Form 1C-167 "Civil Information Sheet" - Hawaii

What Is Form 1C-167?

This is a legal form that was released by the Hawaii Circuit Court - a government authority operating within Hawaii. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2019;
  • The latest edition provided by the Hawaii Circuit Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 1C-167 by clicking the link below or browse more documents and templates provided by the Hawaii Circuit Court.

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STATE OF HAWAI`I
CIRCUIT COURT OF THE
CIVIL INFORMATION SHEET
___________ CIRCUIT
I (A). PLAINTIFF(S)
Additional page(s) attached
I (B). DEFENDANT(S)
Additional page(s) attached
II. (B). DEFENDANT’S (S’) ATTORNEY (NAME/NUMBER)
II. (A). PLAINTIFF’S (S’) ATTORNEY (NAME/NUMBER)
Additional page(s) attached
Additional page(s) attached
III. NATURE OF SUIT
IV. ORIGIN
V. DEMAND
Contract
(A). Original Proceeding
Motor Vehicle Tort
(B). Transfer from District Court CIV. NO.
________________
Assault & Battery
________________
(C). Transfer from another Circuit CIV. NO. ________________
Construction Defects
Medical Malpractice
VIII. REQUEST TO EXEMPT
VII. CLASS ACTION
VI. JURY DEMAND
Legal Malpractice
FROM ARBITRATION
Product Liability
YES
YES
YES
Other Non-Vehicle Tort
NO
NO
NO
Condemnation
Foreclosure
Agreement of Sale Foreclosure
IX. RELATED CASE(S)
Agency Appeal
Declaratory Judgment
JUDGE
_______________________________________________________
Other Civil Action
CIVIL NUMBER _______________________________________________________
Environmental Court
_______________________________________________________
DATE
ATTORNEY NAME / PARTY NAME
SIGNATURE
RESERVED FOR COURT USE
CIVIL NO.
In accordance with the Americans with Disabilities Act, and other applicable state and federal laws, if you require a
reasonable accommodation for a disability, please contact the ADA Coordinator at the Circuit Court Administration Office
on OAHU- Phone No. 808-539-4400, TTY 808-539-4853, FAX 539-4402; MAUI- Phone No. 808-244-2929, FAX 808-244-
2777; HAWAII- Phone No. 808-961-7424, TTY 808-961-7422, FAX 808-961-7411; KAUAI- Phone No. 808-482-2365,
TTY 808-482-2533, FAX 808-482-2509, at least ten (10) working days prior to your hearing or appointment date.
Civil Info Sheet
CLEAR
Form 1C-167 (10/19)
RG-AC-508 (10/19)
STATE OF HAWAI`I
CIRCUIT COURT OF THE
CIVIL INFORMATION SHEET
___________ CIRCUIT
I (A). PLAINTIFF(S)
Additional page(s) attached
I (B). DEFENDANT(S)
Additional page(s) attached
II. (B). DEFENDANT’S (S’) ATTORNEY (NAME/NUMBER)
II. (A). PLAINTIFF’S (S’) ATTORNEY (NAME/NUMBER)
Additional page(s) attached
Additional page(s) attached
III. NATURE OF SUIT
IV. ORIGIN
V. DEMAND
Contract
(A). Original Proceeding
Motor Vehicle Tort
(B). Transfer from District Court CIV. NO.
________________
Assault & Battery
________________
(C). Transfer from another Circuit CIV. NO. ________________
Construction Defects
Medical Malpractice
VIII. REQUEST TO EXEMPT
VII. CLASS ACTION
VI. JURY DEMAND
Legal Malpractice
FROM ARBITRATION
Product Liability
YES
YES
YES
Other Non-Vehicle Tort
NO
NO
NO
Condemnation
Foreclosure
Agreement of Sale Foreclosure
IX. RELATED CASE(S)
Agency Appeal
Declaratory Judgment
JUDGE
_______________________________________________________
Other Civil Action
CIVIL NUMBER _______________________________________________________
Environmental Court
_______________________________________________________
DATE
ATTORNEY NAME / PARTY NAME
SIGNATURE
RESERVED FOR COURT USE
CIVIL NO.
In accordance with the Americans with Disabilities Act, and other applicable state and federal laws, if you require a
reasonable accommodation for a disability, please contact the ADA Coordinator at the Circuit Court Administration Office
on OAHU- Phone No. 808-539-4400, TTY 808-539-4853, FAX 539-4402; MAUI- Phone No. 808-244-2929, FAX 808-244-
2777; HAWAII- Phone No. 808-961-7424, TTY 808-961-7422, FAX 808-961-7411; KAUAI- Phone No. 808-482-2365,
TTY 808-482-2533, FAX 808-482-2509, at least ten (10) working days prior to your hearing or appointment date.
Civil Info Sheet
CLEAR
Form 1C-167 (10/19)
RG-AC-508 (10/19)
I
NSTRUCTIONS FOR COMPLETING THE CIVIL INFORMATION SHEET
The civil information sheet and the information it contains neither replace nor supplement the filings, the service
pleadings or other documents as required by law, except as provided by the rules of court.
This form is required for the purpose of initiating the civil docket sheet.
Consequently, a civil information sheet is required for each civil complaint filed.
The attorney/party filing a civil complaint shall complete the form as follows:
I. PLAINTIFF(S)/DEFENDANT(S)
List names: last, first, middle initial.
If the plaintiff or defendant is a government agency, indicate the full name.
If the plaintiff or defendant is an official of a government agency, first indicate the agency name and then the official’s
name and title.
If the space provided is insufficient, attach additional page(s) and check the box so indicating.
II. PLAINTIFF’S(S’)/DEFENDANT’S(S’) ATTORNEY
Indicate the attorney name and license number.
If the space provided is insufficient, attach additional page(s) and check the box so indicating.
III. NATURE OF SUIT
Place a check mark in the appropriate box.
If more than one category applies, select the one category that best describes the action.
Do not select more than one category.
For cases arising under Hawaii Revised Statutes, section 604A-2, place a check mark in the Environmental Court box.
IV. ORIGIN
(A)
Original Proceedings: cases originating in the circuit court.
(B)
Transfer from District Court: cases transferred from district court under
Haw. Rev. Stat. §§ 604-5 (Supp. 2006), 633-31 (1993).
(C)
Transfer from another Circuit: cases transferred from another circuit under
Haw. Rev. Stat. §§ 603-37, -37.5 (1993)
V. DEMAND
Indicate the remedy being demanded (e.g., damages, preliminary injunction, etc.)
VI. JURY DEMAND
Indicate whether a jury is being demanded.
VII. CLASS ACTION
Indicate whether the action is brought as a class action.
VIII. REQUEST TO EXEMPT FROM ARBITRATION
Indicate whether a “Request to Exempt from Arbitration” is filed.
IX. RELATED CASES
List the civil number and the assigned judge for related pending cases.
X. SIGNATURE OF ATTORNEY OR PARTY
Date and sign the civil information sheet
Civil Info Sheet
Form 1C-167 (10/19)
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