative Agency
Other Civil Appeal SMALL CLAIMS
DOMESTIC
MARRIAGE DISSOLUTION/DIVORCE PROTECTION FROM ABUSE PROTECTION FROM STALKING UIFSA
OTHER DOMESTIC RELATIONS NON-DIVORCE SUPPORT, CUSTODY OR VISITATION PATERNITY
PROBATE/ESTATE
GUARDIAN /CONSERVATOR DETERMINATION OF DESCENT ELDER ABUSE ADOPTION
Conservatorship/Trusteeship
Guardianship – Adult SEXUALLY VIOLENT PREDATOR OTHER PROBATE / ESTATE
Guardianship - Minor
Guardian/Conservator – Adult DECEDENT ESTATE
CARE AND TREATMENT
Guardian/Conservator - Minor
JURY DEMAND YES (Check yes only if jury demand is included in petition or as a separate pleading) NO
SUMMONS ATTACHED: YES NO
SERVICE BY: PROCESS SERVER/ATTORNEY SHERIFF IN STATE ____________ SHERIFF OUT OF STATE _____________
County State
SHERIFF’S PROCESS FEE ATTACHED YES NO
PLAINTIFF / SUBJECT INFORMATION
DEFENDANT / OTHER PARTY INFORMATION
(ATTACH ADDITIONAL SHEET, IF NECESSARY) (ATTACH ADDITIONAL SHEET, IF NECESSARY)
NAME: NAME:
ADDRESS: ADDRESS:
PHONE:
SEX: PHONE: SEX:
SSN:
DOB: SSN: DOB:
DL OR STATE ID NO:__________________________
DL OR STATE ID NO:_ _________________________
State and Number State and Number
ALIAS NAMES USED:__________________________ ALIAS NAMES USED:
__________________________________________
ATTORNEYS ATTORNEYS (if known)
(Firm Name, Address, Telephone Number and Supreme Court ID Number) (Firm Name, Address, Telephone Number and Supreme Court ID Number)
FOR DOMESTIC CASES
- NAME, DATE OF BIRTH AND SOCIAL SECURITY NUMBER OF EACH DEPENDENT CHILD:
(Name) (Date of Birth) (Social Security Number)
The requirement that Social Security numbers be included on domestic cases is mandatory, and authorized by the Supreme Court
and federal law. On non-domestic cases, the Social Security number is not mandatory. The number is used for purposes of
identification and may be disclosed as permitted by law. This form is not considered to be a public record.
07-11-06
For Office Use Only
