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SUPERIOR COURT OF CALIFORNIA OF ORANGE COUNTY SELF-HELP (The Superior Court of California - County of Orange)

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SHC-APP-04 (Rev. 01/01/2020)
Please visit our Self-Help Portal at: https://selfhelp.occourts.org
SUPERIOR COURT OF CALIFORNIA
COUNTY
OF ORANGE
SELF-HELP CENTER
www.occourts.org/self-help
LamoreauxJusticeCenter
Room C-190
341TheCityDrive
Orange,CA
HarborJusticeCenter
R
oom107,Self‐HelpWindow
4601JamboreeRoad
NewportBeach,CA
Cen
tralJusticeCenter
RoomG‐100
700CivicCenterDrive
SantaAna,CA
SuperiorCourt
Ser
viceCenter
27573PuertaReal
MissionViejo,CA
NorthJusticeCenter
R
oom355
1275N.BerkeleyAvenue
Fullerton,CA
WestJusticeCenter
1
st
Floor
814113thStreet
Westminster,CA
APPEALING A CIVIL CITATION
The Self-Help Center provides a free document review
service. To obtain an appointment to have your documents
reviewed, you must first fully complete the forms.
Pleaseuseblackink.
Self-Help Center Locations:
CM-010
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
FOR COURT USE ONLY
TELEPHONE NO.: FAX NO.:
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
CASE NAME:
CIVIL CASE COVER SHEET
Complex Case Designation
LimitedUnlimited
Counter Joinder
(Amount(Amount
demanded isdemanded Filed with first appearance by defendant
(Cal. Rules of Court, rule 3.402)
$25,000 or less)exceeds $25,000)
Items 1–6 below must be completed (see instructions on page 2).
1. Check one box below for the case type that best describes this case:
Auto Tort
Contract
Provisionally Complex Civil Litigation
(Cal. Rules of Court, rules 3.400–3.403)
Auto (22)
Breach of contract/warranty (06)
Uninsured motorist (46)
Other collections (09)
Antitrust/Trade regulation (03)
Other PI/PD/WD (Personal Injury/Property
Damage/Wrongful Death) Tort
Construction defect (10)
Insurance coverage (18)
Mass tort (40)
Rule 3.740 collections (09)
Asbestos (04)
Securities litigation (28)
Real Property
Product liability (24)
Environmental/Toxic tort (30)
Eminent domain/Inverse
condemnation (14)
Medical malpractice (45)
Insurance coverage claims arising from the
above listed provisionally complex case
types (41)
Other PI/PD/WD (23)
Wrongful eviction (33)
Non-PI/PD/WD (Other) Tort
Enforcement of Judgment
Business tort/unfair business practice (07)
Enforcement of judgment (20)
Civil rights (08)
Commercial (31)
Miscellaneous Civil Complaint
Defamation (13)
Residential (32)
RICO (27)
Fraud (16)
Drugs (38)
Other complaint (not specified above) (42)
Intellectual property (19)
Judicial Review
Miscellaneous Civil Petition
Asset forfeiture (05)
Partnership and corporate governance (21)
Petition re: arbitration award (11)
Employment
Writ of mandate (02)
Wrongful termination (36)
Other judicial review (39)
is2. This case is not complex under rule 3.400 of the California Rules of Court. If the case is complex, mark the
factors requiring exceptional judicial management:
Extensive motion practice raising difficult or novel
issues that will be time-consuming to resolve
Large number of witnesses a.
b.
f.
c.
3. Remedies sought (check all that apply):
punitive
a.
monetary
nonmonetary; declaratory or injunctive relief
c.
4. Number of causes of action (specify):
is
is not a class action suit.
5. This case
Date:
(TYPE OR PRINT NAME)
(SIGNATURE OF PARTY OR ATTORNEY FOR PARTY)
NOTICE
Plaintiff must file this cover sheet with the first paper filed in the action or proceeding (except small claims cases or cases filed
under the Probate Code, Family Code, or Welfare and Institutions Code). (Cal. Rules of Court, rule 3.220.) Failure to file may result
in sanctions.
File this cover sheet in addition to any cover sheet required by local court rule.
If this case is complex under rule 3.400 et seq. of the California Rules of Court, you must serve a copy of this cover sheet on all
other parties to the action or proceeding.
Unless this is a collections case under rule 3.740 or a complex case, this cover sheet will be used for statistical purposes only.
Page 1 of 2
Cal. Rules of Court, rules 2.30, 3.220, 3.400–3.403, 3.740;
Cal. Standards of Judicial Administration, std. 3.10
www.courtinfo.ca.gov
Form Adopted for Mandatory Use
Judicial Council of California
CM-010 [Rev. July 1, 2007]
CIVIL CASE COVER SHEET
Other non-PI/PD/WD tort (35)
Professional negligence (25)
Other real property (26)
Other petition (not specified above) (43)
Other employment (15)
e.
d.
Substantial amount of documentary evidence
Large number of separately represented parties
Coordination with related actions pending in one or more courts
in other counties, states, or countries, or in a federal court
Substantial postjudgment judicial supervision
Unlawful Detainer
CASE NUMBER:
JUDGE:
DEPT:
•
•
•
•
If there are any known related cases, file and serve a notice of related case. (You may use form CM-015.)
6.
b.
Other contract (37)
Auto (22)–Personal Injury/Property
Auto Tort
case involves an uninsured
motorist claim subject to
arbitration, check this item
instead of Auto)
Uninsured Motorist (46) (if the
Damage/Wrongful Death
INSTRUCTIONS ON HOW TO COMPLETE THE COVER SHEET
To Plaintiffs and Others Filing First Papers. If you are filing a first paper (for example, a complaint) in a civil case, you must
complete and file, along with your first paper, the Civil Case Cover Sheet contained on page 1. This information will be used to compile
statistics about the types and numbers of cases filed. You must complete items 1 through 6 on the sheet. In item 1, you must check
one box for the case type that best describes the case. If the case fits both a general and a more specific type of case listed in item 1,
check the more specific one. If the case has multiple causes of action, check the box that best indicates the primary cause of action.
To assist you in completing the sheet, examples of the cases that belong under each case type in item 1 are provided below. A cover
sheet must be filed only with your initial paper. Failure to file a cover sheet with the first paper filed in a civil case may subject a party,
its counsel, or both to sanctions under rules 2.30 and 3.220 of the California Rules of Court.
To Parties in Complex Cases
. In complex cases only, parties must also use the Civil Case Cover Sheet to designate whether the
case is complex. If a plaintiff believes the case is complex under rule 3.400 of the California Rules of Court, this must be indicated by
completing the appropriate boxes in items 1 and 2. If a plaintiff designates a case as complex, the cover sheet must be served with the
complaint on all parties to the action. A defendant may file and serve no later than the time of its first appearance a joinder in the
plaintiff's designation, a counter-designation that the case is not complex, or, if the plaintiff has made no designation, a designation that
the case is complex.
CASE TYPES AND EXAMPLES
Contract
Provisionally Complex Civil Litigation (Cal.
Rules of Court Rules 3.400–3.403)
Breach of Contract/Warranty (06)
Breach of Rental/Lease
Contract (not unlawful detainer
Antitrust/Trade Regulation (03)
Construction Defect (10)
Claims Involving Mass Tort (40)
Securities Litigation (28)
Environmental/Toxic Tort (30)
or wrongful eviction)
Contract/Warranty Breach–Seller
Plaintiff (not fraud or negligence)
Negligent Breach of Contract/
Warranty
Insurance Coverage Claims
Other Breach of Contract/Warranty
(arising from provisionally complex
case type listed above) (41)
Collections (e.g., money owed, open
Other PI/PD/WD (Personal Injury/
Property Damage/Wrongful Death)
Tort
book accounts) (09)
Collection Case–Seller Plaintiff
Asbestos (04)
Enforcement of Judgment
Other Promissory Note/Collections
Enforcement of Judgment (20)
Asbestos Property Damage
Case
Asbestos Personal Injury/
Insurance Coverage (not provisionally
Abstract of Judgment (Out of
Wrongful Death
complex) (18)
County)
Confession of Judgment (non-
Product Liability (not asbestos or
Auto Subrogation
toxic/environmental) (24)
domestic relations)
Other Coverage
Other Contract (37)
Medical Malpractice (45)
Sister State Judgment
Medical Malpractice–
Administrative Agency Award
Contractual Fraud
Physicians & Surgeons
(not unpaid taxes)
Petition/Certification of Entry of
Judgment on Unpaid Taxes
Other Contract Dispute
Other Professional Health Care
Malpractice
Real Property
Eminent Domain/Inverse
Other PI/PD/WD (23)
Other Enforcement of Judgment
Premises Liability (e.g., slip
Condemnation (14)
Case
and fall)
Wrongful Eviction (33)
Intentional Bodily Injury/PD/WD
Other Real Property (e.g., quiet title) (26)
Miscellaneous Civil Complaint
RICO (27)
(e.g., assault, vandalism)
Writ of Possession of Real Property
Mortgage Foreclosure
Intentional Infliction of
Other Complaint (not specified
above) (42)
Emotional Distress
Quiet Title
Negligent Infliction of
Declaratory Relief Only
Other Real Property (not eminent
domain, landlord/tenant, or
foreclosure)
Injunctive Relief Only (non-
Emotional Distress
Other PI/PD/WD
harassment)
Mechanics Lien
Non-PI/PD/WD (Other) Tort
Unlawful Detainer
Other Commercial Complaint
Business Tort/Unfair Business
Case (non-tort/non-complex)
Commercial (31)
Residentia
l (32)
P
ractice (07)
Civil Rights (e.g., discrimination,
false arrest) (not civil
Other Civil Complaint
(non-tort/non-complex)
Drugs (38) (if the case involves illegal
drugs, check this item; otherwise,
report as Commercial or Residential)
Miscellaneous Civil Petition
harassment) (08)
Defamation (e.g., slander, libel)
Partnership and Corporate
(13)
Governance (21)
Judicial Review
Fraud (16)
Other Petition (not specified
Asset Forfeiture (05)
above) (43)
Intellectual Property (19)
Petition Re: Arbitration Award (11)
Civil Harassment
Professional Negligence (25)
Writ of Mandate (02)
Workplace Violence
Legal Malpractice
Other Professional Malpractice
(not medical or legal)
Other Non-PI/PD/WD Tort (35)
Writ–Administrative Mandamus
Writ–Mandamus on Limited Court
Elder/Dependent Adult
Abuse
Case Matter
Election Contest
Writ–Other Limited Court Case
Petition for Name Change
Review
Petition for Relief From Late
Employment
Claim
Other Judicial Review (39)
Wrongful Termination (36)
Other Employment (15)
Review of Health Officer Order
Notice of Appeal–Labor
Commissioner Appeals
Other Civil Petition
CM-010 [Rev. July 1, 2007]
Page 2 of 2
CIVIL CASE COVER SHEET
CM-010
To Parties in Rule 3.740 Collections Cases. A "collections case" under rule 3.740 is defined as an action for recovery of money
owed in a sum stated to be certain that is not more than $25,000, exclusive of interest and attorney's fees, arising from a transaction in
which property, services, or money was acquired on credit. A collections case does not include an action seeking the following: (1) tort
damages, (2) punitive damages, (3) recovery of real property, (4) recovery of personal property, or (5) a prejudgment writ of
attachment. The identification of a case as a rule 3.740 collections case on this form means that it will be exempt from the general
time-for-service requirements and case management rules, unless a defendant files a responsive pleading. A rule 3.740 collections
case will be subject to the requirements for service and obtaining a judgment in rule 3.740.
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address):
Telephone No.: Fax No. (Optional):
E-Mail Address (Optional):
ATTORNEY FOR (Name): Bar No:
FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE
&(175$/JUSTICE CENTER:
700 Civic Center Dr. West, Santa Ana, CA 92701-4045
APPELLANT:
RESPONDENT:
NOTICE OF APPEAL – CIVIL CITATION
CASE NO:
Civil Citation fine/penalty has been paid. has been waived by the citing agency.
Contestant/Appellant, , of the above entitled action,
having exhausted the administrative review process, hereby appeals to the Superior Court of California, County of Orange
from the final decision of the administrative review, which was mailed or personally served on ,
regarding Civil Citation number: .
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
(TYPE OR PRINT NAME) (SIGNATURE OF APPELLANT OR ATTORNEY)
NOTE: A separate appeal must be filed for each civil citation. A copy of this document must be mailed to the citing
agency. The original appeal with proof of service must be filed with the court with the proper filing fee.
PROOF OF SERVICE BY MAIL
I deposited a copy of the Notice of Appe al in the United States mail, in a sealed envelope with postage fully prepaid. The
envelope was addressed as follows: (Name and address of citing agency)
Date of mailing: Place of mailing (city and state): .
I am a resi dent of or employed in the county whe re the Notice of Appeal was mailed. My residence or business address
is: Street Address: City: State: .
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
________________________
(TYPE OR PRINT NAME) (SIGNATURE OF DECLARANT)
Approved for Optional Use
L-1044 (Rev. July 2013)
NOTICE OF APPEAL - CIVIL CITATION
Govt. Code § 53069.4
www.occourts.org
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SUPERIOR COURT OF CALIFORNIA OF ORANGE COUNTY SELF-HELP (The Superior Court of California - County of Orange)

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