This form contains 39 fields organized into 22 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Case Closed Confirmation
This order resolves the last pending claim and closes the case Checkbox
Check this box if this dismissal order resolves the last pending claim and the case is now closed. Fill only if 'ORDER TO DISMISS' is 'Yes'.
Depends on: Order to Dismiss
Case Number and Judge
case number Text
Judge Text
Enter the name of the judge assigned to this case.
Case Number Text
Enter the court case number assigned to this matter.
Court Contact Information
Court Address Text
Enter the full mailing address of the court handling this case.
Court Telephone Number Text
Enter the court’s telephone number.
Court Type Selection
Judicial District Text
Enter the judicial district information for the court handling this case.
Judicial Circuit Text
Enter the judicial circuit information for the court handling this case.
County Probate Text
Enter the county probate court information for the court handling this case.
Defendant Attorney Information
Defendant's Attorney Information Text
Enter the defendant’s attorney’s name, bar number, mailing address, and telephone number.
Defendant Information
Defendant name, address, and telephone number Text
Enter the defendant’s full name along with their complete mailing address and telephone number.
Dismissal Conditions
Conditions of Dismissal Text
Enter any conditions or terms that apply to the dismissal order, if applicable. Fill only if 'ORDER TO DISMISS' is 'Yes'.
Depends on: Order to Dismiss
Dismissal Prejudice Selection
With prejudice Checkbox
Check this box if the case is being dismissed with prejudice (the claims cannot be refiled). Fill only if 'ORDER TO DISMISS' is 'Yes'.
Depends on: Order to Dismiss
Without prejudice Checkbox
Check this box if the case is being dismissed without prejudice (the claims may be refiled). Fill only if 'ORDER TO DISMISS' is 'Yes'.
Depends on: Order to Dismiss
Judge/Magistrate Signature and Date
Signature Date Date
Enter the date the judge or magistrate signs the order. Fill only if 'ORDER TO DISMISS' is 'Yes'.
Depends on: Order to Dismiss
Judge/Magistrate Signature Text
Enter the name or signature of the judge or magistrate authorizing this order. Fill only if 'ORDER TO DISMISS' is 'Yes'.
Depends on: Order to Dismiss
Notice of Dismissal by Plaintiff Selection
All defendants Checkbox
Check this box if the plaintiff is dismissing the case as to all defendants.
Notice of Dismissal Date and Plaintiff Signature
Notice of Dismissal Date Date
Enter the date the notice of dismissal is signed and submitted.
Plaintiff/Attorney Signature Text
Provide the signature of the plaintiff or the plaintiff’s attorney filing the notice of dismissal.
Notice of Dismissal Parties Being Dismissed
All defendants Checkbox
Check this box if the plaintiff is dismissing the case as to all defendants.
The following defendant(s) Checkbox
Check this box if the plaintiff is dismissing the case only as to the specific defendant(s) listed on the line provided.
Defendant(s) Being Dismissed Text
Enter the name(s) of the defendant(s) to whom the notice of dismissal applies. Fill only if 'The following defendant(s)' is 'Yes'.
Depends on: The following defendant(s)
Notice of Dismissal Prejudice Option
With prejudice Checkbox
Check this box if the plaintiff is dismissing the case with prejudice (the claims cannot be refiled).
Without prejudice Checkbox
Check this box if the plaintiff is dismissing the case without prejudice (the claims may be refiled).
Notice of Dismissal Service Method
Mail Checkbox
Check this box if a copy of the Notice of Dismissal was provided to the appearing defendant/attorney by mail.
Personal service Checkbox
Check this box if a copy of the Notice of Dismissal was provided to the appearing defendant/attorney by personal service.
ORDER TO DISMISS (1)
Order to Dismiss Checkbox
Check this box to indicate that the court is issuing an Order to Dismiss for this case.
Plaintiff Attorney Information
Plaintiff Attorney Contact Information Text
Enter the plaintiff’s attorney’s name, bar number, mailing address, and telephone number.
Plaintiff Information
Plaintiff Name, Address, and Telephone Text
Enter the plaintiff’s full name, mailing address, and telephone number.
Stipulation to Dismiss Defendant Date and Signature
Defendant Signature Date Date
Enter the date the defendant or the defendant’s attorney signed the stipulation to dismiss.
Defendant/Attorney Signature Text
Provide the defendant’s or defendant’s attorney’s signature for the stipulation to dismiss.
Stipulation to Dismiss Parties Included
All parties Checkbox
Check this box if the stipulation dismisses the case as to all parties.
The following parties Checkbox
Check this box if the stipulation dismisses the case only as to specific parties listed on the line provided.
Parties to Be Dismissed Text
Enter the name(s) of the specific party or parties included in this stipulation to dismiss. Fill only if 'The following parties' is 'Yes'.
Depends on: The following parties
Stipulation to Dismiss Plaintiff Date and Signature
Plaintiff Stipulation Date Date
Enter the date the plaintiff or plaintiff’s attorney signs the stipulation to dismiss.
Plaintiff/Attorney Signature Text
Provide the plaintiff’s or plaintiff’s attorney’s signature for the stipulation to dismiss.
Stipulation to Dismiss Prejudice Option
With prejudice Checkbox
Check this box if the stipulation dismisses the case with prejudice (the claims cannot be refiled).
Without prejudice Checkbox
Check this box if the stipulation dismisses the case without prejudice (the claims may be refiled).
Stipulation to Dismiss Selection
Stipulation to Dismiss Checkbox
Check this box if the parties are filing a stipulation to dismiss the case (instead of a notice of dismissal by plaintiff).