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SUMMARY SHEET M.R. Civ. P. 5(h) This summary

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SUMMARY SHEET
M.R. Civ. P. 5(h)
This summary sheet and the information contained herein neither replace nor supplement the filing and service of pleadings or other papers as
required by the Maine Rules of Court or by law. This form is required for the use of the Clerk of Court for the purpose of initiating or updating
the civil docket. (SEE ATTACHED INSTRUCTIONS)
I. County of Filing or District Court Jurisdiction:
II. CAUSE OF ACTION (Cite the primary civil statutes under which you are filing, if any.)
III. NATURE OF FILING
Initial Complaint
Third-Party Complaint
Cross-Claim or Counterclaim
If Reinstated or Reopened case, give original Docket Number
(If filing a second or subsequent Money Judgment Disclosure, give docket number of first disclosure)
IV. TITLE TO REAL ESTATE IS INVOLVED
V. MOST DEFINITIVE NATURE OF ACTION. (Place an X in one box only) Check the box that most closely describes your case.
GENERAL CIVIL (CV)
Personal Injury Tort Contract Other Forfeitures/Property Libels
Property Negligence Contract Land Use Enforcement (80K)
Auto Negligence Declaratory/Equitable Relief Administrative Warrant
Medical Malpractice General Injunctive Relief HIV Testing
Product Liability Declaratory Judgment Arbitration Awards
Assault/Battery Other Equitable Relief Appointment of Receiver
Domestic Torts Constitutional/Civil Rights Shareholders' Derivative Actions
Other Negligence Constitutional/Civil Rights Foreign Deposition
Other Personal Injury Tort Statutory Actions Pre-action Discovery
Non-Personal Injury Tort Unfair Trade Practices Common Law Habeas Corpus
Libel/Defamation Freedom of Access Prisoner Transfers
Auto Negligence Other Statutory Actions Foreign Judgments
Other Negligence Miscellaneous Civil Minor Settlements
Other Non-Personal Injury Tort Drug Forfeitures Other Civil
CHILD PROTECTIVE CUSTODY (PC) SPECIAL ACTIONS (SA)
Money Judgment
Non-DHS Protective Custody Money Judgment Request Disclosure
REAL ESTATE (RE)
Title Actions Foreclosure Misc. Real Estate
Quiet Title Foreclosure (ADR exempt) Equitable Remedies Nuisance
Eminent Domain Foreclosure (Diversion eligible) Mechanics Lien Abandoned Roads
Easements Foreclosure - Other Partition Trespass
Boundaries Adverse Possession Other Real Estate
APPEALS (AP) (To be filed in Superior Court) (ADR exempt)
Governmental Body (80B) Administrative Agency (80C) Other Appeals
VI. M.R. Civ. P. 16B Alternative Dispute Resolution (ADR):
I certify that pursuant to M.R. Civ. P. 16B(b), this case is exempt from a required ADR process because:
The parties have participated in a formal ADR process with ____ _________ (name of neutral)
on
It falls within an exemption listed above (i.e., an appeal or an action for non-payment of a note in a secured transaction).
The plaintiff or defendant is incarcerated in a local, state or federal facility.
The parties have participated in a statutory pre-litigation screening process with
The parties have participated in a formal ADR process with
(date).
This is an action in which the plaintiff’s likely damages will not exceed $50,000, and the plaintiff requests an exemption
from ADR pursuant to M.R. Civ. P. 16C(g).
Page 1 of 3
CV-001, Rev. 07/15
VII. (a) PLAINTIFFS (Name & Address including county)
or Third-Party, Counterclaim or Cross-Claim Plaintiffs
The plaintiff is a prisoner in a local, state or federal facility.
(b) Attorneys (Name, Bar number, Firm name, Address, Telephone Number) If all counsel listed do NOT represent all plaintiffs,
specify who the listed attorney(s) represent.
VIII. (a) DEFENDANTS (Name & Address including county)
and/or Third-Party, Counterclaim or Cross-Claim Defendants
The defendant is a prisoner in a local, state or federal facility.
(b) Attorneys (Name, Bar number, Firm name, Address, Telephone Number) If all counsel listed do NOT represent all defendants,
(If known) specify who the listed attorney(s) represents. represent.
IX. (a) PARTIES OF INTEREST (Name & Address including county)
(b) Attorneys (Name, Bar number, Firm name, Address, Telephone Number) If all counsel listed do NOT represent all parties,
(If known) specify who the listed attorney(s) represents.
X. RELATED CASE(S) IF ANY
Assigned Judge/Justice Docket Number
Date:
Name of Plaintiff or Lead Attorney of Record
Signature of Plaintiff or Attorney
CV-001, Rev. 07/15
Page 2 of 3
INSTRUCTIONS FOR COMPLETING SUMMARY SHEET
I. County of Filing / District Court Jurisdiction. For Superior Court cases enter the county name where this complaint is being filed. For
District Court cases enter the location of the District Court where this complaint is being filed.
II. Cause of Action. Report the civil statute directly related to the primary cause of action and give a brief description of the cause. If the cause
of action is not statutorily based enter N/A.
III. Nature of Filing. Place an "X" in the appropriate box
.
Initial Complaint. Check this box if the complaint is being filed as an original proceeding. A filing fee is required.
Third-Party Complaint. Check this box if the original defendant is filing an action against a third party, not part of the original proceeding. A
filing fee is required.
Cross-Claim or Counterclaim. Check this box if an original defendant is filing a cross-claim against another original defendant or if an original
defendant if filing a counterclaim against a party not part of the original proceeding.
Reinstated or Reopened. Check this box for cases reinstated or reopened in the court. Use the reopening date as the filing date. Indicate the
docket number of the original proceeding. This should be filled in for Money Judgment second or subsequent Disclosures, or for post-judgment
motions.
IV. Title to Real Estate. Place an "X" in the box if this case is not designated as Real Estate action but Title to Real Estate is involved
.
V. Most Definitive Nature of Action. Place an "X" in the appropriate box. If the cause fits more than one nature of action, select the category
that best describes the primary cause of action.
VI. Place an "X" in the appropriate box if the case is exempt from alternative dispute resolution as required by M. R. Civ. P. 16B.
VII. (a) Plaintiffs, Third-Party or Counterclaim or Cross-Claim Plaintiffs. Enter names (first, middle initial, last) of all plaintiffs and their
address including county of residency. If the plaintiff is a government agency, use only the full name or standard abbreviations. If the plaintiff is
an official within a government agency, identify first the agency and then the official, giving both name and title. If there are several plaintiffs,
list as many plaintiffs as possible and list the additional plaintiffs on an attachment and note "(see attachment)."
(b
) Plaintiff’s Attorney. Enter firm name, attorney of record, attorney of record bar number, address and telephone number. If there are several
attorneys, list as many as possible and list the additional attorneys on an attachment, noting in this section "(see attachment)." If more than one
attorney is listed for a party, a lead attorney must be designated. If all counsel listed do NOT represent all plaintiffs, specify who the listed
attorney(s) represent.
VIII. (a) Defendants Enter names (first, middle initial, last) of all defendants and their address including county of residency. If
the defendant is a government agency, use only the full name or standard abbreviations. If the defendant is an official within a government
agency, identify first the agency and then the official, giving both name and title. If there are several defendants, list as many defendants as
possible and list the additional defendants on an attachment and note "(see attachment)".
(b
) Defendant’s Attorney. Enter firm name, attorney of record, attorney of record bar number, address and telephone number. If there are several
attorneys, list as many as possible and list the additional attorneys on an attachment, noting in this section "(see attachment)." If more than one
attorney is listed for a party, a lead attorney must be designated. If all counsel listed do NOT represent all defendants, specify who the listed
attorney(s) represent.
IX. (a) Parties of Interest. Enter names (first, middle initial, last) of all parties of interest and their address including county of residency. If
the party of interest is a government agency, use only the full name or standard abbreviations. If the party of interest is an official within
a
government agency, identify first the agency and then the official, giving both name and title. If there are several parties of interest, list as many
parties of interest as possible and list the additional parties of interest on an attachment and note "(see attachment)."
(b
) Party of Interest’s Attorney. Enter firm name, attorney of record, attorney of record bar number, address and telephone number. If there are
several attorneys, list as many as possible and list the additional attorneys on an attachment, noting in this section "(see attachment)." If more
than one attorney is listed for a party, a lead attorney must be designated. If all counsel listed do NOT represent all parties of interest, specify
who the listed attorney(s) represent.
X. Related Cases. This section is used to reference relating pending cases if any. If there are related pending cases, insert the docket numbers
and the corresponding justices name when appropriate for such cases.
Date, Attorney or Pro se Party Name and Signature. 1. Date the summary sheet. 2. Sign the summary sheet. Type or print the name of the
Plaintiff or lead attorney of record. The attorney signing the filing document should sign the summary sheet. The information on the cover sheet
is subject to the requirements of M. R. Civ. P. 11. The Maine Rules of Civil Procedure, and all other Court Rules, are found at:
www.courts.maine.gov.
Page 3 of 3
CV-001
Instructions, Rev. 07/15
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Completed 17 March 2021

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