Get Cc Dcm 001

Circuit Court for City or County CIVIL - DOMESTIC CASE INFORMATION REPORT DIRECTIONS Plaintiff This information Report must be completed and attached to the complaint filed with the Clerk of Court unless your case is exempted from the requirement by the Chief Judge of the Court of Appeals pursuant to Rule 2-111. A copy must be included for each defendant to be served* Defendant You must file an Information Report as required by Rule 2-323 h. THIS INFORMATION REPORT CANNOT BE ACCEPTED AS AN ANSWER OR RESPONSE FORM FILED BY PLAINTIFF DEFENDANT CASE NUMBER Clerk to insert CASE NAME vs. Plaintiff PHONE PARTY S NAME Defendant - Day Time Phone ADDRESS PARTY S ATTORNEY S NAME ATTORNEY S ADDRESS I am not represented by an attorney RELATED CASE PENDING Yes No Special Requirements If yes Court and case s if known Interpreter Please attach Form CC-DC 41 ADA accommodation Please attach Form CC-DC 49 ALTERNATIVE DISPUTE RESOLUTION INFORMATION Is this case appropriate for referral to an ADR process under Md. Rule 17-101 Check all that apply A. Mediation C. Settlement Conference B. Arbitration D. Neutral Evaluation IS THIS CASE CONTESTED No If yes which issues appear to be contested Ground for divorce Child Custody Visitation Child Support Alimony Permanent Rehabilitative Use and possession of family home and property Marital property issues involving Valuation of business Pensions Bank accounts/IRA s Real Property Other Paternity Adoption/termination of parental rights Request is made for Initial order Modification Contempt Absolute Divorce Limited Divorce For non-custody/visitation issues do you intend to request Court-appointed expert name field Mediation by a Court-sponsored settlement program Initial conference with the court For custody/visitation issues do you intend to request Mediation by a private mediator Evaluation by mental health professional Other Evaluation Appointment of counsel to represent child not just to waive psychiatric privilege A conference with the Court Is there an allegation of physical or sexual abuse of party or child CC/DCM 001 Rev* 2/2010 Page 1 of 2 TIME ESTIMATE FOR A MERITS HEARING hours days COMPLEX SCIENCE MEDICAL CASE MANAGEMENT PROGRAM ASTAR FOR PURPOSES OF POSSIBLE SPECIAL ASSIGNMENT TO AN ASTAR RESOURCE JUDGE under Md. Rule 16-202. Please check the applicable box below and attache a duplicate copy of your complaint* Standard - Trial within 18 months of filing Expedited - Trial within 7 months of filing Signature of Counsel/Party Date Print Name Street Address City/State/Zip Reset. A copy must be included for each defendant to be served* Defendant You must file an Information Report as required by Rule 2-323 h. THIS INFORMATION REPORT CANNOT BE ACCEPTED AS AN ANSWER OR RESPONSE FORM FILED BY PLAINTIFF DEFENDANT CASE NUMBER Clerk to insert CASE NAME vs. THIS INFORMATION REPORT CANNOT BE ACCEPTED AS AN ANSWER OR RESPONSE FORM FILED BY PLAINTIFF DEFENDANT CASE NUMBER Clerk to insert CASE NAME vs. Plaintiff PHONE PARTY S NAME Defendant - Day Time Phone ADDRESS PARTY S ATTORNEY S NAME ATTORNEY S ADDRESS I am not represented by an attorney RELATED CASE PENDING Yes No Special Requirements If yes Court and case s if known Interpreter Please attach Form CC-DC 41 ADA accommodation Please attach Form CC-DC 49 ALTERNATIVE DISPUTE RESOLUTION INFORMATION Is this case appropriate for referral to an ADR process under Md.