(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 "no" [as to all defendants,] sign and return this verdict. 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 the negligence of defendant a cause of injury to the plaintiff?
Write "yes" or "no" after the name of 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: 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. 5 by stating that plaintiff suffered "no damage", sign and return this verdict. If you answer "yes" [as to one or more defendants] to Question No. 2 and answer "yes" to Question No. 4, then answer Question No. 6. However, if you answer "no" to either Question No. 3 or Question No. 4, then do not answer Question No. 6 but answer Question No. 7.
Question No. 6: Assuming the combined negligence [and fault] [and wrongful conduct] of the plaintiff and of the defendant [or defendants] [and of other persons] whose [negligence] [and] [fault] [and] [wrongful conduct] contributed to the plaintiff's injury to be 100%, what percentage of such combined [negligence] [and] [fault] [and] [wrongful conduct] is attributable to the plaintiff and what percentage is attributable to [each] defendant [and such other persons] whose [negligence] [and] [fault] [and] [wrongful conduct] was a cause of the plaintiff's injury?
Answer: To plaintiff ______________ __________%
[To plaintiff ______________ __________%]
To defendant ______________ __________%
[To defendant ______________ __________%
[Other person ______________ __________%
(Identify)
[Other person ______________ __________%
(Identify)
TOTAL __________%
If you answer Question No. 5 by stating that plaintiff suffered "no damage", sign and return this
If you answer Question No. 6, do not answer Question No. 7 but sign and return this verdict.
Question No. 7: Assuming the combined negligence [and fault] [and wrongful conduct] of the defendants [and of other persons] whose [negligence] [and] [fault] [and] [wrongful conduct] contributed to the plaintiff's injury to be 100%, what percentage of such combined [negligence] [and] [fault] [and] [wrongful conduct] is attributable to each defendant [and such other persons] whose [negligence] [and] [fault] [and] [wrongful conduct] was a cause of the plaintiff's injury?
Answer: To defendant ______________ __________%
[To defendant ______________ __________%]
[To defendant ______________ __________%]
[To other persons __________ __________%]
TOTAL __________%
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 the defendant negligent?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 1 "no", sign and return this verdict. If you answer "yes" to Question No. 1, then answer the next question.
Question No. 2: Was the negligence of the defendant 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 "yes" to Questions No. 1 and 2, then answer the next question.
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 the next question.
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, agent or employee, other than the plaintiff?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 5 "no", answer Question No. 7. If you answer Question No. 5 "yes", then answer the next question.
Question No. 6: Did the negligence of plaintiff's employer, 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] [the plaintiff in intervention] and caused by the accident involved herein?
[As to the Plaintiff:]
Answer: (a) Economic Damages $__________
(b) Non-Economic Damages $__________
[As to the Plaintiff in intervention:] $__________
[As to both Plaintiffs:] $__________
TOTAL $__________
If you answer Question No. 7 "no damage", sign and return this verdict.
If you have entered an amount of damages, then answer Question No. 8.
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, 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, agent or employee, other than the plaintiff, and (3) to [each] defendant [and (4) to such other persons] whose [negligence] [and] [fault] [and] [wrongful conduct] was a cause of plaintiff's injury?
Answer:
To plaintiff ______________ __________%
[To plaintiff ______________ __________%]
[To plaintiff's employer, agent or employee, other than
the plaintiff _____________ __________%]
To defendant ______________ __________%
[To defendant ______________ __________%]
[Other person ______________ __________%]
(Identify)
[Other person ______________ __________%]
TOTAL __________%
Dated: _______________
____________________ Foreperson | TOP |
(Title of Court and Cause)
SPECIAL [VERDICT] [FINDINGS]
We, the jury in the above entitled action, find the following special [verdict] [findings] on the questions submitted to us:
Question: [Do you find by clear and convincing evidence that the defendant (was guilty of) (committed) oppression in the conduct upon which you base your finding of liability [for _______________ (cause of action)]?
Write the answer "yes" or "no" after the name of [each] defendant.
Yes No
Answer: Defendant_______________ _____ ____
Defendant______________ _____ ____
Defendant______________ _____ ____
Do you find by clear and convincing evidence that the defendant (was guilty of) (committed) malice in the conduct upon which your finding liability [for _______________ (cause of action)]?
Write the answer "yes" or "no" after the name of [each] defendant.
Yes No
Answer: Defendant_______________ _____ ____
Defendant______________ _____ ____
Defendant______________ _____ ____
[Do you find by clear and convincing evidence that the defendant was [guilty of] [committed] fraud in the conduct upon which you base your finding of liability?
Write the answer "yes" or "no" after the name of [each] defendant.
Yes No
Answer: Defendant_______________ _____ ____
Defendant______________ _____ ____
Defendant______________ _____ ____
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 questions submitted to us:
Write the answer "yes" or "no" after the name of [each] defendant.
Question No. 1: Shall punitive damages be assessed against [the]
Yes No
Defendant_______________ _____ ____
Defendant______________ _____ ____
Defendant______________ _____ ____
If your answer if "yes" [for any defendant], answer the next question [for that defendant only]. If your answer if "no" [for all defendants], have your foreperson sign and date this special verdict.
Question No. 2: We assess punitive damages against [the following named] defendant as follows:
Amount
Defendant_______________ _________
Defendant______________ _________
Defendant______________ _________
Dated:
_______________________
Foreperson | TOP |
This action came on regularly for trial on _______________ , 19__, in Department _______________ of the Superior Court, the Honorable _______________ Judge presiding; the plaintiff[s] appearing by attorney[s] and the defendant[s] appearing by attorney[s]
A jury of _______________ persons was regularly impaneled and sworn. Witnesses were sworn and testified. After hearing the evidence and arguments of counsel, the jury was duly instructed by the Court and the cause was submitted to the jury with directions to return a verdict on special issues. The jury deliberated and thereafter returned into court with its verdict consisting of the special issues submitted to the jury and the answers given thereto by the jury, which said verdict was in words and figures as follows, to-wit:
(Here insert special verdict.)
It appearing by reason of said special verdict that: _______________ (plaintiff/defendant), _______________ is entitled to judgment against _______________ (defendant/plaintiff), _______________ in the amount of $_______________.
NOW, THEREFORE, IT IS ORDERED, ADJUDGED AND DECREED:
[That plaintiff _______________ have judgment, [jointly and severally,] against defendant[s]_______________, _______________, and _______________ for economic damages in the sum of $_______________, with interest thereon at the rate of [_______________] percent per annum from _______________ in the sum of $_______________ for a total sum of $_______________.]
[And that plaintiff _______________ further have judgment for non-economic damages:
Against defendant ______________in the sum of $_______________.
Against defendant ______________in the sum of $_______________.
Against defendant _______________in the sum of $_______________, with interest thereon at the rate of [_______________] percent per annum from _______________.]
[That defendant[s] _______________ [and] _______________ have judgment that plaintiff take nothing.]
[That [plaintiff _______________] [Defendant[s] _______________, _______________ [and] _______________] recover from [plaintiff _______________] [Defendant[s] _______________, _______________, [and] _______________] costs and disbursements taxed in the sum of $_______________.]
Dated:
_________________________ Judge of the __________ Court | TOP |
(Title of Court and Cause)
SPECIAL FINDING
We, the jury in the above entitled action, find as follows on the particular questions of fact herein:
Question No. 1: [Without taking into consideration the question of reduction of damages due to the negligence of the plaintiff, if any,] what is the total amount of damages, economic and non-economic suffered by the plaintiff, a cause of which was the [accident] [incident] in question?
Answer: (a) Economic damages $__________
(b) Non-Economic damages $__________
[Question No. 2: Was the plaintiff negligent?
Answer "yes" or "no".
Answer: __________
If you answer Question No. 2 "no", answer Question No. 4. If you answer Question No. 2 "yes", then answer the next question.
Question No. 3: Did the negligence of the plaintiff contribute as a cause of plaintiff's injury?
Answer "yes" or "no".
Answer: __________
Regardless of your answer, answer the next question.]
Question No. 4: Assuming that 100% represents the combined negligence [and fault] [and wrongful conduct] of [the plaintiff, and] the defendant[s] [and the other persons] whose [negligence] [and] [fault] [and] [wrongful conduct] contributed as a cause of plaintiff's injury, what proportion, if any, of such combined [negligence] [and] [fault] [and] [wrongful conduct] is attributable [to the plaintiff on the one hand and] to the defendant[s] [and such other persons] [on the other hand]?
(Fill in the name of any person whose conduct you find to be a cause of plaintiff's injury.)
Answer: To plaintiff] _____________ __________%
[To defendant _______________ __________%]
[To defendant _______________ __________%]
[To defendant _______________ __________%]
[Other person _______________ __________%]
[Other person _______________ __________%]
TOTAL __________%
[In making this allocation, an employer and his or her employees [other than plaintiff], are to be treated as one person.] | TOP |
(Title of Court and Cause)
SPECIAL FINDING
If you have reached a verdict in favor of the plaintiff and against both defendant __________ (driver) and the defendant __________ (owner), answer the following:
Question No. 1: Was __________ (driver) operating the motor vehicle belonging to __________ (owner) [as the agent of the owner] at the time of the events out of which the accident occurred?
(Place an "x" in the box which corresponds to your answer.)
Yes No
Answer: _____ _____
If your answer is "no", the foreperson should sign and date this form. If your answer is "yes", answer the next question.
Question No. 2: Was __________ (driver) operating the motor vehicle belonging to __________ (owner) acting within the scope of [his] [her] employment at the time of the events out of which the accident occurred?
(Place an "x" in the box which corresponds to your answer and thereafter date and sign this form.)
Yes No
Answer: _____ _____
Dated: _______________
____________________ Foreperson
(Title of Court and Cause)
SPECIAL FINDING
We, the jury in the above entitled action, find as follows on the particular questions of fact herein:
Question No. 1: Did defendant __________ (owner) permit defendant __________ (driver) to use the motor vehicle when __________ (owner) knew or should have known that __________ (driver) was under the influence of [[intoxicating liquor,] [drugs,] [or any combination thereof]] [[a reckless] [or] [an incompetent] driver]?
(Place an "x" in the box which corresponds to your answer. If your answer is "yes", answer the next question; if your answer is "no", date and sign this form.)
Yes No
Answer: _____ _____
Question No. 2: Was the [intoxication] [recklessness] [or] [incompetence] of the defendant __________ (driver) a cause of the accident?
(Place an "x" in the box which corresponds to your answer, and then date and sign this form.)
Yes No
Answer: _____ _____
Dated: _______________
____________________ Foreperson | TOP |