No Value: Shahnaz Mina PourPasha VS Mohammad Reza Miremami

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                                General Civil and Domestic Relations Case Filing Information Form

                             f= Superior or LF) State Court of Dekalb                            County

         For Clerk Use Only

         Date Filed                                              Case Number
                            MM-DD-YYYY

Plaintiff(s)                                                        Defendant(s)
PourPasha       Shahnaz           M                                  Miremami        Mohammed      R
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Plaintiff's Attorney Nicole Amanda Elder, Esq.                      State Bar Number 375846                Self-Represented [1]

                        Check one case type and one sub-type in the same box (if a sub-type applies):

         General Civil Cases
                                                                            Domestic Relations Cases
         o        Automobile Tort
         oO       Civil Appeal                                              Oo     Adoption
         oO       Contempt/Modification/Other                               o      Contempt
                  Post-Judgment                                                    O Non-payment of child support,
                  Contract                                                         medical support, or alimony
                  Garnishment                                                      Dissolution/Divorce/Separate
                  General Tort                                                     Maintenance/Alimony
                  Habeas Corpus                                                    Family Violence Petition
                  Injunction/Mandamus/Other Writ                                   Modification
                  Landlord/Tenant                                                  O Custody/Parenting Time/Visitation
                  Medical Malpractice Tort                                         Paternity/Legitimation
                  Product Liability Tort                                           Support - IV-D
                  Real Property                                                    Support -    ‘ivate (non-IV-D)

                  Restraining Petition                                             Other Domestic Relations
                  Other General Civil

         Check if the action is related to another action pending or previously pending in this court involving some or all of
         the same: parties, subject matter, or factual issues. If so, provide a case number for each.


                   Case Number                                      Case Number

         | hereby certify that the documents in this filing, including attachments and exhibits, satisfy the requirements for
         redaction of personal or confidential information in OCGA § 9-11-7.1.

         Is a foreign language or sign-language interpreter needed in this case? If so, provide the language(s) required.

                                             Language(s) Required
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