COVER SHEET FOR FILING CIVIL ACTIONS Case No. ...............................................................................
COMMONWEALTH OF VIRGINIA (CLERK’S OFFICE USE ONLY)
................................................................................................................................................................................................................................. Circuit Court
................................................................................................................................... v./In re: .........................................................................................................................
PLAINTIFF(S) DEFENDANT(S)
................................................................................................................................... .........................................................................................................................
I, the undersigned [ ] plaintiff [ ] defendant [ ] attorney for [ ] plaintiff [ ] defendant hereby notify the Clerk of Court that I am filing
the following civil action. (Please indicate by checking box that most closely identifies the claim being asserted or relief sought.)
GENERAL CIVIL
Subsequent Actions
[ ] Claim Impleading Third Party Defendant
[ ] Monetary Damages
[ ] No Monetary Damages
[ ] Counterclaim
[ ] Monetary Damages
[ ] No Monetary Damages
[ ] Cross Claim
[ ] Interpleader
[ ] Reinstatement (other than divorce or
driving privileges)
[ ] Removal of Case to Federal Court
Business & Contract
[ ] Attachment
[ ] Confessed Judgment
[ ] Contract Action
[ ] Contract Specific Performance
[ ] Detinue
[ ] Garnishment
Property
[ ] Annexation
[ ] Condemnation
[ ] Ejectment
[ ] Encumber/Sell Real Estate
[ ] Enforce Vendor’s Lien
[ ] Escheatment
[ ] Establish Boundaries
[ ] Landlord/Tenant
[ ] Unlawful Detainer
[ ] Mechanics Lien
[ ] Partition
[ ] Quiet Title
[ ] Termination of Mineral Rights
Tort
[ ] Asbestos Litigation
[ ] Compromise Settlement
[ ] Intentional Tort
[ ] Medical Malpractice
[ ] Motor Vehicle Tort
[ ] Product Liability
[ ] Wrongful Death
[ ] Other General Tort Liability
ADMINISTRATIVE LAW
[ ] Appeal/Judicial Review of Decision of
(select one)
[ ] ABC Board
[ ] Board of Zoning
[ ] Compensation Board
[ ] DMV License Suspension
[ ] Employee Grievance Decision
[ ] Employment Commission
[ ] Local Government
[ ] Marine Resources Commission
[ ] School Boa
rd
[ ] Voter Registration
[ ] Other Administrative Appeal
DOMESTIC/FAMILY
[ ] Adoption
[ ] Adoption – Foreign
[ ] Adult Protection
[ ] Annulment
[ ] Annulment – Counterclaim/Responsive
Pleading
[ ] Child Abuse and Neglect – Unfounded
Complaint
[ ] Civil Contempt
[ ] Divorce (select one)
[ ] Complaint – Contested*
[ ] Complaint – Uncontested*
[ ] Counterclaim/Responsive Pleading
[ ] Reinstatement
Custody/Visitation/Support/Equitable
Distribution
[ ] Separate Maintenance
[ ] Separate Maintenance Counterclaim
WRITS
[ ] Certiorari
[ ] Habeas Corpus
[ ] Mandamus
[ ] Prohibition
[ ] Quo Warranto
PROBATE/WILLS AND TRUSTS
[ ] Accounting
[ ] Aid and Guidance
[ ] Appointment (select one)
[ ] Guardian/Conservator
[ ] Standby Guardian/Conservator
[ ] Custodian/Successor Custodian (UTMA)
[ ] Trust (select one)
[ ] Impress/Declare/Create
[ ] Reformation
[ ] Will (select one)
[ ] Construe
[ ] Contested
MISCELLANEOUS
[ ] Amend Death Certificate
[ ] Appointment (select one)
[ ] Church Trustee
[ ] Conservator of Peace
[ ] Marriage Celebrant
[ ] Approval of Transfer of Structured
Settlement
[ ] Bond Forfeiture Appeal
[ ] Declaratory Judgment
[ ] Declare Death
[ ] Driving Privileges (select one)
[ ] Reinstatement pursuant to § 46.2-427
[ ] RestorationHabitual Offender or 3
rd
Offense
[ ] Expungement
[ ] Firearms Rights – Restoration
[ ] Forfeiture of Property or Money
[ ] Freedom of Information
[ ] Injunction
[ ] Interdiction
[ ] Interrogatory
[ ] Judgment
Lien-Bill to Enforce
[ ] Law Enforcement/Public Official Petition
[ ] Name Change
[ ] Referendum Elections
[ ] Sever Order
[ ] Taxes (select one)
[ ] Correct Erroneous State/Local
[ ] Delinquent
[ ] Vehicle Confiscation
[ ] Voting Rights – Restoration
[ ] Other (please specify)
......................................
...............................................................................
....................................................................... _____________________________________________________________________
DATE [ ] PLAINTIFF [ ] DEFENDANT [ ] ATTORNEY FOR [ ] PLAINTIFF
[ ] DEFENDANT
................................................................................................................................................
PRINT NAME
................................................................................................................................................
ADDRESS/TELEPHONE NUMBER OF SIGNATOR
................................................................................................................................................
................................................................................................................................................
EMAIL ADDRESS OF SIGNATOR (OPTIONAL)
*“Contesteddivorce means any of the following matters are in
dispute: grounds of divorce, spousal support and maintenance,
child custody and/or visitation, child support, property distribution
or debt allocation. An “Uncontested” divorce is filed on no fault
grounds and none of the above issues are in dispute.
[ ] Damages in the amount of $
................................................................
are claimed.
FORM CC-1416 (MASTER) PAGE ONE 07/16
Clear All Data
Civil Action Type Codes
(Clerk’s Office Use Only)
Accounting
............................................................................. ACCT
Adoption
................................................................................. ADOP
Adoption Foreign
............................................................ FORA
Adult Protection
.................................................................... PROT
Aid and Guidance
.................................................................... AID
Amend Death Certificate
.................................................... ADC
Annexation
........................................................................... ANEX
Annulment
............................................................................ ANUL
Annulment – Counterclaim/Responsive Pleading
... ACRP
Appeal/Judicial Review
ABC Board
...................................................................... ABC
Board of Zoning
......................................................... ZONE
Compensation Board
.............................................. ACOM
DMV License Suspension
.............................................. JR
Employment Commission
......................................... EMP
Employment Grievance Decision
........................... GRV
Local Government
.................................................... GOVT
Marine Resources
........................................................ MAR
School Board
....................................................................... JR
Voter Registration
..................................................... AVOT
Other Administrative Appeal
................................ AAPL
Appointment
Conservator of Peace
.................................................... COP
Church Trustee
............................................................ AOCT
Custodian/Successor Custodian (UTMA)
....... UTMA
Guardian/Conservator
............................................... APPT
Marriage Celebrant
................................................... ROMC
Standby Guardian/Conservator
............................ STND
Approval of Transfer of Structured Settlement
............... SS
Asbestos Litigation
.................................................................... AL
Attachment
................................................................................. ATT
Bond Forfeiture Appeal
........................................................ BFA
Child Abuse and Neglect Unfounded Complaint
.. CAN
Civil Contempt
.................................................................... CCON
Claim Impleading Third Party Defendant
Monetary Damages/No Monetary Damages
........... CTP
Complaint (Miscellaneous)
........................................... COM
Compromise Settlement
.................................................. COMP
Condemnation
..................................................................... COND
Confessed Judgment
.................................................................. CJ
Contract Action
.................................................................... CNTR
Contract Specific Performance
....................................... PERF
Counterclaim Monetary Damages/No Monetary
Damages
.................................................................................... CC
Cross Claim
........................................................................... CROS
Declaratory Judgment
....................................................... DECL
Declare Death
...................................................................... DDTH
Detinue
........................................................................................ DET
Divorce
Complaint Contested/Uncontested
....................... DIV
Counterclaim/Responsive Pleading
.................... DCRP
Reinstatement Custody/Visitation/Support/
Equitable Distribution
............................................. CVS
Driving Privileges
Reinstatement pursuant to § 46.2-427
................ DRIV
Restoration Habitual Offender or
3
rd
Offense .......................................................................... REST
Ejectment
............................................................................. EJET
Encumber/Sell Real Estate
................................................ RE
Enforce Vendor’s Lien
................................................ VEND
Escheatment
.......................................................................... ESC
Establish Boundaries
...................................................... ESTB
Expungement
.................................................................... XPUN
Forfeiture of Property or Money
............................... FORF
Freedom of Information
.................................................... FOI
Garnishment
..................................................................... GARN
Injunction
................................................................................. INJ
Intentional Tort
.................................................................. ITOR
Interdiction
......................................................................... INTD
Interpleader
......................................................................... INTP
Interrogatory
....................................................................... INTR
Judgment Lien Bill to Enforce
................................ LIEN
Landlord/Tenant
..................................................................... LT
Law Enforcement/Public Official Petition
................ LEP
Mechanics Lien
.............................................................. MECH
Medical Malpractice
........................................................ MED
Motor Vehicle Tort
............................................................. MV
Name Change
......................................................................... NC
Other General Tort Liability
...................................... GTOR
Partition
............................................................................... PART
Permit, Unconstitutional Grant/Denial by Locality LUC
Petition (Miscellaneous)
............................................... PET
Product Liability
............................................................. PROD
Quiet Title
................................................................................. QT
Referendum Elections
.................................................... ELEC
Reinstatement (Other than divorce or driving
privileges)
....................................................................... REIN
Removal of Case to Federal Court
............................. REM
Restore Firearms Rights Felony
............................ RFRF
Restore Firearms Rights Review
........................... RFRR
Separate Maintenance
........................................................ SEP
Separate Maintenance Counterclaim/Responsive
Pleading
.......................................................................... SCRP
Sever Order
........................................................................ SEVR
Taxes
Correct Erroneous State/Local
......................... CTAX
Delinquent
............................................................... DTAX
Termination of Mineral Rights
..................................... MIN
Trust – Impress/Declare/Create
................................. TRST
Trust – Reformation
....................................................... REFT
Uniform Foreign Country Money Judgments
....... RFCJ
Unlawful Detainer
................................................................ UD
Vehicle Confiscation
........................................................ VEH
Voting Rights Restoration
....................................... VOTE
Will Construction
............................................................ CNST
Will Contested
.................................................................. WILL
Writs
Certiorari
........................................................................ WC
Habeas Corpus
.......................................................... WHC
Mandamus
.................................................................... WM
Prohibition
...................................................................... WP
Quo Warranto
......................................................... WQW
Wrongful Death
.................................................................... WD
FORM CC-1416 (MASTER) PAGE TWO 07/16