Form Cc 1416 – Fill Out and Use This PDF

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 Board

[ ] 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 [ ] Restoration – Habitual Offender or 3rd

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)

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PRINT NAME

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ADDRESS/TELEPHONE NUMBER OF SIGNATOR

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EMAIL ADDRESS OF SIGNATOR (OPTIONAL)

*“Contested” divorce 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.

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
3rd 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
Sex Change	COS
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