seers 11/98/2012 @5:07FH ayy MICHAEL R SHABIRO PAGE 09 ORIGINAL : pe Law Offices of Michael R. A ef Kend S OAM 4 Michacl R. Shapiro SBN 370011 1 || 612 North Sepulveda Biva. 2 || Suite 11 Los Angeles , CA 90049 2 |] Phone: (310) 472 8900 3 || Fax: (10) 472 4600 FILED aaa SUPERS SLooancLes 4 || Attorney for Plaintiff WOV.09 2012 || Melissa ishage Joa 9. ars, xorg Ofc Clerk ‘ a Dai aida 6 wf 7 8 SUPERIOR COURT FOR THE STATE OF CALIFORNIA 9 COUNTY OF LOS ANGELES 10 4 BC495398 12 ||Melissa isha THE ae IGHI Ye WO C 14 REA CRBRIFUBIST FoR DAMAGES: 15 ||Micah S. Katt Williams an individuat; & 3. ASSAULT, DOES 1 through 100, Inclusive, 16 3 INTENTIGNAL INFLICTION OF Defendants. EMOTI STRESS; AND 7 ya NEGLIGENCE 18 |) ° 19 20 GENERAL ALLEGATIONS: a 4. At all times mentioned herein, Plaintiff Melissa Ishage (hereinafies she 22 ||" Melissa” andlor *Plainti?) was, and now is, an individual and a resident offhS Sai 23 |lof Los Angeles, State of California. Melissa was a personal assistant fh i ns. 24 2. Atal times mentioned herein, Defendant Micah S. Katt Williims¢!Waft") 25 ||, was, and now Is an individual and a resident of the County of Los Angeles, 26 || State of California, and within the jurisdiction of this Court. a7 ha 28 ur SOLES 86011/08/2012 ©], H AYN 10 12 13 14 15 16 7 18 19 20 21 22 23 24 25 26 a 28 es:e7eM 31247: MICHAEL R SHAPIRO Page 10 3. The true name or capacities, whether individual, corporate, associate, of otherwise, of the Defendants DOES 1 through 100 are unknown to Plaintif at this time, ‘who therefore sues such Defendants by such fictitious names, and will amend ‘thi Complaint to allege their true names and capacities when ascertained. Plaintiff i informed and believes, and thereon alleges, that each of said fictiiously named Defendants is responsible for the occurrences herein alleged, and that Plaintif injuries, as herein alleged, were proximately caused by said Defendants. 4, Plaintiff is informed and believes and thereon alleges that at ail timeg herein mentioned each of the Defendants sued herein as DOE were the agents; servants, employees or employers of their Co-Defendant, and in doing the things hereinafter alleged, were acting in the course and scope of their authority as sucl agents, servants, employees or employers and with the permission and consent of thei “Folidigaed (AGAINST DEFENDANT KATT WILLIAMS, AND DOES 1 THROUGH 100, INCLUSIVE) 5. Plaintiff refers to the whole of the General Allegations, and by reference] incorporates the same herein as if set forth in full herein. 6. On of about October 6, 2012, at 22561 Quinta Road Woodland Hills, CA. Defendant, Katt, and DOES 1 through 100, intentionally, willfully, wantonly and maliciously threatened to strike Plaintiff and did raise his open hand in a manner so as to cause Plaintiff to reasonably believe she was about to be struck in a harmful and offensive manner. Due to Defendant's prior acts of threats toward Plaintiff, including, but not limited to, actually hitting and grabbing Plaintiff, a reasonabl person in Plaintiff's situation would have been offended by the threatened, violent touching. 7 2 ‘COMPLAINT FOR DAMAGES: 1. ASSAULT; 2. BATTERY: 3. INTENTIONAL INFLICTION OF EMOTIONAL, DISTRESS; and 4. NEGLIGENCE1i/es/2a12 95:07PM 3ie4724500 ereseett MICHAEL R SHAPIRO PASE 11 7. Atno time during the events described in the preceding paragraph, nor at any time prior thereto, did Plaintiff consent to any of Defendant's, and DOES 1 through 100, threatened conduct 8. Asa direct and proximate result of Defendant's, end DOES 1 through 10d threats, coupled with their present ability to carry them out, Plaintiff felt the imminent apprehension of such contact, and he therefore suffered severe emotional distress and other injuries to his person, in an amount to be shown according to proof. 9. As a direct, legal and proximate result of the actions of Defendants, and DOES 1 through 100, Plaintiff sustained serious and permanent injuries to her person| all to her damage in an amount fo be shown according to proof and within the jurisdiction of the Superior Court. 10. As a diract, legal and proximate result of such acts of Defendants, and DOES| 4, through 100, Pigintiff was Jbofibiilied to and did _employthe services of hospitals, hospital, medical, professional ahdgngiienig}yexpgnsegzend Plaintiff is informed an believes, and upon such information and belief alleges, that she will necessarily reason, of her injuries, incur additional like expenses for an indefinite period of time ir the future, all to Plaintiff's damage in a sum to be shown according to proof. 11. Plaintiff is informed and believes and alleges thereon that such acts directed! towards the Plaintiff were malicious and belligerent, and the acts were done with 4 conscious disregard of Plaintiffs right to be free from such tortious and criminal behavior, such as to constitute oppression, fraud or malice pursuant to California Civil Code § 3294, entitling Plaintiff to punitive damages in an amount appropriate to punish] and set an example of said Defendants and DOES 1 through 100. a a mi uy 3 COMPLAINT FOR DAMAGES, 1. ASSAULT, 2. BATTERY, 5. INTENTIONAL INFLICTION OF EMOTIONAL DISTRESS: and 4. NEGLIGENCE11/08/2012 ed 10 " 12 13 14 15 16 7 16 19 21 23 24 25 26 27 5:97 3184724600 MICHAEL R SHAPIRO Pace 12 SECOND CAUSE OF ACTION (FOR BATTERY) {AGAINST DEFENDANT KATT WILLIAMS, AND DOES 1 THROUGH 100) 12. Plaintiff refers to the whole of the General Allegations, as well as the whole the First Cause of Action, and by reference incorporates the same herein as if were in full hereat. 8 13. On or about October 6, 2012, Defendants, and DOES 1 through 100, intentionally and recklessly did acts which resulted in offensive contact with the Plaintiffs person| including but not limited to: hitting Plaintif with a closed fist causing serious injury. 14, Defendants, and DOES 1 through 100, did such acts with the intent to cause} a harmful or offensive contact with the body of Plaintiff. 15. As iregt, legaljin (Foxlifiate result of such acts Bf Defendants, and DOES| her damage in an amount to be showmgagoertingetg peneband within the jurisdiction of the Superior Court. 16. As adirect, legal and proximate result of such acts of Defendants, and DOES| 1 through 100, Plaintiff was compelled to and did employ the services of hospitals; Physicians and surgeons, nurses, and the like, to care for and treat her, and did incur hospital, medical, professional and incidental expenses, and Plaintiff is informed anc believes, and upon such information and belief alleges, that she will necessarily bj reason of her injuries, incur additional like expenses for an indefinite period of time i the future, all to Ptaintif’s damage in a sum to be shown accarding to proof. 17. Plaintiff is informed and believes that such acts directed towards Plaintiff were! malicious, and belligerent, and the acts were done with a conscious disregard o| Plaintiffs right to be free from such tortious and criminal behavior, such as to constitut oppression, fraud or malice pursuant to California Civil Code § 3294, entitling Plaintiff t pynitive damages in an amount appropriate to punish and set an example of said : ‘COMPLAINT FOR DAMAGES: 1, ASSAULT; 2. BATTERY, 3, INTENTIONAL INFLICTION OF EMOTIONAL DISTRESS; and 4. NEGLIGENCE14/08/2012 vee earyraanren o5:07PH 3104724600 MICHAEL R SHAPIRO POSE 13; Defendants and DOES 1 through 100. THIRD CAUSE OF ACTION (FOR INTENTIONAL INFLICTION OF EMOTIONAL DISTRESS) (AGAINST DEFENDANT KATT Williams, AND DOES 1 THROUGH 100, INCLUSIVE) 18. Plaintiff refers to the whole of the General Allegations, as well as the whole of ttle First and Second Causes of Action, and by reference incorporates the same herein, as if set forth in full herein. 19. Plaintit informed and believes, and thereon alleges, that such acts of Defendants, and DOES 1 through 100, were intentional, extreme, and outrageous Plaintiff is further informed and believes, and thereon alleges, that such actions werd done with the intent to cause serious emotional distress or with reckless disregard of the, probability of Plait Hee 6 20. As in 3 is & ‘of Defendants, and DOES| 4 through 100, Plaintiff su UE HOG ich has caused Plaintif ta sustain severe, serious and permanent injuries to her person, all to her damage in 4 sum to be shown according to proof and within the jurisdiction of the Superior Court. 21. As adirect, legal and proximate result of such acts of Defendants, and DOES| 1 through 100, Plaintiff was compelled to and did employ the services of hospitals. physicians and surgeons, nurses, and the like, to care for and treat her, and did ineu hospital, medical, professional and incidental expenses, 22, Plaintiff is informed and believes, and upon such information and bel alleges, that she will necessarily by reason of her injuries, incur additional like expense {for an indefinite period of time in the future, all to Plaintiffs damage in a sum to shown according to proof, a a Ue 6 | COMPLAINT FOR DAMAGES: 1. ASSAULT, Z. BATTERY, 9. INTENTIONAL INFLICTION OF EMOTIONAL — | DISTRESS; and 4, NEGLIGENCE11/08/2012 Canoaren a 10 12 13 14 15 16 7 18 19 20 24 23 24 25 26 2 28 the First and Second Causes of Action, and by reference incorporates the same herein| s:e7FM 3108724600 MICHAEL R SHAPIRO PAGE 14 23. Plaintiff is informed and believes that such acts directed towards Plaintiff word cared out with a conscious disregard of Plaintif’s right to be free from such tortioug and criminal behavior, such as to constitute oppression, fraud or malice pursuant td Califomia Civil Code § 3294, entiling Plaintiff to punitive damages in an amount appropriate to punish and set an example of said Defendants and DOES 14 through 100.| EQURTH CAUSE OF ACTION (FOR NEGLIGENCE) (AGAINST DEFENDANT KATT WILLIAMS, AND DOES 1 THROUGH 100, INCLUSIVE) 24. Plaintiff refers to the whole of the General Allegations, as well as the whole of as if set forth in full herein. 25. Ongral oT Vidi a , carelessly, recklessly, b wantonly PION things: Defendant conducted hime in Such @ manner that iainJif's person in a forceful, life threatening and harmful manner. 26. As a direct and proximate result of the negligence, carélessness| recklessness, wantonness and unlawfuiness of Defendants, and each of them, Plaintiff Sustained severe and serious injury to his person, all to Plaintif's damage in a sum within the jurisdiction of this Court and to be shown according to proof. 27. By reason of the foregoing, Plaintiff has been required to employ the services of‘hospitals, physicians, surgeons, nurses and other professional services, and Plainti has been compelled to incur expenses for ambulance service, machines, x-rays =] other medical supplies and services. Plaintiff is informed and believes, and thereon alleges, that further services of said nature will be required by Plaintiff in an amount tq be shown according to proof. a am 6 TERY, 3. INTENTIONAL INFLICTION OF EMOTIONAL 1nd 4, NEGLIGENCE, ‘COMPLAINT FOR DAMAGES: 1 ASSAULT: 2, DISTRES:11/@8/2012 ‘876 ties Wy, Sot ‘Ay Towa, CA 60 2 Teaser 31/8073 JEROME B. MUMBLIN, ESO. " 12 13 4 18 16 7 18 19 20 2 22 23 24 25 26 a7 28 es: e7eM 31n4724500 MICHAEL R SHAPIRO PAGE 15 WHEREFORE, Plaintiff prays judgment against Defendants as follows: ON THE FIRST CAUSE OF ACTION (1) For general damages in an amount subject to proof at trial; (2) For sums incurred and to be incurred for services to hospitals, physicians, surgeons, nurses and othor professional services, ambulance service, x- rays and other medical supplies and services; (3) For punitive and exemplary damages in the amount of § million dollars; (4) For interest provided by law including, but not limited to, Califoriia Civ Code § 3291; ON THE SECOND CAUSE OF AgTION © Mott CHO 14 ll at trial; surgeons, nurse® Aottgiococt: ambulance service, x rays and other medical supplies and services; (7) For punitive and exemplary damages in the amount of § milion dollars; (8) For interest provided by law including, but not limited to, Califomia Civil Code § 3281; 1 THI USI CT! (9) For general damages in an amount subject to proof at tr (10) For sums incurred and to be incurred for services to hospitals, physicians] surgeons, nurses and other professional services, ambulance service, x. . rays and other medical supplies and services; (14) For punitive and exemplary damages in the amount of 5 million dollars; (12) For interest provided by law including, but not limited to, California Civil Code § 3291; 7 COMPLAINT FOR DAMAGES: 1. ASSAULT; 2. BATTERY; 3, INTENTIONAL INFLICTION OF EMOTIONALereaeees 11/08/2812 ©ervYeoae en = 10 1 12 13 14 16 16 7 18 19 20 a 22 23 24 25 26 27 28 esre7e 31ad72a500 MICHEL R SHAPIRO Pace 16 ON THE FOURTH CAUSE OF ACTION (13) For general damages in an amount subject to proof at trial (14) For sums incurred and to be incurred for services to hospitals, physicians, surgeons, nurses and other professional services, ambulance service, x- rays and other medica! supplies and services; (15) For interest provided by law including, but not limited to, California Civil Code § 2291; ON ALL CAUSES OF ACTION (18) For costs of sult herein incurred; (17) For attomeys' feos; and (18) For such other and further relief as the court may deem just and proper. The Date: Nov 204 ary . SHAPIRO, for Plaintiff Z 8 ‘COMPLAINT FOR DAMAGES: 1. ASSAULT; 2. BATTERY; 3. INTENTIONAL INFLICTION OF EMOTIONAL DISTRESS, and 4. NEGLIGENCE11/28/2012 85: 87PH ee ORIGIN MICHAEL R “> PaGe 08 SINAL oon PRRCAEETC STAG ESO SBN 38 rn eee S12 Non Sepulveda Di Sule 1 Las Angeles California 90 hinge PILED ‘reveorone Wo: raxwo. 310472 4600 ARCOURT OF CaLine scurrrornom sia Melissa shape """*- 77° A OFLSR ERIN srmeeraneness 11 North Hill Street forearm cover orcauromacaumrr or Los Aligeles ‘Uniroured motor 6) ‘Other PUPDIWD (Porven njurPropory DamegeWWronghu Death) Tort J paestos (04) Product aiay (24). Medica malpractve 46) ‘otner PEPDIWD @>) 3 PURI (Other Tor. ‘usinesstotuntal bln ona ore Fpl A. ans, arvmozecone Los Angeles CA 90012 ty, OdticeeCterk semcanane Downtown, saobhts CASE NAME: CIVIL CASE COVER SHEET ‘Complex Case Designation BUT 9 te enone dati eeiure Cl counter) sJoindor 5398 Semmnded Gemardedis | Fed wii frst appearance by detencant | °° exceeds $25,000) $25,000 origss}|__ (Cal Rules of Cour, re 3.402) | oer. ‘ems 1-6 below must be comoleted (see Inszcions 67 pag8 2) [F Check one bax below Tore case type hat best ceacrbes is case: ‘Auto Tort ‘Contact Provitonaly Complex Chit Ugaon ue (22) [Za] french of coracwwraranty (06) (Cal Rules of Cour, rules 3.400—2.483) Rude 3.740 cotections (03) LE) anasv trace roguation (3) Other eatectora (06) ‘Conatrstion defect (10) Inaurance coverage (18) ass tr (40 Other conot (37) CE soourtic tigation (28) ‘Real Property Endvonmenta Tanto (20) C2) eirinent domaiv/inverse aman inaunnoe coverage ca ating fom te fed provlonaly eames case judamont a4esectt Bereser oof amet 2a) eee) Corn Fraws (36) CS neg RE PORTER reactant rope (9) © ones T'S comoisin ia epee above (4) 1 Frotesionat negigene (2) ic Revie Inestaneove CM Peten [1 onerrenieonno wns) ett okie (0) Partnership and cerporate governance (21) Employrnent ) ) canar potion (ct spoerted above) (23) \Viongtu termination (2) 77) otter employment (15) Peon eatin we (1 2 witermanase 3 [onesie 9) Z Thiecave [Tis LeTiondt complex under ule 3.400 of te Calfomia Rule of Cour. ithe case is Complex mak the Factors requitng exceptional judicial management. 0. [2 Large number of separately represented pares — d. [_] Large number of witnesses. ». (_) Extensive motion practice raising dificut crnevel @,[_] Coordination with related actions pending in one of more courts inntes that wil e time-consuming to resove ‘nother counties, states, or counties, orin« federal court c (7) Substantia! amount of documentary evidence +. [1 Substantial posttudgment judicial supervision 3. Remedies sought (check al that apply): aZ'] monetary b.—] nonmonetary: dectaratory oF inuncive ratiet —c. (Z Ipunitive 4, Mumbor of causes of acon (spect): four Assault, Batery, Intentional Infliction of Emotional Distress &Negli 5. Ths case [Tis isnot aciass action suit é lftnere are any known rofated cases, filo and servo a notice of rotated cate. (You may us ate: Novernbet 8, 2012 Michael R. Shapiro Toe NOTcE + Plointit must fie this cover sheet wih the fst paper Fed in the action o: proceeding (except small aims cases or cases fled under the Probate Code, Family Code, or Welfare and Instttione Code). (Cal Rules of Cour, rule 3.220) Faihure to fle may result ‘in sanctions, * Fie his cover sneet in addtion to any cover sheet required by local court ute. | * itis case Is complex under rule 3400 ot 609, of the Califeria Rules of Cour, you must serve a copy ofthis cover sheet on all | ‘Mer parties tothe action or proceeding + Unless this a collections case under rue 3.740 ora complex cas, this cover shaot wil be used for static purposes on ‘Givi GASE COVER SHEET Se ee ein ay eawieser41/99/2012 117820 uy MICHAEL R SHAPIRO PASE 83 . ORIGINAL SOT Metiasa Ishage vs Katt Wiliams [eee ; BC4o5308 CIVIL CASE COVER SHEET ADDENDUM AND STATEMENT OF LOCATION (CERTIFICATE OF GROUNDS FOR ASSIGNMENT TO COURTHOUSE LOCATION) This form ie roquired pursuant to Local Rule 2.0 in all new civil case filings in the Los Angolos Superior Court. Item 1. Check the types of hearing and fil inthe estimated iongth of hearing expected for this case: aurv tant Wl yes cuassacton C1] ves umreocaser Clyes time esniwareo ror Tra.____[i Hours pars ttem Il indicate the correct cistrit and courthouse location (4 steps — Ifyou checked “Limited Case’, skip to tem il, Pg. 4) ‘Step 1: After frst completing the Civil Case Cover Sheet form, find the main Civil Case Cover Sheet heading for your 280 In the leh margin Below, and, tothe right in Column A, the Cnil Case Cover Sheet case type you selected. ‘Step 2: Chock ane Superior Court type of action in Column B below which best describes the nature ofthis case ‘Step 3: In Column C, circle the roason for the court location choice that applies to the type of action you have checked. For any exception to the court location, see Local Rule 2.0, eye REPORTER ‘Step 4: Fil in the information requasted on page 4 in tem Il; complete Item IV. Sign the declaration. A 8 c Gt Cana Cover Shoat Type adion peptic Giamgary No (Checcery oe) ee Sep 3 nove ex ‘it 22) [2 A700 Motor Voice Persona ery Property DamageWtongt Death FFT arewes ote oe) [A710 Pecan ey onery Danapettongtd Denes Maat | 1.2.6 (© ASOT Asbestos Propery Damage fs fopeswe() | _aazs asbetts -Pervena rfurongte Das fs Product Liabily 24) | 7260 Product Uiy (pt asbestos or tasiclerwronmentat) 40218 4B 5s eccatMapracioe sy [47210 Medal Malnctice Pryicans & Supers 14 af 1D 47240 Otter Poesia Heath Cae Malpacoo th BR ae 1 A7250 Premios Usb (op and te) ta A A720 mtn oy i : 5 i consign Sty hay opr Demagrnomts Dea a 1 wwonghien Lea arzro ame teeit a 12 A7220 Canae Perot Corrapomronat Boat ta Trew 108 een car CIVIL CASE COVER SHEET ADDENDUM Toca Rule 26 LASC Approved 03-04 AND STATEMENT OF LOCATION Page 1 of411/09/2012 11:02aM sLe472a6¢0 MICHAEL R SHAPIRO Pace 94 | oer Melissa Ishage vs Katt Wiliams Employent ‘ter Employment (18) ‘wrongful Tenminaton (36) [CD AGO Wong Termination A : B c cna case Ct Seat ection, gpm Rorsore ear Bescany Sob Ae rea Torn [C1 Ate Overcome Tot omtreaenmoteomec) | 1.3 el eee a Defamation (1) {° ‘80%0 Datamation (lant) ee as B © A007 Laan ha BB [Cece os sate cto arene tas one ce _[ A028 ones Non Fume un Pepty Danae at 28 1D A8Q24 One Employment Complaint Cave 11 A8109 Labor Commiteonar Aponte 18004 ‘Breach of Renta ease Contract (nat ulandl deine or wrong evcton) 2.8, 2,6, 44205 1,248. ye zee) TE: b 2 A601Z Ger Promesety NotelCotections Case 2,648, 2.5 12 A8016 Insurance Coverage (not comlex) Wrongful Eviction (93) 1 8008 Contracts! Froud 1 AG03) Totous nerterence 1 Asa27 Oter Contac Dispute react/nuucancataudiogigerce) 0. 46023. org Eviction Case 12.8.8 1,2,3.5. Real Popety 1 Ato oreoe Feecoase 28 Ger Reat Peper 26) | Aett2 Cus THe 2.8 1. Atco Oba Ral Propet tense oman anderen, redosue) | 2,6 a 7 SpE COMPERT T cy A6021 UnawAl Detainar Commerc (Pe use oF wrongs eicon) 2.8 ‘iowa Deane Resear 3 ne 2 Aa nae aera ommaenem fave i uit petinas, 1 seaaor Untied Ooi oct Felons 26 ‘Uniawu Detaire-Onige (38) 190022 Union Detar Ong LAGN 109 (Rev. 37%) ASC Approved 03.08, CIVIL CASE COVER SHEET ADDENDUM AND STATEMENT OF LOCATION Local Rule 2.0 Page 2otéaes. (2012 yie2am 3104724600 MICHAEL R SHAPIRO Pace ob ORT vlissa Ishage ve Kant Willams Camel isa Ist naa A 8 c Chit Case Cover Shoot Sy of Acton Reasons ‘Category Ho (Check oye) Reo Ste 3 Above |__“Sevon ee Aavet Fortine (09) | AOI08 Aunat Forelare Case 2. Pelion e Ativaton (13) | AGITS Palon 1 CompalContm/vecae AITatON Julia Review Pravisionally Complex Litigation Enforcement of Judgment Miscottareous Givi Complaints vir ofttanaat (2) Other dudidal Rowow (88) 1D AS1O1 Ywrt-Admiristawve Mandamus | Ab162 wek-Mandamus on Litieg Coun Goss Mater 1D 6169 Wt Other United Court Gate Review TL ASI60 Ofer Wnt ucla Revew ‘AnduusVTmnde Regulation (0s) | A6oO3 AnusvTade Reguaton| ‘Construction Detac (10) (© AA007 Constucn Detect 1.2.3. Clams nveera Mase Tet |. goon Clams imaiing Maes To 142.8, ‘Secumtes Ligation (28) | AS03S Securties Ligation Case. 12.8 0 sr create Ret ee PER do D. ABLAO Admiistate Agency Award (ct unpald taxes) |G ABITA Patton Cortente fer Ent of susgmort on Unpald Tax 1B 6112 Ober Enforcement of Judgment Case : 1 A6C23 Rackouoing (RICO) Cove 14208 128090 DedarataryRelet ny 128 ‘omerGomplaints | ABQAO nfunctve Reet ny (nat damestomarnsement) 28 (ot Spected Azve) (42) | ey Ago Omer Conmmscial Complaint Cove (nertervner-compen) 1.2.8, [3 A8000 Other Civ Complaint (ron tarinon-comglex) 1.2.8 tership Corporation ‘Govaranon Paget [_n0119 Panmanie ane Corpor Goveranca Cae 2.8 1 AST21 Cet Harassment 2.948 (G._A6123 Workplace Harassment 2.3.8 aie 0. 6124 ideuDependonc Aduh Abuee Case 2.3.0 (vot Species Ave) | ABT00 Bledion Contact 2 al 12_AWt10 Pettion for Chenae of ame 27, 12.8120 Petiion fer Rett trom Late Csim aw ree 1 AS100 Oe Cit Petton 2,9. ery 100 ew. 3711) ASC Approved 0-04 CIVIL CASE COVER SHEET ADDENDUM AND STATEMENT OF LOCATION Toeat Rule 20 Page 3 of ¢11/03/2812 11:02am 3104724600 MICHAEL R SHAPIRO PAGE 06 inant jae Melissa Ishage vs Katt Wiliams emit, Statement of Location: Enter the address of the accident, party's residence or place of business, performance, or other circumstance indicated in Item Il. Step 3 on Page 1, as the proper reason for fing in the court location you selected. [REASON:. Check he approprtal box9s for thenumbere shown | 22561 Quinta Rost { lunder Colum G forthe ype of acon tha you have voles for | Wis case. |_O1 02.02. 04.8. 06, C7. cs, C8, O10 Woodtend te joa fess0eaoo2 tem IV. Declaration of assignment: | deciare under penalty of perjury unde the laws ofthe State of Calforia thatthe foregoing is tue ‘and correct and at the above-eniiled matter is properly fled for asigament to the Stanley Mosk __gourthouse in the Contra) Distt of the Superior Court of Caiforria, County of Los Angeles [Code Civ. Proc. § 282 etseq.. end Local Rule 20, subds. (0), () and (B). iff Dated: November 8, 2012 VY THE Yivaoe PLEASE HAVE THE FOLLOWING Fi ql DER TO PROPERLY e REPORTER 1. Original Complaint or Petition, 2. Iffling a Complaint, @ completed Summons form for issuance by the Clerk. 3. Gwil Case Cover Sheet, Judicial Council form CM-010. 4. Chi Case Cover Shoot Addendum and Statement of Loaton frm, LAGI 108, LASC Approved 03-04 Rev. n Payment in ful ofthe fling fee, untess fees have been walved. 6. Asigned order appointing the Guardian ad Litem, Jucicial Council form CiV-010, if the plaintiff or tioneris a Aggro ppoctrg te Grain ar ul are ay C2 e elton 7. Addtional copies of documents to be conformed by the Clerk. Copies of the cover sheet and this addendum ‘must be served slong wth the summons and compraint, oF other initiating pleading in the case. exvaavere LAGIV 400 (Rov. 09717) CIVIL CASE COVER SHEET ADDENDUM Local Rule 20) LASC Approved 02.04 AND STATEMENT OF LOCATION Page 40f 6