Challenge to Constitutionality of a State Statute Print This form must be completed by a party filing a petition, motion or other pleading challenging the constitutionality of a state statute. The completed form must be filed with the court in which the cause is pending as required by Section 402.010 (a-1), Texas Government Code. Cause Number (For Clerk Use Only): Court (For Clerk Use Only): Styled: (e.g., John Smith v. All American Insurance Co.; in re Mary Ann Jones; In the Matter of the Estate of George Jackson)

Contact information for party* challenging the constitutionality of a state statute. (*If party is not a person, provide contact information for party, party's representative or attorney.)

Name: Telephone: Address: Fax: City/State/Zip: State Bar No. (if applicable): Email: Person completing this form is: Attorney for Party Unrepresented Party Other: Identify the type of pleading you have filed challenging the constitutionality of a state statute.

Petition Answer Motion (Specify type): Other: Is the Attorney General of the State of Texas a party to or counsel in this cause?

Yes No List the state statute(s) being challenged in your pleading and provide a summary of the basis for your challenge. (Additional pages may be attached if necessary.)

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