JUSTICE COURT CIVIL CASE INFORMATION SHEET ( )

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JUSTICE COURT CIVIL CASE INFORMATION SHEET (10-2015) CAUSE NUMBER (FOR CLERK USE ONLY): STYLED (e.g., John Smith v. All American Insurance Co; In re Mary Ann Jones; In the Matter of the Estate of George Jackson) A civil case information sheet must be completed and submitted when an original petition i s f i l e d t o i n i t i a t e a n e w s u i t. The information should be the best available at the time of filing. This sheet, required b y R u l e o f C i v i l P r o c e d u r e 502, is intended to collect information that will be used for statistical purposes only. It neither replaces nor supplements the filings or service of pleading or other documents as required by law or rule. The sheet does not constitute a discovery request, response, or supplementation, and it not admissible as trial. 1. Contact information for person completing case information sheet: 2. Name of parties in case: Name: Telephone: Plaintiff(s): Address: Fax: Defendant(s): City/State/Zip: State Bar No: (Attach additional page as necessary to list all parties) Email: Signature: o Debt Claim: A debt claim case is a lawsuit brought to a debt by an assignee of a claim, a debt collector collection agency, a financial institution, or a person or entity primarily engaged in the business of lending money at interest. The claim can be for no more than $10,000 in damages, excluding statutory interest and court costs but including attorney fees, if any. o Eviction: An eviction case is a lawsuit brought to recover possession of real property, often by a landlord or against a tenant. A claim for rent may be joined with an eviction case if the amount of rent due and unpaid is not more than $10,000, including costs and attorney fees, if any. 3. Indicate case type, or identify the most important issue in the case (select only 1): o Repair and Remedy: A repair and remedy case is a brought to seek judicial remedy for the alleged failure of a landlord to remedy or repair a condition as required by Chapter 92 of the Texas Property Code. The relief sought can be for no more than $10,000, excluding statutory Interest and court costs but including attorney fees, if any. o Small Claims: A small claims case is a lawsuit brought for the recovery of money damages, civil penalties, or personal property. The claim can be for no more than $10,000 excluding statutory interest and court costs but including attorney fees, if any.

Case No. Plaintiff ---- - - - (landlord's name as stated in oral or written lease) v. Defendant(s) (List all tenants) STATE OF TEXAS COUNTY OF McLENNAN In the Justice Court Precinct One Place One County of McLennan, Texas AFFIDAVIT OF MILITARY STATUS OF DEFENDANT(S) Before me the undersigned notary or clerk of the justice court, on this day personally appeared the undersigned affiant whose identity is known to me. After I administered an oath to such affiant, he or she upon oath and under penalty ofpetjury (fine and/or up to one year in jail), stated the following: My name is [please printl.-,----,----= ------------------- I am [check one] 0the plaintiff or 0an authorized agent of the plaintiff in the case described at the top right of this page. I am capable of making this affidavit. The facts stated in the affidavit are within my personal knowledge and are true and correct. [check or fill in as applicable] 0I.No defendant in this case is on active duty in the U.S. military (Army, Navy, Air Force, Marines, or Coast Guard). The facts on which I base my conclusion are as follows: 02. Defendant [insert name(s)]. is on active duty in the U.S. military. 03. Defendant [insert name(s)].-:c:----=--:---------------- has been deployed by the U.S. military to a foreign country. 04. Plaintiff and the undersigned (if the undersigned is acting as an agent of plaintiff) are not able to determine whether any defendant is with the U.S. military-except for any defendant named in paragraph 2 above. 05. Plaintiff and the undersigned (if the undersigned is acting as an agent of plaintiff) are not able to determine whether any defendant who is in the U.S. military has been deployed to a foreign country-except for any defendant named in paragraph 3 above. 06. Defendant [insert name(s)] -;-;----:---:---cc---:------:----:----- has signed, while on active duty, a separate, limited written waiver or a written lease containing a limited waiver of his or her rights under the U.S. Servicemembers Civil Relief Act of2003. Signature of affiant SWORN TO and SUBSCRIBED before me by on,20 0 Notary Public for the State of Texas or 0Clerk of the Justice Court PLEASE NOTE

ANY CASE FILED IN OUR COURT HAS TO HAVE A PROOF OF MILITARY STATUS TO CHECK STATUS AND PRINT CERTIFICATE YOU CAN GO TO www.dmdc.asd.mil/appj/scra/singlerecord.xhtml

CAUSE NO. IN THE JUSTICE COURT Plaintiff vs PRECINCT 1, PLACE 1 Defendant MCLENNAN COUNTY,TEXAS CERTIFICATE OF LAST KNOWN MAILING ADDRESS This Certificate of filed pursuant to Rule 239a of the Texas Rules of Civil Procedure and certifies that the last known address of Defendant is: Name: Street Address: City, State, Zip Code: Plaintiffs signature