This is a Personal Injury action in which the plaintiff's likely damages will not exceed $30,000, and the plaintiff requests an exemption from ADR. CV-001, Rev.. 06/14 Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com VII. (a) PLAINTIFFS (Name & Address including county) or Third-Party, Counterclaim or Cross-Claim Plaintiffs The plaintiff is a prisoner in a local, state or federal facility