(Title of Court and Cause)
SPECIAL VERDICT
We, the jury in the above entitled action, find the following special verdict on the We, the jury in the above entitled action, find the following special verdict on the following questions submitted to us:
Question No. 1: Was the public property in question in a dangerous condition at the time of the accident in question?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 1 "no", sign and return this verdict. If you answer Question No. 1 "yes", then answer the next question.
Question No. 2: Was the dangerous condition of the public property a cause of injury to the plaintiff?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 2 "no", sign and return this verdict. If you answer Question No. 2 "yes", then answer the next question.
Question No. 3: Did the dangerous conditions create a reasonably foreseeable risk of the kind of injury which was incurred?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 3 "no", sign and return this verdict. If you answer Question No. 3 "yes", then answer Questions No. 4 and No. 5.
Question No. 4: Was the dangerous condition of the property created by a negligent or wrongful act or omission of an employee of the defendant, acting within the scope of employment?
Answer "yes" or "no".
Answer: __________
Question No. 5: Did the defendant have actual or constructive notice of the dangerous condition a sufficient time prior to the accident within which measures could have been taken to protect against the dangerous condition?
Answer "yes" or "no".
Answer: __________
If you answer both Questions No. 4 and No. 5 "no", sign and return this verdict. If you answer either Question No. 4 or Question No. 5 "yes", then answer the next question.
(Here follow with damage questions and contributory negligence questions.)
Dated:
________________________
Foreperson | TOP |
(Title of Court and Cause)
SPECIAL VERDICT
We, the jury in the above entitled action, find the following special verdict on the following questions submitted to us:
Question No. 1: Did the defendant make a representation as to a past or existing material fact?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 1 "no", sign and return this verdict. If you answer Question No. 1 "yes", then answer the next question.
Question No. 2: Was the representation false?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 2 "no", sign and return this verdict. If you answer Question No. 2 "yes", then answer Questions 3a and 3b.
Question No. 3a: Did the defendant know that the representation was false when [he] [she] made it?
Answer "yes" or "no".
Answer: __________
Question No. 3b: Did the defendant make the representation recklessly without knowing whether it was true or false?
Answer "yes" or "no".
Answer: __________
If you answer Questions 3a and 3b "no", sign and return this verdict. If you answer either Question No. 3a or 3b "yes", then answer the next question.
Question No. 4: Did the defendant make the representation with an intent to defraud the plaintiff?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 4 "no", sign and return this verdict. If you answer Question No. 4 "yes", then answer the next question.
Question No. 5: Was the plaintiff aware of the falsity of the representation?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 5 "yes", sign and return this verdict. If you answer Question No. 5 "no", then answer the next question.
Question No. 6: Did the plaintiff act in reliance upon the truth of the representation?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 6 "no", sign and return this verdict. If you answer Question No. 6 "yes", then answer the next question.
Question No. 7: Was the plaintiff justified in relying upon the representation?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 7 "no", sign and return this verdict. If you answer Question No. 7 "yes", then answer the next question.
Question No. 8: Did defendant's misrepresentation cause plaintiff damage?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 8 "no", sign and return this verdict. If you answer Question No. 8 "yes", then answer the next question.
Question No. 9: What is the total amount of all damage suffered by the plaintiff and caused by the reliance upon the truth of the representation?
Answer: $__________
Dated:
_________________________
Foreperson | TOP |
(Title of Court and Cause)
SPECIAL VERDICT
We, the jury in the above entitled action, find the following special verdict on the following questions submitted to us:
Question No. 1: Did the defendant conceal or suppress a material fact?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 1 "no", sign and return this verdict. If you answer Question No. 1 "yes", then answer Question No. 2.
Question No. 2: Did the defendant intentionally conceal or suppress the fact with the intent to defraud the plaintiff?
Answer "yes" or "no".
Answer: ___________
If you answer Question No. 2 "no", sign and return this verdict. If you answer Question No. 2 "yes", then answer Question No. 3.
Question No. 3: Was the plaintiff aware of the fact at the time plaintiff acted?
Answer "yes" or "no".
Answer: __________
Don't FORM OF SPECIAL VERDICT--CONCEALMENT Page 2
If you answer Question No. 3 "yes", sign and return this verdict. If you answer Question No. 3 "no", then answer Question No. 4.
Question No. 4: Would plaintiff have acted in the way plaintiff acted if plaintiff had known of the concealed or suppressed fact?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 4 "yes", sign and return this verdict. If you answer Question No. 4 "no", then answer Question No. 5.
Question No. 5: Did defendant's concealment or suppression of the fact cause plaintiff damage?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 5 "no", sign and return this verdict. If you answer Question No. 5 "yes", then answer Question No. 6.
Question No. 6: What is the total amount of all damage suffered by the plaintiff and caused by the concealment or suppression of the fact?
Answer: $__________
Dated:
________________________
Foreperson | TOP |
(Title of Court and Cause)
SPECIAL VERDICT
We, the jury in the above entitled action, find the following special verdict on the following questions submitted to us:
Question No. 1: Did the defendant make a promise as to a material matter?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 1 "no", sign and return this verdict. If you answer Question No. 1 "yes", then answer Question No. 2.
Question No. 2: At the time defendant made the promise, did the defendant intend to perform it?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 2 "yes", sign and return this verdict. If you answer Question No. 2 "no", then answer Question No. 3.
Question No. 3: Did the defendant make the promise with an intent to defraud the plaintiff?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 3 "no", sign and return this verdict. If you answer Question No. 3 "yes", then answer Question No. 4.
Question No. 4: Was the plaintiff at the time plaintiff acted aware of the defendant's intention not to perform the promise?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 4 "yes", sign and return this verdict. If you answer Question No. 4 "no", then answer Question No. 5.
Question No. 5: Did the plaintiff act in reliance upon the promise?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 5 "no", sign and return this verdict. If you answer Question No. 5 "yes", then answer Question No. 6.
Question No. 6: Was the plaintiff reasonably justified in relying upon the promise?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 6 "no", sign and return this verdict. If you answer Question No. 6 "yes", then answer Question No. 7.
Question No. 7: Did defendant's promise cause plaintiff damage?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 7 "no", sign and return this verdict. If you answer Question No. 7 "yes", then answer Question No. 8.
Question No. 8: What is the total amount of all damage suffered by the plaintiff and caused by plaintiff's reliance upon defendant's promise?
Answer: $__________
Dated:
_________________________
Foreperson | TOP |
(Title of Court and Cause)
SPECIAL VERDICT
We, the jury in the above entitled action, find the following special verdict on the following questions submitted to us:
Question No. 1: Did the defendant make a representation as to a past or existing material fact?
Answer "yes" or "no".
Answer: __________.
If you answer Question No. 1 "no", sign and return this verdict. If you answer Question No. 1 "yes", then answer the next question.
Question No. 2: Was the representation false?
Answer "yes" or "no".
Answer: __________.
If you answer Question No. 2 "no", sign and return this verdict. If you answer Question No. 2 "yes", then answer the next question.
Question No. 3: Regardless of the defendant's actual belief, did the defendant make the representation without any reasonable grounds for believing it to be true?
Answer "yes" or "no".
Answer: __________.
If you answer Question No. 3 "no", sign and return this verdict. If you answer Question No. 3 "yes", then answer the next question.
Question No. 4: Did the defendant make the representation with the intent to induce the plaintiff to rely on it?
Answer "yes" or "no".
Answer: __________.
If you answer Question No. 4 "no", sign and return this verdict. If you answer Question No. 4 "yes", then answer the next question.
Question No. 5: Was the plaintiff aware of the falsity of the representation?
Answer "yes" or "no".
Answer: __________.
If you answer Question No. 5 "yes", sign and return this verdict. If you answer Question No. 5 "no", then answer the next question.
Question No. 6: Did the plaintiff act in reliance upon the truth of the representation?
Answer "yes" or "no".
Answer: __________.
If you answer Question No. 6 "no", sign and return this verdict. If you answer Question No. 6 "yes", then answer the next question.
Question No. 7: Was the plaintiff justified in relying upon the representation?
Answer "yes" or "no".
Answer: __________.
If you answer Question No. 7 "no", sign and return this verdict. If you answer Question No. 7 "yes", then answer the next question.
Question No. 8: Did defendant's misrepresentation cause plaintiff damage?
Answer "yes" or "no".
Answer: __________.
If you answer Question No. 8 "no", sign and return this verdict. If you answer Question No. 8 "yes", then answer the next question.
Question No. 9: What is the total amount of all damage suffered by plaintiff and caused by the reliance upon the truth of the representation?
Answer: $__________
Dated: _______________
____________________
Foreperson | TOP |
(Title of Court and Cause)
SPECIAL VERDICT
Question No. 1: At the time of the events out of which the case arose, was ____________________ (alleged agent/ employer) the agent of _____________________________? (alleged principal/ employee)
Answer "yes" or "no".
Answer: __________
If you answer Question No. 1 "no", do not answer Question No. 2. If you answer Question No. 1 "yes", then answer Question No. 2.
Question No 2: At that time was ____________________ (alleged agent/ employee) acting within the scope of [his] [her] [agency] [employment]?
Answer "yes" or "no".
Answer: __________
Dated: _______________
____________________
Foreperson | TOP |
(Title of Court and Cause)
SPECIAL VERDICT
Question No. 1. At the time of the accident in question in this case, did __________ (driver) have __________ (owner's) permission, express or implied, to use the vehicle __________ (driver) was driving?
Answer "yes" or "no".
Answer: __________
Dated:
___________________________
Foreperson | TOP |
Title of Court and Cause)
SPECIAL VERDICT
We, the jury in the above entitled action, find the following special verdict on the following questions submitted to us:
Question No. 1: [Was] [Were any of] the defendant[s] negligent?
Write the answer "yes" or "no" [after the name of [each] defendant].
Yes No
Answer: Defendant _______________ _____ _____
[Defendant ______________ _____ _____]
[Defendant ______________ _____ _____]
If you answer Question No. 1 "no" as to any defendant, sign and return this verdict as to that defendant. If you answer Question No. 1 "yes" [as to one or more defendants], then answer Question No. 2 [only as to such defendants].
Question No. 2: [As to each defendant that you answered "yes" in Question No. 1,] was such negligence a cause of injury to the plaintiff?
Write the answer "yes" or "no" after the name of [each] such defendant.
Yes No
Answer: Defendant _______________ _____ _____
[Defendant ______________ _____ _____]
[Defendant ______________ _____ _____]
If you answer Question No. 2 "no" [as to all defendants], sign and return this verdict. If you answer "yes" [as to one or more defendants] to Question No. 2, then answer Question No. 3.
Question No. 3: Was the plaintiff negligent?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 3 "no", then answer Question No.
5. If you answer Question No. 3 "yes", then answer Question No. 4.
Question No. 4: Did the negligence of the plaintiff contribute as a cause to plaintiff's injury?
Answer "yes" or "no".
Answer: __________
Answer Question No. 5.
Question No. 5: Was there negligence on the part of the plaintiff's employer or an agent or employee of said employer, other than the plaintiff?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 5 "no", then answer Question No. 7. If you answer Question No. 5 "yes", then answer Question No. 6.
Question No. 6: Did the negligence of plaintiff's employer or plaintiff's employer's agent or employee, other than plaintiff, contribute as a cause to plaintiff's injury?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 5 "No", then answer Question No. 7. If you answer Question No. 5 "yes", then answer Question No. 6.
Question No. 6: Did the negligence of plaintiff's employer or plaintiff's employer's agent or employee, other than plaintiff, contribute as a cause to plaintiff's injury?
Answer "yes" or "no".
Answer: __________
Answer Question No. 7.
Question No. 7: Without taking into consideration the reduction of damages due to the negligence of the plaintiff, if any, what do you find to be the total amount of damages, including economic and non-economic damages, if any, suffered by the plaintiff and caused by the accident involved herein?
Answer: (a) Economic Damages $__________
(b) Non-Economic Damages $__________
TOTAL $__________
If you answer Question No. 7 "no damage", sign and return this verdict. If you find plaintiff suffered damage and answered "yes" to both Questions Nos. 3 and 4 or answered "yes" to both Questions Nos. 5 and 6, then answer Question No. 8. If you answered "no" to all four questions, sign and return this verdict.
Answer Question No. 7.
Question No. 7: Without taking into consideration the
reduction of damages due to the negligence of the plaintiff, if any, what do you find to be the total amount of damages, including economic and non-economic damages, if any, suffered by the plaintiff and caused by the accident involved herein?
If you answer Question No. 5 "No", then answer Question No. 7. If you answer Question No. 5 "yes", then answer Question No. 6.
Question No. 6: Did the negligence of plaintiff's employer or plaintiff's employer's agent or employee, other than plaintiff, contribute as a cause to plaintiff's injury?
Answer "yes" or "no".
Answer: __________
Answer Question No. 7.
Question No. 7: Without taking into consideration the reduction of damages due to the negligence of the plaintiff, if any, what do you find to be the total amount of damages, including economic and non-economic damages, if any, suffered by the plaintiff and caused by the accident involved herein?
Answer: (a) Economic Damages $__________
(b) Non-Economic Damages $__________
TOTAL $__________
If you answer Question No. 7 "no damage", sign and return this verdict. If you find plaintiff suffered damage and answered "yes" to both Questions Nos. 3 and 4 or answered "yes" to both Questions Nos. 5 and 6, then answer Question No. 8. If you answered "no" to all four questions, sign and return this verdict.
Answer Question No. 7.
Question No. 7: Without taking into consideration the
reduction of damages due to the negligence of the plaintiff, if any, what do you find to be the total amount of damages, including economic and non-economic damages, if any, suffered by the plaintiff and caused by the accident involved herein?
Answer: (a) Economic Damages $__________
(b) Non-Economic Damages $__________
TOTAL $__________
If you answer Question No. 7 "no damage", sign and return this verdict. If you find plaintiff suffered damage and answered "yes" to both Questions Nos. 3 and 4 or answered "yes" to both Questions Nos. 5 and 6, then answer Question No. 8. If you answered "no" to all four questions, sign and return this verdict.
Question No. 8: Assuming that 100% represents the sum of the [negligence] [and] [fault] [and] [wrongful conduct], if any, (1) of the plaintiff, and (2) of the plaintiff's employer, or agent, or employee other than the plaintiff, and (3) of the defendants [and (4) of other persons] whose [negligence] [and] [fault] [and] [wrongful conduct] contributed to plaintiff's injury, what proportion, if any, of such combined [negligence] [and] [fault] [and] [wrongful conduct] is attributable to the following: (1) to the plaintiff, (2) to the plaintiff's employer or agent or employee, other than the plaintiff, and (3) to [each] defendant [and (4) to such other persons]?
Answer: To plaintiff _______________ __________%
[To plaintiff _______________ __________%]
To plaintiff's employer or
agent or employee, other than
the plaintiff ______________ __________%
To defendant _______________ __________%
[To defendant ______________ __________%]
[Other person ______________ __________%]
(Identify)
[Other person ______________ __________%]
(Identify)
TOTAL __________%
Dated: _______________
____________________
Foreperson | TOP |