CIVIL    SETTLEMENT    JUDGMENT

REPORT OF CIVIL COMPLAINT FILING

Original:	Check this box if this is the first complaint filed in the case.
Supplemental:	Check this box if this is an amended complaint in the same case for which you already filed the original complaint.
Corrected:	Check this box only if you are correcting errors in a previously-filed report of a complaint.
Plaintiff(s):	List all parties to the action on behalf of plaintiffs, e.g., Environmental Health Consortium and Robert Reed.
Defendant(s):	List all defendants separately identified in the complaint including corporate affiliations, e.g., Drill Manufacturing Company, a subsidiary of Power Tool, Inc.
Court Docket Number:	Number assigned by the court of record.
Court Name:	Identify the court in which the complaint was filed, e.g., San Francisco Superior Court.
Short Case Name:	Generally, one plaintiff and one defendant, e.g., Environmental Health v. Power Tool
Type of Claim:	Please check all descriptions that apply to the particular complaint being filed.
Relief Sought:	Please check all descriptions that apply to the particular complaint being filed.
Name of Contact:	This is the person who should be contacted if there are any questions about the complaint or the specific allegation of violation. This could be the attorney or organization representative.
Name of Organization:	This should include the name, address, phone number of the organization of the contact person. This could be the law firm or the organization headquarters.

*** A Copy of the Complaint Must Be Attached ***

REPORT OF SETTLEMENT

Original:	Check this box if this is the first settlement in the case.
Supplemental:	Check this box if this is a settlement with an additional party or parties, or a change to a prior settlement.
Corrected:	Check this box only if you are correcting errors from a previously-filed report of a settlement.
Plaintiff(s):	List all plaintiff parties settling in this settlement document, e.g., Environmental Health Consortium and Robert Reed.
Defendant(s):	List all defendants who are a part of this settlement including corporate affiliations, e.g., Drill Manufacturing Company, a subsidiary of Power Tool, Inc.
Court Docket Number:	Number assigned by the court of record.
Court Name:	Identify the court in which the complaint was filed, e.g., San Francisco Superior Court.
Short Case Name:	Generally, one plaintiff and one defendant, e.g., Environmental Health v. Power Tool
Relief:	Please briefly describe the injunctive relief agreed to by the parties.
Payment(s):	Please indicate the distribution of the settlement funds. Identify other, e.g., American Cancer Society.
Date Settlement Signed:	Indicate the date of agreement by all parties.
Will Settlement be Submitted to Court?:	Will the parties submit this settlement for court approval? Please remember, if settlement is submitted for court approval a Report of Entry of Judgment must be submitted to the Attorney General.
Name of Contact:	This is the person who should be contacted if there are any questions about the settlement This could be the attorney or organization representative.
Name of Organization:	This should include the name, address, phone number of the organization of the contact person. This could be the law firm or the organization headquarters.

*** A Copy of the Settlement Must Be Attached ***

REPORT OF ENTRY OF JUDGMENT

*** A Copy of the Judgment Must Be Attached ***