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STATE OF NORTH CAROLINA

County

Name Of Petitioner 1 Name Of Petitioner 2 Name Of Petitioner 3

File No.

In The General Court Of Justice Superior Court Division

SPECIAL PROCEEDINGS ACTION COVER SHEET

Rule 5(b),Rules of Practice For Superior and District Courts

Name Of Respondent 1

VERSUS

Name And Address Of Attorney Or Party If Not Represented (complete for initial appearance or change of address)

Summons Submitted

Yes

No

Attorney Bar No.

Name Of Respondent 2

Initial Appearance in Case

Name Of Firm Yes No

Change of Address

Summons Submitted

Name Of Respondent 3

Telephone No. Counsel for

FAX No.

Summons Submitted Yes No

All Petitioners

All Respondents

Only (List party(ies) represented)

APPLICATION

(check appropriate box)

Adoption (ADOP) Appointing Guardian Ad Litem (AGAL) Amend (AMND) Assess Motion Fee (SEE NOTE) Add Additional Party (ADOP) Assess Motion Fee Attorney Fees (ATFE) No Motion Fee Assessed If Sole Claim Boundary Settlement (BNDR) Cartway (CART) Change Of Venue (CHVN) Assess Motion Fee Compel (CMPL) Assess Motion Fee Condemnation - Private Condemnor/Mill (CNDM) Continue (CNTN) Assess Motion Fee Costs (COST) No Motion Fee Assessed If Sole Claim Determine Owner Surplus Funds (DOSF) Decedent Estate - Sell Land To Create Assets (PESE) Decedent's Estate - Sell Prsnl Property (SLPS) Dismiss (Involuntary) (DISM) Assess Motion Fee Drainage - Individual/Corporation (DRNG) Drainage District - Establishment (DRDS) Extension Of Time (EXTM) Assess Motion Fee Foreclosure (FORE)

Date

Incompetency (INCM) Land Registration - Torrens Act (TORR) Legitimation (LGMT) Lis Penders (LISP) Minor's Estate - Disbute Funds (DFND) Minor/Incom Estate - Sale/Release/Mortgage (MIES) Motor Vehicle Lien G.S. 44A (MVLN) Name Change (NAME) Partition (PART) Restoration To Competency (RTCO) Sterilization (STRL) To Determine Heirs (TDHE) Transfer Of Title (TOTL) Voluntary Dismissal (VOLD) Year's Allowance - Spouse/Child (SSCA) Other (specify and list separately)

NOTE: Assess fee only if court permission is required. Signature Of Attorney/Party All filings in special proceedings shall include as the first page of the filing a cover sheet summarizing the critical elements of the filing in a format prescribed by the Administrative Office of the Courts, and the Clerk of Superior Court shall require a party to refile a filing which does not include the required cover sheet. For subsequent filing the filling party must include either a Special Proceedings (AOC-SP-550), Motion (AOC-CV-752) and Court Action (AOC-CV-753) cover sheet. (Over)

NOTE:

AOC-SP-550, Rev. 11/12 © 2012 Administrative Office of the Courts

No.

Additional Petitioner(s)

No.

Additional Respondent(s)

Summons Submitted

Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No No No No No No No No No No No No

AOC-SP-550, Side Two, Rev. 11/12 © 2012 Administrative Office of the Courts

Information

Fsp550

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