West Virginia State Courts

GENERAL CIVIL CASE COVER SHEET

[// GUIDANCE: File this Cover Sheet as the first page of any new civil Complaint or Petition in any West Virginia Circuit Court or Magistrate Court (as applicable). Failure to submit a properly completed Cover Sheet may delay docketing and could subject the filing to rejection under W. Va. R. Civ. P. 3(a) and applicable local rules.]

SECTION 1 – CASE IDENTIFICATION

SECTION 2 – PARTY INFORMATION

[// GUIDANCE: For minors or incapacitated persons, list the appropriate fiduciary (guardian ad litem, conservator, etc.) as required by W. Va. R. Civ. P. 17(c).]

SECTION 3 – CASE CATEGORY (Check ONE primary category and ONE sub-category)

A. Contract ☐
  1. Debt / Collection ☐  2. Construction ☐  3. Insurance ☐  4. Employment Contract ☐  5. Other Contract ☐

B. Torts ☐
  1. Personal Injury ☐  2. Wrongful Death ☐  3. Medical Malpractice ☐  4. Product Liability ☐  5. Intentional Tort ☐  6. Defamation ☐  7. Other Tort ☐

C. Real Property ☐
  1. Boundary / Title ☐  2. Quiet Title ☐  3. Condemnation / Eminent Domain ☐  4. Landlord–Tenant ☐  5. Other Real Property ☐

D. Civil Rights ☐
  1. Discrimination ☐  2. ADA ☐  3. § 1983 / Constitutional ☐  4. Other Civil Rights ☐

E. Business / Commercial ☐
  1. Shareholder / Partnership ☐  2. Antitrust ☐  3. Securities ☐  4. Mass Litigation ☐ (attach Mass Litigation Sheet)

F. Other ☐
  1. Declaratory Judgment ☐  2. Administrative Appeal ☐  3. Extraordinary Writ ☐  4. Election Contest ☐  5. Foreign Judgment ☐  6. Other (explain): _________

[// GUIDANCE: West Virginia Mass Litigation proceedings must be identified at filing pursuant to Trial Court Rule 26.03 and accompanied by the Supreme Court-issued Mass Litigation Cover Sheet.]

SECTION 4 – RELATED OR COMPANION CASES

1. Are there any related, predecessor, or companion cases involving substantially the same parties or issues?
     Yes ☐  No ☐
2. If YES, list Court, Case No., and disposition status:
     [_____]

[// GUIDANCE: Prompt disclosure assists the Clerk in proper assignment and helps avoid inconsistent rulings.]

SECTION 5 – JURY DEMAND / ARBITRATION

| Jury Trial Demanded? | Yes ☐  No ☐ |
| Statutory / Contractual Arbitration Required? | Yes ☐  No ☐ |

[// GUIDANCE: Jury demand must also appear in the Complaint per W. Va. R. Civ. P. 38(b).]

SECTION 6 – DAMAGES SOUGHT (check all that apply)

☐ Compensatory   ☐ Punitive   ☐ Injunctive / Declaratory
☐ Attorney Fees   ☐ Pre- & Post-Judgment Interest   ☐ Costs

SECTION 7 – ATTORNEY / PRO SE INFORMATION

If Pro Se, check here ☐ and provide residential address and contact details above.

SECTION 8 – FILING FEE CALCULATION (Circuit Court)

1. Base Filing Fee (civil complaint) | $ [200.00]*
2. Additional Party Fee (# of defendants over two × $[20.00]) | $ [__]
3. Mass Litigation Surcharge (if applicable) | $ [__]
4. Other Statutory Surcharges | $ [__]
   TOTAL REMITTED | $ [__]

Verify current fees with the Clerk; amounts subject to periodic legislative adjustment.

[// GUIDANCE: Fees are governed principally by W. Va. Code § 59-1-11 et seq. and Supreme Court Administrative Orders. Magistrate Court fees vary; consult W. Va. Code § 50-3-1 and local rules.]

SECTION 9 – CERTIFICATION & SIGNATURE

I hereby certify that:
1. The information provided in this Cover Sheet is true and correct to the best of my knowledge, information, and belief, formed after reasonable inquiry;
2. The Complaint or Petition submitted with this Cover Sheet is filed in good faith and not for the purpose of delay; and
3. All required filing fees and surcharges have been tendered contemporaneously with this filing.

SECTION 10 – CLERK’S OFFICE USE ONLY

[// GUIDANCE:
1. Attach additional sheets for multiple plaintiffs, defendants, or complex fee calculations.
2. If filing electronically where permitted, ensure the Cover Sheet is submitted as a separate lead document.
3. Retain a conformed copy for your records—many counties require a file-stamped Cover Sheet to accompany service packages on opposing parties.]

END OF COVER SHEET