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Arizona Supreme Court Page 1 of 6 CVC10f-070118

FOR CLERK’S USE ONLY

Person Filing:

Address (if not protected):

City, State, Zip Code:

Telephone:

Email Address:

Representing [  ] Self or [  ] Attorney for

Lawyer’s Bar Number:

SUPERIOR COURT OF ARIZONA

IN COUNTY

Name of Plaintiff

Name of Defendant

Case Number:

Title: CIVIL COMPLAINT

Plaintiff hereby submits this complaint against Defendant(s) and alleges the following:

JURISDICTION and VENUE

1. The Superior Court in County has the legal authority to

hear and decide this case because: (Check all boxes that are true.)

[  ] The value of this case exceeds $10,000 dollars.

[  ] Replevin or other nonmonetary remedy will take place in

County.

[  ] The Plaintiff resides in County.

[  ] The Defendant resides in County.

[  ] The Defendant does business in County.

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Case Number:

Arizona Supreme Court Page 2 of 2 CVC10f-070118

[  ] The events, actions, or debts subject of this Complaint occurred in

County.

[  ] Other reason:

DISCOVERY TIER

2. Pursuant to Arizona Rules of Civil Procedure, Rule 26.2 (c) (3), the Court should assign my case

to the following tier based on the amount of damages I request.

[  ] Tier 1 = Actions claiming $50,000 or less in damages.

[  ] Tier 2 = Actions claiming more than $50,000 and less than $300,000 in damages,

OR Actions claiming nonmonetary relief.

[  ] Tier 3 = Actions claiming $300,000 or more in damages.

PARTIES

3. The Plaintiff in this case is:

4. The Defendant in this case is:

STATEMENT OF FACTS AND BREACH

5.

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Case Number:

Arizona Supreme Court Page 3 of 2 CVC10f-070118

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(If you need more space, add an attachment labeled “Statement of Facts and Breach,” and continue

consecutive numbering.)

APPLICABLE LAW SUPPORTING CLAIMS

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