Miscellaneous: Jerry Cannis, et al Plaintiff vs. Universal Property And Casualty Insurance Company Defendant

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                                Filing #   133747515 E-Filed 08/31/2021 11:58:12 AM




            FORM 1.997.                CIVIL COVER SHEET


            The civil        cover    sheet and the informationcontained in it neither
                                                                               replace nor supplement the filing
            and service of pleadings or other documents as required by law. This form must be filed by the
            plaintiff or petitioner with the Clerk of Court for the purpose of reporting uniform data pursuant
            to section 25.075, Florida Statutes. (See instructions for completion.)




                        I.            CASE STYLE


                       IN THE CIRCUIT/COUNTYCOURT OF THE SEVENTEENTH JUDICIAL CIRCUIT,
                                             IN AND FOR BROWARD           COUNTY, FLORIDA

            JERRY CANNIS, PEGGY CANNIS
            Plaintiff                                                                    Case #
                                                                                         Judge
            VS.

           UNIVERSALPROPERTY AND CASUALTY INSURANCE COMPANY
            Defendant




                        II.           AMOUNT OF CLAIM
           Please indicate the estimated amount of the claim, rounded to the nearest dollar. The estimated amount of
           the claim is requested for data collection and clerical processing purposes only. The amount of the claim
           shall not be used for any other purpose.

            E $8,000 or less
            El    $8,001 $30,000
                              -




            El    $30,001- $50,000
            .U $50,001- $75,000
            El$75,001 $100,000    -




            E over $100,000.00


                        III.          TYPE OF CASE         (If the case fits more than one type of case, select the most
            definitive category.) If the most         descriptive label is a subcategory (is indented under a broader
            category), place an x          on both the main category and subcategory lines.




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                 ***
                       FILED: BROWARD COUNTY, FL BRENDA D.             FORMAN, CLERK 08/31/2021 11:58:08 AM.****
CIRCUIT CIVIL

m Condominium
m   Contracts and indebtedness
m   Eminent domain
m   Auto negligence
m   Negligence-other
         m   Business governance
         m   Business torts
         m   Environmental/Toxic tort
         m   Third party indemnification
         m   Constructiondefect
         m Mass tort
         m   Negligent security
         m   Nursing home negligence
         m Premises
         m Premises
m Products liability
m Real   Property/Mortgageforeclosure
       m    Commercial foreclosure
       m    Homesteadresidential foreclosure
       m Non-homestead residential foreclosure
       m Other real   property actions

El Professional malpractice
         m
         m   Malpractice-medical
         m   Malpractice-otherprofessional
m   Other
         m   Antitrust/Traderegulation
         m   Business transactions
         m Constitutionalchallenge-statute or ordinance
         m Constitutionalchallenge-proposed amendment
         m   Corporate trusts
         m                                     or   other
         m   Insurance claims
         m   Intellectual property
         m   Libel/Slander
         m   Shareholder derivative action
         m   Securities litigation
         m   Trade secrets
         m   Trust litigation


COUNTY CIVIL


O Small Claims up to      $8,000
O Civil

1 Real      property/Mortgage foreclosure
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 O   Replevins
 0 Evictions
          O ResidentialEvictions
          0 Non-residential Evictions
 El Other civil       (non-monetary)

                                             COMPLEX BUSINESS COURT


This action is     appropriatefor assignment to Complex Business Court as delineated and mandated by the
Administrative Order. Yes C] No E



          IV.         REMEDIES SOUGHT (check all that apply):
          @    Monetary;
          m    Nonmonetary declaratory or injunctive relief;
          E] Punitive


          V.          NUMBER OF CAUSES OF ACTION:                   [ ]
          (Specify)
               1


          VI.         IS THIS CASE A CLASS ACTION LAWSUIT?
                       0 yes
                       @   no



          VII.        HAS NOTICE OF ANY KNOWN RELATED CASE BEEN FILED?
                       @   no

                       O yes    If"yes," list all related cases by name,   case   number,   and court.


          VIII.       IS JURY TRIAL DEMANDED IN COMPLAINT?
                       W yes
                       O   no



 I CERTIFY that the information I have            provided in this cover sheet is accurate to the best of
 my knowledge and belief, and that I           have read and will comply with the requirements of
 Florida Rule of Judicial Administration2.425.


 Signature:        s/ Your Insurance Attorney    Esq.           Fla. Bar # 13685

                      Attorney or party                                            (Bar # if attorney)

Your Insurance Attorney           Esq.                          08/31/2021
 (type   or   print name)                                Date




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