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Virginia Civil Cover Sheet Form

To notify the court about the type of case to be filed at the clerk’s office, concerned individual must fulfill this form. This form is usually attached to the official complaint along with the filing fee.

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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 Cou rt 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 pr
 ivileges) 
[  ]  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 Board 
[  ]  Voter Registration 
[  ]  Other Administrative Appeal 
 
DOMESTIC/FAMILY 
[  ]  Adoption  [  ]  Adoption – Foreign 
[  ]  Adult Protection 
[  ]  Annulment  [  ]  Annulment – Counterclaim/Responsive P	
 leading 
[  ]  Child Abuse and Neglect – Unfounded 
Com	
 plaint 
[  ]  Civil Contempt 
[  ]  Divorce (select one)  [  ]  Complaint – Contested* 
[  ]  Complaint – Uncontested* 
[  ]  Counterclaim/Responsive Pleading 
[  ]  Reinstatement – Custod	
 y/Visitation/Support/Equitable 
Distribution 
[  ]  Separate Maintenance 
[  ]  Separate Main tenance 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 
[  ]  Trust (select one)  [  ]  Impress/Declare 
[  ]  Reformation 
[  ]  Will (select one) 
[  ]  Construe 
[  ]  Contested 
 
MISCELLANEOUS  
[  ]  Appointment (select one) 
[  ]  Church Trustee 
[  ]  Conservator of Peace 
[  ]  Marriage Celebrant 
[  ]  Bond Forfeiture Appeal 
[  ]  Declaratory Judgment 
[  ]  Declare Death 
[  ]  Driving Privileges (select one)  [  ]  Reinstatement pursuant to § 46.2-427 
[  ]  Restoration – Habitual Offender or 3	
rd 
Offense 
[  ]  Expungement 
[  ]  Firearms Rights – Restoration 
[  ]  Forfeiture of U.S. Currency 
[  ]  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) 	
 	 
 .......................................................................\
........ 
 	
[  ]  Damages in the amount of $ 	.................................................................	 are claimed. 	 
 
.......................................................................  
_____________________________________________________________________  DATE 	[  ] 	PLAINTIFF 	[  ] 	DEFENDANT 	[  ] 	ATTORNEY FOR 	[  ] 	PLAINTIFF 
 	[  ] 	DEFENDANT 	 ........................................................................\
........................................................................  	*“Contested” divorce means any of the following matters are in 
dispute:  grounds of divorce, sp ousal support and maintenance, 
child custody and/or visitation, child support, property distribution 
or debt allocation.  An “Uncontes ted” divorce is filed on no fault 
grounds and none of the above issues are in dispute. 	 PRINT  NAME  ........................................................................\
........................................................................   ADDRESS/TELEPHONE NUMBER OF SIGNATOR	 
 
........................................................................\
........................................................................

FORM CC-1416 (MASTER) PAGE TWO 10/12	 Civil Action Type Codes 
(Clerk’s Office Use Only) 	
 
 
Accounting 	
........................................................................\
.....	ACCT 
Adoption 	
........................................................................\
.........	ADOP 
Adoption – Foreign 	
............................................................	FORA 
Adult Protection 	
....................................................................	PROT 
Aid and Guidance 	
....................................................................	AID 
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 
Guardian/Conservator 	
...............................................	APPT 
Marriage Celebrant 	
...................................................	ROMC 
Standby Guardian/Conservator 	
............................	STND 
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 	
........................................................................\
..........	EJCT 
Encumber/Sell Real Estate 	
.....................................................	RE 
Enforce Vendor’s Lien 	
.....................................................	VEND 
Escheatment 	
........................................................................\
.......	ESC 
Establish Boundaries 	
...........................................................	ESTB 
Expungement 	
........................................................................\
	XPUN 
Firearms Rights – Restoration 	
.........................................	REST 
Forfeiture of U.S. Currency 	
.............................................	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 
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 
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 	
.....................................................	TRST 
Trust – Reformation 	
............................................................	REFT 
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
Next: Vermont Parental Rights and Responsibilities Stipulation and Order Form Previous: Virginia Depositions in Support of Divorce From The Bond of Matrimony Form
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