This form contains 89 fields organized into 30 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Action Type
Contract Checkbox
Check this box if the case is an action arising from a contract.
Tort Checkbox
Check this box if the case is an action for a civil wrong or injury.
Replevin Checkbox
Check this box if the case is an action to recover unlawfully seized or detained personal property.
Detinue Checkbox
Check this box if the case is an action to recover goods wrongfully detained by the defendant.
Bad Faith Insurance Claim Checkbox
Check this box if the case involves a claim that an insurance company acted in bad faith.
Consumer Debt (Original Creditor) Checkbox
Check this box if the case involves consumer debt and the plaintiff is the original creditor.
Attorney Information
Plaintiff Attorney Information Text
Please provide the plaintiff's attorney's full name, complete address, telephone number, and any relevant attorney code.
Attorney's Fees
Attorney's Fees Amount Number
Enter the total amount claimed for attorney's fees.
Case Number
Civil Case Number Text
Enter the unique civil case number assigned to this complaint.
Case Particulars
Case Particulars Description Text
Provide a detailed explanation of the particulars of this case.
Certifier Identity
Plaintiff Checkbox
Check this box if the person certifying this document is the plaintiff in this case.
Agent of Plaintiff Checkbox
Check this box if the person certifying this document is an agent or representative acting on behalf of the plaintiff.
Certifier's Relationship to Plaintiff Text
Provide your relationship to the plaintiff, such as 'attorney' or 'agent', if you are not the plaintiff directly.
Court and Case Information
Court Jurisdiction Combobox
Enter the name of the Maryland county or city where this District Court is located.
Somerset County Cecil County Talbot County Baltimore County St. Mary's County Charles County Worcester County Dorchester County Garrett County Allegany County Carroll County Calvert County Montgomery County Harford County Baltimore City Anne Arundel County Caroline County Washington County Wicomico County Kent County Prince George's County Queen Anne's County Howard County Frederick County
Court Location
Court Address Text
Please enter the full physical address of the court.
Detinue Claim
Return of Property or Value Checkbox
Check this box if the plaintiff is seeking the return of property or its value, along with damages, for its detention in an action of detinue. Fill only if 'Detinue' is 'Yes'.
Depends on: Detinue
Property Value Number
Enter the monetary value of the property being claimed in the detinue action. Fill only if 'Detinue' is 'Yes'.
Depends on: Detinue
Detinue Damages Number
Enter the monetary amount claimed for damages due to the detention of the property in the detinue action. Fill only if 'Detinue' is 'Yes'.
Depends on: Detinue
Final Affirmation Signature and Date
Affirmation Date Date
Please enter the date of this affirmation.
Affiant Signature Text
Please provide the signature of the affiant.
First Defendant Information
First Defendant Name Address Telephone Number Text
Provide the full name, address, and telephone number of the first defendant.
Certified Mail Checkbox
Check this box if the first defendant is to be served via Certified Mail.
Private Process Checkbox
Check this box if the first defendant is to be served via Private Process.
Constable Checkbox
Check this box if the first defendant is to be served by a Constable.
Sheriff Checkbox
Check this box if the first defendant is to be served by the Sheriff.
Fourth Defendant Information
Fourth Defendant Name, Address, Telephone Number Text
Please provide the full name, current address, and telephone number of the fourth defendant.
Certified Mail Checkbox
Check this box if the fourth defendant is to be served by certified mail.
Private Process Checkbox
Check this box if the fourth defendant is to be served by a private process server.
Constable Checkbox
Check this box if the fourth defendant is to be served by a constable.
Sheriff Checkbox
Check this box if the fourth defendant is to be served by a sheriff.
General
Reset Button
Judgment Amount
$5,000 or under Checkbox
Check this box if the judgment amount being sought is $5,000 or under.
over $5,000 Checkbox
Check this box if the judgment amount being sought is over $5,000.
Mediation/ADR Interest
Mediation/ADR Interest Checkbox
Check this box if you are interested in trying to resolve this dispute through mediation or Alternative Dispute Resolution (ADR).
Military Service Affiant Signature and Date
Affiant Date Date
Enter the date the affiant signed the document.
Affiant Signature Text
Enter the full name of the affiant.
Military Service Status: In Service
Defendant in Military Service Checkbox
Check this box if the defendant or any of the defendants listed are currently serving in the military.
Number of Defendants in Military Service Number
Provide the number of defendants who are currently in military service. Fill only if 'Defendant in Military Service' is 'Yes'.
Depends on: Defendant in Military Service
Verified through DOD at http://scra.dmdc.osd.mil/ Checkbox
Check this box if the defendant’s military service status has been verified through the Department of Defense at http://scra.dmdc.osd.mil/. Fill only if the 'Defendant(s) in military service' is 'Yes'.
Military Service Status: Not In Service
No defendant is in the military service Checkbox
Check this box if you affirm that no defendant involved in this case is currently serving in the military.
Facts Supporting No Military Service Text
Enter the specific facts that support the statement that no defendant is currently in military service. Fill only if 'No defendant is in the military service' is 'Yes'.
Depends on: No defendant is in the military service
Explanation for Undetermined Military Service Text
Enter the explanation for why you are unable to determine the military service status of any defendant.
Military Service Status: Unable to Determine
I am unable to determine whether or not any defendant is in military service. Checkbox
Check this box if you are unable to determine the military service status of any defendant in this case.
Other Claim
Other Checkbox
Check this box if your claim is not covered by the preceding options and you need to specify it, demanding judgment for relief.
Other Claim Details Text
Please provide details for any other claims not previously specified by the plaintiff. Fill only if 'Other' is 'Yes'.
Depends on: Other
Plaintiff Information
Plaintiff Name, Address, and Telephone Number Text
Provide the full name of the plaintiff, their complete address, and their telephone number.
Plaintiff/Attorney Signature and Information
Signature/Attorney Code Text
Provide the signature of the plaintiff or attorney, or their attorney code.
Attorney Bar Number Text
Enter the attorney's bar registration number.
Printed Name Text
Enter the full printed name of the plaintiff or attorney.
Address Line 1 Text
Enter the first line of the plaintiff's or attorney's address.
Address Line 2 Text
Enter the second line of the plaintiff's or attorney's address, if applicable.
Telephone Number Text
Enter the plaintiff's or attorney's telephone number.
Fax Number Text
Enter the plaintiff's or attorney's fax number.
Email Address Text
Enter the plaintiff's or attorney's email address.
Post-judgment Interest
legal rate Checkbox
Check this box if post-judgment interest should be applied at the legal rate.
contractual rate Checkbox
Check this box if post-judgment interest should be applied at the contractual rate.
Post-judgment Interest Until Date Date
Enter the date until which the post-judgment interest is calculated at the specified rate. Fill only if 'legal rate', 'contractual rate' is 'Yes' for any.
Depends on: legal rate, contractual rate
waived Checkbox
Check this box if post-judgment interest is waived.
Pre-judgment Interest Calculation
Legal Rate Checkbox
Check this box if the pre-judgment interest should be calculated at the legal rate.
Contractual Rate Checkbox
Check this box if the pre-judgment interest should be calculated at the contractual rate.
Pre-judgment Interest Rate Number
Enter the pre-judgment interest rate. Fill only if 'Contractual Rate' is 'Yes'.
Depends on: Contractual Rate
Pre-judgment Interest Start Date Date
Enter the start date for the pre-judgment interest calculation. Fill only if 'Legal Rate', 'Contractual Rate' is 'Yes' for any.
Depends on: Legal Rate, Contractual Rate
Pre-judgment Interest End Date Date
Enter the end date for the pre-judgment interest calculation. Fill only if 'Legal Rate', 'Contractual Rate' is 'Yes' for any.
Depends on: Legal Rate, Contractual Rate
Pre-judgment Interest Days Number
Enter the total number of days for which pre-judgment interest is calculated.
Pre-judgment Interest Per Day Amount Number
Enter the pre-judgment interest amount accrued per day.
Principal Amount
Principal Amount Number
Please enter the principal amount being claimed by the plaintiff.
Replevin Claim
Return of the property valued at Checkbox
Check this box if the plaintiff is claiming the return of property with a specified value and damages for its detention in an action of replevin. Fill only if 'Replevin' is 'Yes'.
Depends on: Replevin
Property Value Number
Enter the monetary value of the property being claimed in the replevin action. Fill only if 'Replevin' is 'Yes'.
Depends on: Replevin
Damages for Detention Number
Enter the amount of damages being claimed for the detention of the property in the replevin action. Fill only if 'Replevin' is 'Yes'.
Depends on: Replevin
Second Defendant Information
Second Defendant Name, Address, Telephone Number Text
Provide the full name, address, and telephone number for the second defendant.
Certified Mail Checkbox
Check this box if the second defendant should be served by certified mail.
Private Process Checkbox
Check this box if the second defendant should be served by a private process server.
Constable Checkbox
Check this box if the second defendant should be served by a constable.
Sheriff Checkbox
Check this box if the second defendant should be served by the sheriff.
Supporting Documents
Properly Authenticated Copy of Note/Security Agreement Checkbox
Check this box if you are attaching a properly authenticated copy of any note or security agreement upon which the claim is based.
Itemized Statement of Account Checkbox
Check this box if you are attaching an itemized statement of the account.
Interest Worksheet Checkbox
Check this box if you are attaching an interest worksheet.
Vouchers Checkbox
Check this box if you are attaching vouchers as supporting documents.
Check Checkbox
Check this box if you are attaching a copy of a check as a supporting document.
Other Written Document Checkbox
Check this box if you are attaching any other written document to support the claim.
Verified itemized repair bill or estimate Checkbox
Check this box if you are attaching a verified itemized repair bill or estimate as supporting evidence. Fill only if 'Other Written Document' is 'Yes'.
Depends on: Other Written Document
Other Document Description Text
Please provide a description of the other written document submitted to support the claim.
Verified Itemized Repair Bill or Estimate Checkbox
Check this box if you are attaching a verified itemized repair bill or estimate.
Third Defendant Information
Third Defendant Name and Address Text
Provide the full name, address, and telephone number for the third defendant.
Certified Mail Checkbox
Check this box if the third defendant should be served by Certified Mail.
Private Process Checkbox
Check this box if the third defendant should be served by Private Process.
Constable Checkbox
Check this box if the third defendant should be served by a Constable.
Sheriff Checkbox
Check this box if the third defendant should be served by the Sheriff.
Total Principal and Pre-judgment Interest
Total Principal and Pre-judgment Interest Number
Enter the total sum of the principal amount and the pre-judgment interest.