Fillable SCA100 (West Virginia Supreme Court of Appeals)

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SCA100 (West Virginia Supreme Court of Appeals)

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BROWSE WEST VIRGINIA SUPREME COURT OF APPEALS (WV) FORMS

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SCA-C-100: Civil Case Information Statement (Other than Domestic Relations) Revision Date: 12/2015
IN THE CIRCUIT COURT OF
COUNTY, WEST VIRGINIA
CIVIL CASE INFORMATION STATEMENT
(Civil Cases Other than Domestic Relations)
I. CASE STYLE: Case No.
Plaintiff(s)
Judge:
vs.
Defendant(s)
Name
Street Address
City, State, Zip Code
Days to
Answer Type of Service
II. TYPE OF CASE:
General Civil
Adoption
Mass Litigation [As defined in T.C.R. 26.04(a)]
Administrative Agency Appeal
Asbestos
Civil Appeal from Magistrate Court
FELA Asbestos
Miscellaneous Civil Petition
Other:
Mental Hygiene
Habeas Corpus/Other Extraordinary Writ
Guardianship
Other:
Medical Malpractice
III. JURY DEMAND:
Yes No CASE WILL BE READY FOR TRIAL BY (Month/Year):
/
IV. DO YOU OR ANY
OF YOUR CLIENTS
OR WITNESSES
IN THIS CASE
REQUIRE SPECIAL
ACCOMMODATIONS?
Yes No
IF YES, PLEASE SPECIFY:
Wheelchair accessible hearing room and other facilites
Reader or other auxiliary aid for the visually impaired
Interpreter or other auxiliary aid for the deaf and hard of hearing
Spokesperson or other auxiliary aid for the speech impaired
Foreign language interpreter-specify language:
Other:
Attorney Name:
Firm:
Address:
Telephone:
Representing:
Plaintiff Defendant
Cross-Defendant
Cross-Complainant
3rd-Party Plaintiff
3rd-Party Defendant
Proceeding Without an Attorney
Dated:
/ /
Original and copies of complaint enclosed/attached.
Signature:
SCA-C-100: Civil Case Information Statement-Defendant(s) Continuation Page Revision Date: 12/2015
Plaintiff:
vs.
Defendant:
Case Number:
CIVIL CASE INFORMATION STATEMENT
DEFENDANT(S) CONTINUATION PAGE
Defendant's Name
Street Address
City, State, Zip Code
Days to Answer:
Type of Service:
Defendant's Name
Street Address
City, State, Zip Code
Days to Answer:
Type of Service:
Defendant's Name
Street Address
City, State, Zip Code
Days to Answer:
Type of Service:
Defendant's Name
Street Address
City, State, Zip Code
Days to Answer:
Type of Service:
Defendant's Name
Street Address
City, State, Zip Code
Days to Answer:
Type of Service:
Defendant's Name
Street Address
City, State, Zip Code
Days to Answer:
Type of Service:
Defendant's Name
Street Address
City, State, Zip Code
Days to Answer:
Type of Service:
, et al
, et al
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SCA100 (West Virginia Supreme Court of Appeals)

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Completed 27 July 2020

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