Request to Enter Into a List

REQUEST TO ENTER A LIST

IN THE COUNTY COURT No. CI--___

OF VICTORIA

BETWEEN

Plaintiff

and

Defendant

Date of document: Solicitors Code:

Filed on behalf of: DX:

Prepared by: Telephone:

Fax. no:

Ref:

Every proceeding upon commencement is to be entered into a list or division of a list by the Registrar [Rule 34A.10(1)].

Responsibility for ensuring that a proceeding is entered into the correct list or division of a list lies with the solicitor having conduct of the case and not the Registrar.

Please complete this form by entering this proceeding in either the Damages and Compensation List or the Commercial List and ticking the main cause of action in the appropriate division.

DAMAGES & COMPENSATION LIST

Applications Division (Tick box to enter the case in this Division)

Application for change of name

Application under Limitation of Actions Act

Order 32 Preliminary/non-party discovery

S. 6 Choice of Law (Limitation Periods) Act 1993

Other: ………………………

Defamation Division (Tick box to enter the case in this Division)

Defamation

General Division (Tick box to enter the case in this Division)

Personal Injury - Assault

Personal Injury - Dog Bite

Personal Injury - Industrial Accident

Personal Injury - Motor Vehicle Accident

Personal Injury – Product Liability

General Division – Cont’d (Tick box to enter the case in this Division)

Personal Injury - Sexual Assault

Personal Injury - School Accident

Personal Injury – Slipping / Occupiers Liability

Personal Injury - Other:……………………..

Damages (other than death or personal injury)

Disability Claim Rejection

Professional Negligence

Property Damage

Public Liability

Seamen’s Compensation

S.138 Acc. Comp. Act - Indemnity

Trespass

Vehicle Property Damage

Wrongful Dismissal

Workplace Injury

Other:…………………………..

Medical Division (Tick box to enter the case in this Division)

Medical Negligence

Family Property Division (Tick box to enter the case in this Division)

Domestic Partners Property Dispute

Testators Family Maintenance

Serious Injury Applications Division (Tick box to enter the case in this Division)

S.134AB Accident Compensation Act

S.135A Accident Compensation Act

S.93 Transport Accident Act

WorkCover Division (Tick box to enter the case in this Division)

WorkCover Case (EXCLUDING Serious Injury Application)

COMMERCIAL LIST

General Division (Tick box to enter the case in this Division)

Breach of Agreement or Monies Owing

Breach of Consumer Legislation (previously Trade Practices Act and/or Fair Trading Act)

Corporations Law or Preference Payment

Customs and Excise Prosecutions

Detinue and Conversion

Goods Sold and Delivered

Hire of Goods and Chattels

Instruments Act

Insurance

General Division cont.

Landlord and Tenant

Rate Appeal

Taxation

General Division – Cont’d (Tick box to enter the case in this Division)

Trusts

Work and Labour Done

Other: …………………………

Expedited Cases Division (Tick box to enter the case in this Division)

Expedited Commercial Case

Note: This box should only be ticked if the case would otherwise be included in the General Commercial Division or the Banking and Finance Division and the case is appropriate for an expedited hearing or requires more intensive case management.

Banking and Finance Division (Tick box to enter the case in this Division)

Banking and Finance Case (including to Recover Possession of Land)

Building Cases Division (Tick box to enter the case in this Division)

Building & Construction Industry Security of Payments Act Applications

Commercial Arbitration Act

Damages

Monies Outstanding