INTERROGATORIES TO DEFENDANT (Slip/Trip/Fall)
|
|
|
- Gary Dean
- 10 years ago
- Views:
Transcription
1 INTERROGATORIES TO DEFENDANT (Slip/Trip/Fall) 1. Please state your full name, your present home address, your employer s name and business address, and the title you hold with the named defendant, or the capacity in which you are associated with said defendant. 2. State the names and addresses of all persons known to you or to your insurance company or attorney who witnessed any part of the incident, or have knowledge of the events leading up to said incident, and give a brief description of all witnesses whose names or addresses are not known. 1
2 3. Were any statements concerning the incident made to any police officer, private investigator, insurance company agent or adjuster, or anyone else? If so, state: a) The name, address and employer of the person to whom the statement was made; b) The date of each statement; c) Whether the statement was oral or written, and if oral, whether it was recorded; d) The name and address of the custodian(s) of each statement. 4. Describe any photographs, movies, videotapes, diagrams or drawings taken or made by you or on your behalf of the scene, if any, the plaintiff(s), or anything related to the events alleged in the Complaint. 2
3 5. Other than this incident, has any person reported slipping and/or tripping and/or falling in the area where this incident occurred during the five-year period prior to the date of this incident and/or during the two-year period subsequent to the date of this incident? If so, as to each such reported slip and/or trip and/or fall incident, please provide the following information: a) The date of each such incident; b) A brief description of each such incident, including the type of surface on which the person involved in each such incident slipped and/or tripped and/or fell; c) A brief description of the injuries suffered by any person involved in each such incident; d) Whether any of the incidents referred to above resulted in a claim and/or lawsuit, and if so, the name of each claimant, date of the filing of each such claim and/or lawsuit, the civil number, if any, and a summary of the disposition of each such claim or lawsuit. 6. During the five-year period before this incident, did you receive any reports and/or complaints with regard to a condition of the floors and/or walking surfaces in the area where this incident occurred? If so, please state: a) The date of such complaint and/or report; b) Whether or not you have or maintained any documentary material of any kind or nature relating or referring to such complaints and/or reports; c) What action, if any, was taken by you with respect to such complaint and/or report. 3
4 7. On the date of this incident, did you have a system or routine of any kind whereby the floors and/or stairs and/or carpeting and/or walking surfaces of the area where this incident occurred were inspected and/or maintained? If so, please state: a) A general description of such system or routine; b) The name, address, and particular duties of each person directly involved in such system or routine of inspection and/or maintenance in the general area where this incident occurred as of the date of this incident; c) The name, title, address and particular duties of each person responsible for the general supervision of the operation of such system or routine as of the date of this incident; d) The date on which such system or routine went into effect; e) Whether or not such system is presently in effect. 8. As of the date of this incident, did the named defendant hire any other individual or entity to assist with maintenance or care of the area where this incident occurred? If so, please state: a) The name and address of each individual or entity; b) Describe generally the functions and/or duties of each individual or entity; c) Whether any agreement existed between the named defendant and any individual or entity, and if so, state the terms of any such agreement. (If in writing, in lieu of stating all terms, you may produce a copy of the agreement.) 4
5 9. After this incident, was the floor and/or walking area and/or floor covering over the area where this incident occurred repaired and/or replaced and/or altered in any manner? If so, please state: a) A description of the nature of each repair and/or replacement and/or alteration; b) The name, title and address of each person, department, company and/or agency who repaired and/or altered such floor and/or walking area and/or floor covering over the area where this incident occurred; c) The reason for such repair and/or alteration; d) Whether or not such action was taken as a result of or following a complaint and/or other notification. 10. On the date of this incident, was there any inspection made of the area where this incident occurred prior to the time of this incident? If so, please state: a) The name, address, occupation and employer of each person making each such inspection; b) The date and time each such inspection was made; c) Whether there is a written log or other documentation referencing each such inspection; d) The name, address, occupation and employer of the person having present custody of any written log or other documents referencing each such inspection. InterDstf 5 1C-P-525 (04/04)
How To File A Claim Of Trespass (Fall)
INTERROGATORIES TO PLAINTIFF (Slip/Trip/Fall) 1. State your full name, your present address, and date of birth. 2. List your occupation or job (full and/or part-time) and employers name and address during
IN THE CIRCUIT COURT OF WILL COUNTY, ILLINOIS COUNTY DEPARTMENT, LAW DIVISION INTERROGATORIES TO DEFENDANT, WERNER ENTERPRISES
IN THE CIRCUIT COURT OF WILL COUNTY, ILLINOIS COUNTY DEPARTMENT, LAW DIVISION JOHN DOE, Plaintiff, v. No. 10-L- JIM TRUCKER, and TRUCKING COMPANY, INC. Defendants. INTERROGATORIES TO DEFENDANT, WERNER
IN THE CIRCUIT COURT OF GREENE COUNTY STATE OF MISSOURI., ) Plaintiff, ) Case No. v. ) ), ) Defendant. )
TO PLAINTIFF IN THE CIRCUIT COURT OF GREENE COUNTY STATE OF MISSOURI, ) Plaintiff, ) Case No. v. ) ), ) Defendant. ) DEFENDANT S FIRST INTERROGATORIES DIRECTED TO PLAINTIFF Comes now defendant, and in
IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, LAW DIVISION PLAINTIFF S FIRST SET OF INTERROGATORIES TO DEFENDANT, XXXXX XXXXX XXXX.
IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, LAW DIVISION INJURED PARTY, Plaintiff, vs. No: 00 L 0000 XXXXX XXXXX XXXXX XXX., Defendant. PLAINTIFF S FIRST SET OF INTERROGATORIES TO
Courtesy of RosenfeldInjuryLawyers.com (888) 424-5757 1
1. State the full name of the Defendant answering, as well as your current residence address, date of birth, marital status, driver's license number and issuing state, and social security number, and,
IN THE DISTRICT COURT OF OKLAHOMA COUNTY STATE OF OKLAHOMA ) ) ) ) ) ) ) PLAINTIFF'S INTERROGATORIES AND REQUESTS FOR PRODUCTION TO DEFENDANT
IN THE DISTRICT COURT OF OKLAHOMA COUNTY STATE OF OKLAHOMA, Plaintiff, vs., Defendant. Case No.: CJ-2011- PLAINTIFF'S INTERROGATORIES AND REQUESTS FOR PRODUCTION TO DEFENDANT TO: COMES NOW the Plaintiff,
IN THE CIRCUIT COURT OF GREENE COUNTY STATE OF MISSOURI., ) Plaintiff, ) Case No. v. ) ), ) Defendant. )
IN THE CIRCUIT COURT OF GREENE COUNTY STATE OF MISSOURI, ) Plaintiff, ) Case No. v. ) ), ) Defendant. ) PLAINTIFF S FIRST INTERROGATORIES DIRECTED Comes now plaintiff, and in accordance with the Missouri
IN THE CIRCUIT COURT OF GREENE COUNTY, MISSOURI
IN THE CIRCUIT COURT OF GREENE COUNTY, MISSOURI JANE DOE, ) ) Plaintiff, ) ) vs. ) ) Case Number 1131-********* MISSOURI COMPANY, ) ) and ) ) INDIANA COMPANY ) ) Defendants. ) PLAINTIFF S FIRST INTERROGATORIES
IN THE CIRCUIT COURT OF CHRISTIAN COUNTY, MISSOURI
IN THE CIRCUIT COURT OF CHRISTIAN COUNTY, MISSOURI JOHN DOE, ) ) Plaintiff, ) ) vs. ) ) Case Number: 11CT-******** JANE DOE, ) ) and ) ) INSURANCE COMPANY ) ) Defendants. ) PLAINTIFF S FIRST INTERROGATORIES
INSTRUCTIONS FOR USE
Uniform Personal Injury Interrogatories INSTRUCTIONS FOR USE A. All information is to be divulged which is in the possession of the individual or corporate party, his attorneys, investigator, agents, employees,
IN THE CIRCUIT COURT OF THE CITY OF ST. LOUIS STATE OF MISSOURI., ) ) Plaintiff, ) ) Cause No. vs. ) ) Division No., ) ) Defendant.
IN THE CIRCUIT COURT OF THE CITY OF ST. LOUIS STATE OF MISSOURI, ) ) Plaintiff, ) ) Cause No. vs. ) ) Division No., ) ) Defendant. ) DEFENDANT S INTERROGATORIES DIRECTED TO PLAINTIFF COMES NOT defendant,
IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, LAW DIVISION ) ) ) ) ) ) ) ) ) ) ) ) ) ) No.
IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, LAW DIVISION INJURED PERSON, Plaintiff, v. RESPONSIBLE PARTY Defendant. No. PLAINTIFFS FIRST SET OF INTERROGATORIES TO DEFENDANT RESPONSIBLE
IN THE CIRCUIT COURT OF THE CITY OF ST. LOUIS STATE OF MISSOURI ) ) ) ) ) ) ) ) ) PLAINTIFF'S INTERROGATORIES DIRECTED TO DEFENDANT
IN THE CIRCUIT COURT OF THE CITY OF ST. LOUIS STATE OF MISSOURI, Plaintiff, vs., Defendant. Cause No. Division No. PLAINTIFF'S INTERROGATORIES DIRECTED Comes now plaintiff and, in accordance with the Missouri
CIVIL DIVISION CASE NO:
IN THE CIRCUIT COURT OF THE 11TH JUDICIAL CIRCUIT IN AND FOR MIAMI-DADE COUNTY, FLORIDA KHASAN GRACE, individually and as parent and natural guardian of ANDREW MASON GRACE, a minor, Plaintiff, CIVIL DIVISION
FIRST JUDICIAL DISTRICT OF PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF PHILADELPHIA NO.
FIRST JUDICIAL DISTRICT OF PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF PHILADELPHIA PLAINTIFF(S) v. DEFENDANT(S) CIVIL TRIAL DIVISION Compulsory Arbitration Program COURT TERM: NO. Plaintiff(s) Interrogatories
APPENDIX II. INTERROGATORY FORMS
APPENDIX II. INTERROGATORY FORMS Form A. Uniform Interrogatories to be Answered by Plaintiff in All Personal Injury Cases (Except Medical Malpractice Cases): Superior Court All questions must be answered
Plaintiff s Interrogatories Directed To Defendant(S)
FIRST JUDICIAL DISTRICT OF PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF PHILADELPHIA COUNTY PLAINTIFF S NAME : Civil Trial Division : : Compulsory Arbitration Program : vs. : : Term, 20 : DEFENDANT S NAME
1. Set forth the following information as to the decedent:
vs. Plaintiff, Defendant. SUPERIOR COURT OF NEW JERSEY LAW DIVISION Docket No.: Civil Action WRONGFUL DEATH INTERROGATORIES TO: Plaintiff,, provides the following answers to Defendant s Wrongful Death
IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, LAW DIVISION PLAINTIFF S FIRST SET OF INTERROGATORIES TO DEFENDANTS
IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS COUNTY DEPARTMENT, LAW DIVISION INJURED PERSON, ) ) Plaintiff, ) ) v. ) Case No.: ) RESPONSIBLE PARTIES ) ) Defendants. ) PLAINTIFF S FIRST SET OF INTERROGATORIES
PERSONAL INJURY/AUTO ACCIDENT QUESTIONNAIRE
PERSONAL INJURY/AUTO ACCIDENT QUESTIONNAIRE TODAY S DATE: PERSONAL INFORMATION: NAME: (home) (cell) Age: Date of Birth: Social Security No: EMPLOYER: (work) Occupation: Worked there how long? Immediate
IN THE CIRCUIT COURT OF THE CITY OF ST. LOUIS STATE OF MISSOURI., ) ) Plaintiff, ) ) Cause No. vs. ) ) Division No., ) ) Defendant.
IN THE CIRCUIT COURT OF THE CITY OF ST. LOUIS STATE OF MISSOURI, ) ) Plaintiff, ) ) Cause No. vs. ) ) Division No., ) ) Defendant. ) PLAINTIFF S INTERROGATORIES DIRECTED TO DEFENDANT Comes not plaintiff,
IN THE SUPREME COURT OF THE STATE OF ALASKA ORDER NO. 1682. Pretrial Conferences; Scheduling; Management.
IN THE SUPREME COURT OF THE STATE OF ALASKA ORDER NO. 1682 Amending Civil Rules 16, 26, 33, 34, 37, and 45 concerning Discovery of Electronic Information IT IS ORDERED: 1. Civil Rule 16 is amended to read
IN THE CIRCUIT COURT OF GREENE COUNTY, MISSOURI
IN THE CIRCUIT COURT OF GREENE COUNTY, MISSOURI JANE DOE, ) ) Plaintiff, ) ) vs. ) ) Case Number 1131-********* MISSOURI COMPANY, ) ) and ) ) INDIANA COMPANY ) ) Defendants. ) PLAINTIFF S FIRST REQUEST
ACCIDENT INVESTIGATION GUIDELINES WITH LITIGATION IN MIND
ACCIDENT INVESTIGATION GUIDELINES WITH LITIGATION IN MIND Introduction The purpose of this paper is to alert the reader to concepts used in the defense of construction related lawsuits and to suggest how
Defendant s Interrogatories Addressed To Plaintiff Premises Liability Cases
FIRST JUDICIAL DISTRICT OF PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF PHILADELPHIA COUNTY PLAINTIFF S NAME : Civil Trial Division : : Compulsory Arbitration Program : vs. : : Term, 20 : DEFENDANT S NAME
No. 77,020. [April 4, 19911
No. 77,020 IN RE: AMENDMENT TO RULES OF CIVIL PROCEDURE - FORM 1.976 STANDARD FORMS FOR INTERROGATORIES [April 4, 19911 PER CURIAM. The Civil Procedure Rules Committee of The Florida Bar, responding to
How to make a personal injury claim
A publication by Cute Injury How to make a personal injury claim A CLEAR AND CONCISE GUIDE TO THE PERSONAL INJURY CLAIMS PROCESS We provide professional and impartial advice from the outset and throughout
IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI AT INDEPENDENCE
IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI AT INDEPENDENCE RICK CULLEN and REBECCA CULLEN, 702 SW 15 th, Apt. 4 Blue Springs, MO 64105 Plaintiffs, v. Case No. Div. No. DELL R. PRIEST, Serve at: 1159
MASTER DISCOVERY TO INSURER AND ADJUSTER DEFENDANTS
Cause No. 2009-23570 IN RE IN THE DISTRICT COURT OF HURRICANE IKE RESIDENTIAL HARRIS COUNTY, TEXAS PROPERTY CLAIM LITIGATION 11 TH JUDICIAL DISTRICT MASTER DISCOVERY TO INSURER AND ADJUSTER DEFENDANTS
DEFENDANT'S ARBITRATION DISCOVERY REQUESTS PERSONAL INJURY CLAIMS. IDENTITY OF PLAINTIFF(s) WITNESSES
,, Plaintiff vs. Defendant IN THE COURT OF COMMON PLEAS OF McKEAN COUNTY, PENNSYLVANIA CIVIL DIVISION NO. CD 20 DEFENDANT'S ARBITRATION DISCOVERY REQUESTS PERSONAL INJURY CLAIMS These discovery requests
Notice of Claim. Last First Middle Area Code/ Telephone Number. Last First Middle Area Code/ Telephone Number
Claimant: Notice of Claim Last First Middle Area Code/ Telephone Number Street Address Additional Address City State Zip Date of Birth Social Security Number If Notices and correspondence in connection
FIRST JUDICIAL DISTRICT OF PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF PHILADELPHIA COURT TERM: NO.
FIRST JUDICIAL DISTRICT OF PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF PHILADELPHIA PLAINTIFF(S) v. DEFENDANT(S) CIVIL TRIAL DIVISION Compulsory Arbitration Program COURT TERM: NO. Defendant s Interrogatories
Sample Pleadings in a Auto Accident Case
Civil Procedure for R.I. Paralegals First Edition - 2000 Printing Sample Pleadings in a Auto Accident Case The following documents are designed to show the kinds of pleadings that may arise in a civil
FORM INTERROGATORIES EMPLOYMENT LAW
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): TELEPHONE NO.: FAX NO. (Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SHORT
IN THE CIRCUIT COURT OF GREENE COUNTY, MISSOURI
IN THE CIRCUIT COURT OF GREENE COUNTY, MISSOURI JANE DOE INDIVIDUALLY ) and on BEHALF OF ) THE CLASS OF PERSONS ) DESIGNATED BY 537.080, ) ) Plaintiff, ) ) Case Number *************** vs. ) ) DEFENDANT
How To Tell Someone You Were Injured In A Car Accident
Personal Injury Questionnaire Answer each question fully and accurately. Success in this case depends on mutual confidence and complete cooperation between you (as the client) and the attorney. It is imperative
Incident Reporting Manual
Pillar Income Asset Management, Inc. Incident Reporting Manual For use in reporting: Property Losses General Liability Incidents Workers Compensation Incidents Commercial Auto Incidents Prepared by: The
California General Interrogatories (Wrongful Death) DEFINITIONS. 1. AREA means the name of the specific structure, building, building
California General Interrogatories (Wrongful Death) DEFINITIONS 1. AREA means the name of the specific structure, building, building number, floor of the building, ship compartment, process line, unit,
, ) ) Plaintiff, ) ) Cause No. vs. ) ) Division No., ) ) Defendant. ) PLAINTIFF S INTERROGATORIES DIRECTED TO DEFENDANT
IN THE CIRCUIT COURT OF THE CITY OF ST. LOUIS STATE OF MISSOURI, ) ) Plaintiff, ) ) Cause No. vs. ) ) Division No., ) ) Defendant. ) PLAINTIFF S INTERROGATORIES DIRECTED TO DEFENDANT Comes now plaintiff,
CASE NO.: CIVIL DIVISION COMPLAINT. through undersigned counsel, and hereby sues Defendant, Winn-Dixie Stores, Inc., a Florida GENERAL ALLEGATIONS
IN THE CIRCUIT COURT OF THE FIFTEENTH JUDICIAL CIRCUIT IN AND FOR PALM BEACH COUNTY, FLORIDA, vs. Plaintiff, CASE NO.: CIVIL DIVISION WINN-DIXIE STORES, INC., Defendant, / COMPLAINT COMES NOW Plaintiff,,
Spoliation of Evidence. Prepared for:
Spoliation of Evidence Prepared for: Spoliation Nationwide anti-spoliation trend Cases can be thrown out of court Insurers can be denied subrogation claims An insured who destroys evidence of a claim can
Vehicle Crash Reporting Procedure
CITY OF PHILADELPHIA RISK MANAGEMENT DIVISION Safety Directive #P-2 Issued: June 29, 2012 Title: Purpose: Vehicle Crash Reporting Procedure This document sets forth procedures governing the reporting of
EXHIBIT C. Filed 8/10/2015 6:09:57 PM Esther Degollado District Clerk Webb District <<Name>> 2015CV2002272D5
EXHIBIT C Filed 8/10/2015 6:09:57 PM Esther Degollado District Clerk Webb District 2015CV2002272D5 REQUESTS FOR PRODUCTION TO PLAINTIFF(S) IN COMMERCIAL CASES REQUEST FOR PRODUCTION NO.1: Produce
Defendant s Interrogatories Addressed to Plaintiff(s) Motor Vehicle Liability Cases
FIRST JUDICIAL DISTRICT OF PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF PHILADELPHIA COUNTY PLAINTIFF S NAME : Civil Trial Division : : Compulsory Arbitration Program : vs. : : Term, 20 : DEFENDANT S NAME
PERSONAL INJURY INTAKE SHEET INITIAL CLIENT STATEMENT HAVE YOU SPOKEN TO ANOTHER ATTORNEY ABOUT THIS CASE?
PERSONAL INJURY INTAKE SHEET INITIAL CLIENT STATEMENT HAVE YOU SPOKEN TO ANOTHER ATTORNEY ABOUT THIS CASE? IF SO, PLEASE GIVE NAME OF ATTORNEY: DO YOU HAVE A SIGNED RELEASE BY THAT ATTORNEY? SOL: DATE
Managing Workers Compensation Costs and Loss Control in the Workplace
Managing Workers Compensation Costs and Loss Control in the Workplace Managing Workers Compensation Costs and Loss Control in the Workplace Presented by: Denise Moore, CIC Association Programs Director
MASTER DISCOVERY TO PLAINTIFFS
Cause No. 2009-23570 IN RE IN THE DISTRICT COURT OF HURRICANE IKE RESIDENTIAL HARRIS COUNTY, TEXAS PROPERTY CLAIM LITIGATION 11 TH JUDICIAL DISTRICT MASTER DISCOVERY TO PLAINTIFFS DEFINITIONS (FOR ALL
OCCUPIERS LIABILITY SLIPS, TRIPS +FALLS
OCCUPIERS LIABILITY SLIPS, TRIPS +FALLS BUSINESS INSURANCE VISIT IBC.CA SLIPS, TRIPS +FALLS result in some of the most common and costly liability claims against business owners. As an occupier of business
The insurance company is also responsible for reasonable towing or storage charges on your vehicle until you receive written notice otherwise.
If you have been in an automobile accident that is not your fault and your vehicle is damaged, you do have certain rights. If total property damage from the wreck to all damages appears to be over $1,000.00,
HAVE YOU SPOKEN TO ANOTHER ATTORNEY ABOUT THIS CASE? WHO WERE YOU REFERRED BY: (INDIVIDUAL, YELLOW PAGE AD, ETC...) Email Address:
PERSONAL INJURY/AUTO ACCIDENT INTAKE SHEET SOL: INITIAL CLIENT STATEMENT TODAY S DATE: HAVE YOU SPOKEN TO ANOTHER ATTORNEY ABOUT THIS CASE? IF SO, PLEASE GIVE NAME OF ATTORNEY : DO YOU HAVE A SIGNED RELEASE
INITIAL CLIENT STATEMENT
PERSONAL INJURY/AUTO ACCIDENT INTAKE SHEET SOL: INITIAL CLIENT STATEMENT HAVE YOU SPOKEN TO ANOTHER ATTORNEY ABOUT THIS CASE? IF SO, PLEASE GIVE NAME OF ATTORNEY: DO YOU HAVE A SIGNED RELEASE BY THAT ATTORNEY?
DEALING WITH POLICE MISCONDUCT OR EXCESSIVE FORCE IN WISCONSIN
DEALING WITH POLICE MISCONDUCT OR EXCESSIVE FORCE IN WISCONSIN Written by: Jonathan S. Safran This guide attempts to answer some of the most common questions and provides a basic understanding of the steps
COBB COUNTY STATE COURT STATE OF GEORGIA * * * * * * * * * * SUMMONS CASE NO.:
COBB COUNTY STATE COURT STATE OF GEORGIA GEORGE LOUIS BAILEY, Plaintiff, vs. MARVIN SIMPSON, Defendant. SUMMONS JURY TRIAL DEMANDED CASE NO.: TO THE ABOVE NAMED DEFENDANT: You are hereby summoned and required
CALIFORNIA TORT FORMS FROM EXPERT LITIGATORS (1st Edition) July 2015 TABLE OF CONTENTS
CALIFORNIA TORT FORMS FROM EXPERT LITIGATORS (1st Edition) July 2015 TABLE OF CONTENTS File Name Book Section Title CH01 Chapter 1 Animals 01-006 1.6 Sample Client Authorization to Release Medical 01-007
GENERAL BACKGROUND INFORMATION
Internal Office Use Staff member initials for interview: Date of Incident : Statute of Limitations: Potential Defendants: CLIENT INTAKE FORM Please take the time to answer the questions below as accurately
CLIENT INTERVIEW FORM AUTO ACCIDENTS
CLIENT INTERVIEW FORM AUTO ACCIDENTS Please fill out the following form to the best of your ability. YOUR INFORMATION First Name: MI: Last Name: Drivers License #: Date of Birth: Email Phone (work): State:
Lowcountry Injury Law
Lowcountry Injury Law 1917 Lovejoy Street Post Office Drawer 850 Beaufort, South Carolina 29901 Personal Injury Phone (843) 524-9445 Auto Accidents Fax (843) 532-9254 Workers Comp [email protected]
ATTACHMENT E. FORM B: DEFENDANT INTERROGATORIES: To be answered by all defendant and
FORM B: DEFENDANT INTERROGATORIES: To be answered by all defendant and third party defendant miners, manufacturers, suppliers and installers of asbestos or asbestos containing products in all cases except
Court Services and Offender Supervision Agency for the District of Columbia Policy Statement 1105.1 Effective date: 12/14/2000 Page 2
Court Services and Offender Supervision Agency for the District of Columbia Page 2 III. DELEGATION OF AUTHORITY The General Counsel is delegated authority pursuant to 28 U.S.C. 2672 to consider, ascertain,
IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF MISSOURI ST. JOSEPH DIVISION. v. Case No :09-00157-01,03,05/08-CR-W-SOW
IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF MISSOURI ST. JOSEPH DIVISION UNITED STATES OF AMERICA, Plaintiff, v. Case No :09-00157-01,03,05/08-CR-W-SOW GARLAND HANKINS, STACEY M. WALKER,
THIS CLAIM FORM MUST BE FILED WITHIN NINETY DAYS OF ACCIDENT/OCCURRENCE OR YOU MAY FORFEIT YOUR RIGHTS PURSUANT TO N.J.S.A. 59:1 ET SEQ.
THIS CLAIM FORM MUST BE FILED WITHIN NINETY DAYS OF ACCIDENT/OCCURRENCE OR YOU MAY FORFEIT YOUR RIGHTS PURSUANT TO N.J.S.A. 59:1 ET SEQ. 1) CLAIMAINT INFORMATION DATE OF ACCIDENT $ AMOUNT OF CLAIM LAST
19. Injury, Accident, and Loss Reporting
19. Injury, Accident, and Loss Reporting Overview This section discusses the following topics: Where to Report Claims Reporting Workers Compensation Illnesses and Injuries Reporting Automobile Accidents
DEPARTMENT OF DEFENSE DeCA DIRECTIVE 80-11 HEADQUARTERS DEFENSE COMMISSARY AGENCY February 2001 Fort Lee VA 28301-1800.
DEPARTMENT OF DEFENSE DeCA DIRECTIVE 80-11 HEADQUARTERS DEFENSE COMMISSARY AGENCY February 2001 Fort Lee VA 28301-1800 General Counsel INVESTIGATING AND PROCESSING CERTAIN NONCONTRACTUAL CLAIMS AND REPORTING
Complaint - Walmart Substance on Floor in Frozen Food Dept.
Home Slip and Fall - Pleadings Main Index - Complaint Walmart Frozen Food Dept Complaint - Walmart Substance on Floor in Frozen Food Dept. IN THE CIRCUIT COURT OF THE 17TH JUDICIAL CIRCUIT IN AND FOR BROWARD
BARROW COUNTY SUPERIOR COURT STATE OF GEORGIA * * * * * * * * * * SUMMONS CASE NO.:
BARROW COUNTY SUPERIOR COURT SHELDON ALLEN Plaintiff, vs. MATTHEW BENNETT, Defendant. STATE OF GEORGIA SUMMONS JURY TRIAL DEMANDED CASE NO.: TO THE ABOVE NAMED DEFENDANT: You are hereby summoned and required
CLAIM FORM AND BODILY INJURY/WRONGFUL DEATH CLAIM QUESTIONNAIRE
CLAIM FORM AND BODILY INJURY/WRONGFUL DEATH CLAIM QUESTIONNAIRE Claimant s Name: Address: City/State: Attorney s Name: Firm: Address: Phone: City/State Phone: * Should you require additional space in responding
FULTON COUNTY STATE COURT STATE OF GEORGIA * * * * * * * * * *
FULTON COUNTY STATE COURT STATE OF GEORGIA JENNIFER GARRISON, vs. Plaintiff, MONTAG REALTY COMPANY, LLC d/b/a VERONA APARTMENTS, THE REALTY FUND III, L.P. and JOHN DOES 1-5, JURY TRIAL DEMANDED CASE NUMBER:
CLAIMS AGAINST TELEPHONE ANSWERING SERVICES: THE TRILOGY OF PREVENTION, HANDLING AND RESOLUTION PART TWO: WHAT TO DO WHEN A CLAIM HAPPENS
CLAIMS AGAINST TELEPHONE ANSWERING SERVICES: THE TRILOGY OF PREVENTION, HANDLING AND RESOLUTION PART TWO: WHAT TO DO WHEN A CLAIM HAPPENS Martin M. Ween, Esq. Partner Wilson, Elser, Moskowitz, Edelman
Claim notification form
Before filling in this form you are encouraged to seek independent legal advice. Date sent / / Claim notification form Low value personal injury claims in road traffic accidents( 1,000-10,000) Are you
Accident & Investigation Pack for Employers & Public Liability Injury Claims
Accident & Investigation Pack for Employers & Public Liability Injury Claims Guide to this Accident and Investigation Pack The 2013 Ministry of Justice (MOJ) reforms comprise a package of interlocking
FIRST JUDICIAL DISTRICT OF PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF PHILADELPHIA COUNTY
FIRST JUDICIAL DISTRICT OF PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF PHILADELPHIA COUNTY TRIAL DIVISION ADMINISTRATIVE DOCKET No. 2005-02 In re: Standard Interrogatories In Compulsory Arbitration Cases
IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF TEXAS AUSTIN DIVISION
IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF TEXAS AUSTIN DIVISION SHELTON CHARLES, Plaintiff, v. Civil Action No. A-06CA158LY TEXAS LOTTERY COMMISSION AND GARY GRIEF IN HIS INDIVIDUAL
POTENTIAL CLIENT INTAKE SHEET - PREMISES LIABILITY IMPORTANT
POTENTIAL CLIENT INTAKE SHEET - PREMISES LIABILITY Date: Lawyer: Date of Accident: I. CLIENT INFORMATION Client Name: First Middle Last Date of Birth: You would be preferred to be called (nickname): If
Steps to take after a fall in a public place
Steps to take after a fall in a public place Henry Carus + Associates 1 Contents 4 Common situations 8 What to do right away 10 Dealing with those responsible 11 Dealing with the responsible company s
Claim notification form
Before filling in this form you are encouraged to seek independent legal advice. Date sent / / Claim notification form Low value personal injury claims in road traffic accidents( 1,000-10,000) Are you
How To Apply For Legal Aid
CL 5 Supplementary Application Form General Negligence, Breach of Contract, Breach of Statutory Duty (excluding Tripping, Employer s Liability and Road Traffic cases) 1 April 2015 This document forms part
POTENTIAL CLIENT INTAKE SHEET - AUTO ACCIDENT IMPORTANT
POTENTIAL CLIENT INTAKE SHEET - AUTO ACCIDENT Date: Lawyer: Date of Accident: I. CLIENT INFORMATION Client Name: First Middle Last Date of Birth: You would be preferred to be called (nickname): Gender:
California General Interrogatories (Personal Injury) DEFINITIONS. 1. AREA means the name of the specific structure, building, building
California General Interrogatories (Personal Injury) DEFINITIONS 1. AREA means the name of the specific structure, building, building number, floor of the building, ship compartment, process line, unit,
THOMPSON, THOMPSON & GLANVILLE, PLC PERSONAL INJURY CLIENT INTERVIEW FORM BACKGROUND INFORMATION
THOMPSON, THOMPSON & GLANVILLE, PLC PERSONAL INJURY CLIENT INTERVIEW FORM Date: Referral Source: Atty: Legal Asst.: Office: BACKGROUND INFORMATION Full Name: First Middle Last Other names known by (including
How To Take Action In New Jersey
Garden State CLE 21 Winthrop Road Lawrenceville, New Jersey 08648 (609) 895-0046 fax- 609-895-1899 [email protected] Video Course Evaluation Form Attorney Name Atty ID number for Pennsylvania: Name of
MODEL JURY SELECTION QUESTIONS
MODEL JURY SELECTION QUESTIONS Standard Jury Voir Dire Civil [] 1. In order to be qualified under New Jersey law to serve on a jury, a person must have certain qualifying characteristics. A juror must
16 Steps to Getting a Fair Settlement for Your Injuries
The Petrylaw Personal Injury Reports 16 Steps to Getting a Fair Settlement for Your Injuries 1. Do not talk to anyone except your doctor, attorney or the police officer at the scene. Do not speak with
Claim notification form (Form RTA1)
Date sent / / Claim notification form (Form RTA1) Low value personal injury claims in road traffic accidents( 1,000-10,000) Before filling in this form you are encouraged to seek independent legal advice.
IN THE CIRCUIT COURT OF THE 99TH JUDICIAL CIRCUIT, IN AND FOR LEON COUNTY, FLORIDA. Plaintiff, vs. CASE NO: 12345
IN THE CIRCUIT COURT OF THE 99TH JUDICIAL CIRCUIT, IN AND FOR LEON COUNTY, FLORIDA PRETENDER BANK, N.A., AS TRUSTEE FOR STPFT 2005-XX, Plaintiff, vs. CASE NO: 12345 JOHN DOE, ET AL, Defendant. / DEFENDANT
WHAT YOU NEED TO KNOW ABOUT YOUR CAR WRECK CASE PAGE 1
WHAT YOU NEED TO KNOW ABOUT YOUR CAR WRECK CASE PAGE 1 GREENVILLE FOUNTAIN INN 330 East Coffee Street 218 South Main Street Greenville, South Carolina 29601 Fountain Inn, South Carolina 29644 (864) 601-9048
THE SALAZAR LAW FIRM, P.A. NEW CLIENT INFORMATION SHEET (PERSONAL INJURY MOTOR VEHICLE) PERSONAL INFORMATION:
THE SALAZAR LAW FIRM, P.A. NEW CLIENT INFORMATION SHEET (PERSONAL INJURY MOTOR VEHICLE) TODAY'S DATE PERSONAL INFORMATION: DATE OF ACCIDENT NAME HOME ADDRESS CITY STATE ZIP HOME TELEPHONE ( ) DATE OF BIRTH
Training for Supervisors
To arrange for this or any other Training for Supervisors course, or to ask about legal issues raised by the course materials, contact the Law Department Field Office that serves your office or facility.
Claims Reporting Procedure
Claims Reporting Procedure This document includes:- An introduction to the claims reporting process Your Belmont contacts The life of your claim A review of the Ministry of Justice Reforms Introduction
FARAH & FARAH RULES OF LAW
RULES OF LAW Injury Case Roadmap: The Legal Process for Personal Injury Cases BY EDDIE E. FARAH & CHARLIE E. FARAH, ATTORNEYS AT LAW ...insurance companies more and more are being run by bean counters,...
