Sample Pleading 1: Breach of Contract The following is a sample pleading for a very simple breach of contract case involving Paul Plaintiff and Doug Sample. In this case, Paul Plaintiff loaned $15,000 to Doug Sample, and the two had a written repayment contract. Features to notice: © There are 10 DOES listed as defendants listed in this case. These are unknown defendants, who are added by the Plaintiff in case someone else needs to be named in the lawsuit. « Ifthere are DOES listed in the Complaint, they MUST also be listed on the Summons. © Although paragraph CC-1(a) is not used in this complaint, the “Open Book Account” and “Account Stated” are often used by businesses. © Open Book Account: The Plaintiff's business keeps a ledger book (now usually electronic), and every customer has an account in the book or system (i.e. each customer has a paged or pages dedicated to his or her transactions, recording all purchases, payments, etc.), and within the last four years there was activity in the account by the customer, and that there is an amount owed. o Account Stated: The Plaintiff's business sends out monthly statements to customers, there is a means to contest the validity of the statement, and within the last four years a statement was received by the customer in which the amount claimed was on the statement, and the defendant customer did not contest the amount. ‘The final page on this Complaint is a “Verification” This is a ‘statement where someone with knowledge of the case affirms under penalty of perjury that the contents of the Complaint are true. Ifa complaint over $1,000 is verified, the defendant’s answer must specifically identify the portions of the complaint alleged to be untrue, and the Answer must also be verified.cM-010 THCY PANTY ITO RTTOROEY ra Ba Paul Plaintiff | | 123 Anystreet Sacramento, CA, 95814 rronens. 916-555-1212 aan. srtomnevror ganas In Pro Per SUPERIOR COURTOF CALEORNA, COUNTY OF Sacramento sreecrconess. 720 Ninth Street sane sooress 720 Ninth Street craw ai cove Sacramento, CA 95814 | seavcrinane CIVIL CASE NAME, Plaintiff v. Defendant COME CASE CHER SHEET | —— CompioxGase Designation | arcu tf Untimited GL) Limited Untied “GO Limited) counter yonder | | demanded demanded is Filéd with first appearance by defendant aia sxseous $25,000) $25,000 ortss|_" (Cal Rules of Curt re 4.402) ser: Items 1-6 below must be completed (See instructions on page 2) F1-Chask one Bax below forthe case type traf best desoribes this case: ‘to Tort Contract, Provaionaly Complex Chi Ligation Act (22) Seach of conathaany (06) (Gal Rules of Cour ules 340-3400) sine mooi (8) Re 740 calectore (03 ‘tue rade ropvation (03) eae oe ter calectons (8) onsireton deer 0) Coie EDD ners Insranee covers (18) Was ot (0) ; Str contac (7) Secures itgaton 26) iabests (08) Environment Ton tt (2 Product aby (24) es! Provarty trounce coverage calms aig fom he Medical malpractos (48) (Eminent domainiverse Se Other PUPDIWD (23) ‘condemnation (14) ere eee Nor-PUPONWD (Othe) Tort Wrong eiton (3) ‘yees at) pica orl rata Other rea property (26) Enforcement of Judgment Givers (8) Unit Dotanar CY erercemet of amen (2) Defamation (12) Commercial (31) Migcotaneous Chil Complaint Fraod 1) Rescontal (2) RICO (27) Ist propeny (19) age 8) ‘ther orp (a spectnd above) (62) ee ee dudiciat Review Miscelanoous Civil Petition see fore (6) Pate'sip and corporate goveranes (21) Employment Petton re iraion avers (11) Sine peton a specie’ above) (3) renal termination (96) ‘it mane (02) Other employment (8), ‘ther cll or (38) 2 Thecase Cis Eid wnot complex under rule 3400 ofthe Calforia Rules of Gout Ifthe case ls complex, mark the factors requitng exceptiona jusicel management a Large number of separately represented parties 4 8 Large number of witnesses ©. CC Extensive motion practice faising ificultor novet ©. CO Coordination vith relat actions pending in one or more courts issues that wil b time-consuming fo resove inotner counties, silos, or counties, orn a federl court c. (2) Substantial amount of documentary evidence | t. ‘Substantial postjudgment judicial supervision Remedies sought (check al that anpy): & Gal monetary b, LFronmonetary; declaratory ot injunctive relef c. CO punitive Number of causes of action (speci Tnscase Cis Tenet _aclass action suit If there are any own related cases, fle and serve a notice of related cas bate. 5/1/2008 Paul Plaintify agai RPT WHET — y A | NoTICE if + Plantif must fo this cover sheet wth te fst paper fle in the action or proceecing (except smal leis cases or cases fled dor the Probate Gove, Family Code, or Welfare and Intute Cods) (Cal. Rules of Cout, rule 3220) Faure to fle may resut in sanctions. «+ Fle this cover shect in action to any cover shest requied by focal cout rule 5 iris caves comply under rus 3.400 et seq ofthe Calfomla Rulaeof Court, you must serve a copy otis cover sheet on al ‘ther partie tothe action o proceeding «Unies is aa eotectone case under flo 3.740 ora complex caso, this cover sheet wl be used for statistical purposes ony. pone E a loupe SE <5 mans _ CIVIL CASE COVER SHEET ah a ED See ee 2 thas a shies!_SUM-100 SUMMONS Fon counruaeowy— (CITACION JUDICIAL) «solo rata ito o€ ta Comme) NOTICE TO DEFENDANT: (AVISO AL DEMANDADO) : Doug Defendant; and DOES 1 to 10 YOU ARE BEING SUED BY PLAINTIFI (LO ESTA DEMANDANDO EL DEMANDANTE) : Paul Plaintiff ‘You have 30 CALENDAR DAYS alter this summons and legal papers are sorved on you to fla a written respon copy served on the plaintt, A letter or phone call wll ot protect you. Your writen response must be in proper legal form Ifyou want the ‘court to hear your ease, There may be a court form that you can use for our response, You can fin these court forms and more information a the California Courts Online Self-Help Center (www.courtinfo.ca.goviseltheip, your county law library or the courthouse nearest you. I you cannot pay the fling fe, agk tie court clerk fora fee waiver form, if you do not fle your respones on timo, you may lose the ease by default, and your wages, money, and property may be taken without further warning from the court. “There are other legal requirements. You may want to call an atiomey right away. If you do not know an attorney, you may want to call an attorney referral service. you cannot aford an attornay, you may be eligible for free legal services from a nonprofit iogal services program. You can locate these nonprofit groups at the California Legal Services Web site (www lawholpeaiforna.org, the California | courts Onine SeitHtp Contr (wovw.courtinfo.a.goveolvalp), or by contacting your loca court or county bar association Tlene 30 DIAS DE CALENDARIO después da que le entreguen esta citacién y papoles legales para presentar una respuesta por escrito cen asta corte y hacer que se entregue una copia al demandante. Una carta 0 una llamada felefOnica no lo protegen. Su respuesta por ‘eerito tiene que estar en formato legal correcto i desea que procesen su caso on fa corte, Es posible que haya un formulario que usted pueda usar para au respuesta. Puede encontrar estos formularies de fa corte y mds informacién en el Centro de Ayuda de las Cortes de ‘Caltforna (www. courtinto.ca.gov'sehelplespanol), en fa biblioteca do leyes de su condado © en la corte que le quede mis cerca. Sino puede pagar la cuota de presentacién, pida al secretaro de fa corte que fe dé un formularo de exencién de pago de cuotas. Sino presenta ‘5u respuesta a tiempo, puede perder el caso por incumplimionto y la corte le podré quitar su suelo, dinaro y blanes sin més advertoncia. Hay otros requlsitos legals. Es recomendable que lame a un abogado inmediatamonte. S/o conces @ un abogado, puede lamar a un ‘servicio de remision a abogados, S1no puede pagar a un abogada, es posible que cumpla con los requisitos para obtener servicios | Jegales gratultos de un programa de servicios lagaes sn fines de lucro, Puede encontrar astos grupos sin fines de lucro en al sitio web de California Legal Services, (www lawhelpcalifornia.org), en el Canto de Ayude de las Cortes de California, | new ourtnfaca.gameaavespanol) o ponindose an contacto can la core ool colete de abogados locales. ‘The name and address ofthe court is CASE NER (El nombre y direccion de la corte es) er i Co ‘Sacramento County Superior Court Civil 720 Ninth Street Sacramento, CA 95814 ‘The name, address, and telephone number of plant's attorney, or plant without an attorney, is (EI nombre, Ia dreccién y @! némero do telsfono del abogado de! demandante, o del demandente que no tisne abogado, es) Paul Plaintiff 123 Anystreet Sacramento, CA 95814 916-555-1212 DATE: Clerk, by Deputy (Focha) (Seorslaro) (Adjunto) (For proof of service of fis summons, use Proof oF Service oF Summons (farm POS-O10).) {Para prusba de entrega de esta otatiin use o formutrio Proof of Service of Summons, (POS-010). —_——— NOTICE TO THE PERSON SERVED: You are served 4, Ql) as an individual defendant. 2, Chas the person sued under the fttous name of (specty) 3. CDontohat of (speci): | under: E] COP 416.10 (corporation) cee sigan inten © cee 416 20 (tetunct corporation) CGP 446.70 (conservatee) cep «16.40 (association or partnership) GP 416.90 (authorized person) 1B othr ‘spooiny 4. CA by personal detivery on (date) fgets ‘SUMMONS Code oa Fans W220 5 ‘SeatalEenet atta Re engos ‘ane ___ptp-c-00t Paul Plaintift 123 Anystreet Sacramento, CA 95814 reterenc na, 916-555-1212 PK ened unt a02R#89 | aromev ror iies_In Pro Per esaeueeeae ‘SUPERIOR COURT OF CALIFORNIA, COUNTY OF Sacramento sweccranonese, 720 Ninth Street unc seonese. 720 Ninth Street crrmozecose. Sacramento, CA 95814 eanownave Civil PlaintiFF: Paul Plainél perenpant: Doug Defendant [igor oie | GONTRACT Dl compat CCLAMENDED COMPLAINT (Numbor : | (Ci cross.compLaInt — (] AMENDED CROSS-COMPLAINT (Number) = | “Turisdiction (check all that apply) = eae {SD ACTION Is A LIMITED CIVIL CASE Amount demanded (_} does not exceed $10,000 [exceeds $10,000 but does not exceed $25,000 | [GI AcTION IS AN UNLIMITED CIVIL CASE (exceeds $25,000) Ti AcTION is RECLASSIFIED by this amended complaint or eross-complaint fron timited to untimited from untimited to timited \ 1 Plaintifh namo ornames): Paul PlaintifT alleges causes of action againstdefendant® (name or names): Doug Defendant; and DOES | to 10 2. This pleasing, including attachments and exhibits, consist o the following number of pages: 2. a. Each plantffnemed above is @ competent adut CD except piaintitt (name) (2) El a corporation qualifd to do business In California (2) Can unincorporated entity (describe) (2) Eo other (spect) b, COD Plaintit (name) [oD has complied withthe fctiious business name laws and is doing business under the tious name (specify) . (has complied with al licensing requirements as a licensed(speoiy) ‘c. CO) Information about additonal plaintits who aro not competent adults is shown in Attachment do. 4. a. Each defendant named above is a natural person {except defendant (name) (2 except defendant (name) (1) (a business organization, form unknown (1) (DI a business organization, form unknown ne (2) Bh acomoration (2) C2 an unincorporated entity (desorbe) @) © anunincorporetes entity (desarbe). 44) Ca public entity (descnbe) (4) (A a public entity (describe) (8) CA other éspecity) ©) Dotter (speciy) “Yussemisuedasecesconnrt sei ars uecoreert eer ee oes eed SEES, Biante Cain pamtom 652 COMPLAINT - Contract_ PLD-C-001 SHORT TE poms Plaintiff v, Defendant 4, (Continued) b. The true names of defendants sued as Does are unknown to plaintiff. (1) GED Doe defendants (spectty Doe numbers): Lin S_____were the agents or employees of the named defendants and acted within the scope ofthat agency or employment. (2) (Q) Doe defendants /specity Doe numbers): 61010 _are persons whose capacities are unknown to. plaintf. (Ql Information about edditional defendants who are not natural persons is contained in Attachment 4. &. © Defendants who are joined under Code of Civil Procedure section 382 are names) 5. (2) Plaintiff is required to comply with a claims statute, and 2. Eo) has complied with applicable claims statutes, or b, () is excused from complying because (specify) 6. (Cl This actions subjectto CE civil Code section 1812.10 CT) Civil Code section 2964.4 7. This courts the proper court because [1 a defendant entered into the contract here. [) 2 cefendant ied nere when the contract was entered into. TD a cofendant ives here now. (Dd the contract was to be performed here Cl a defendants @ corporation or unincorporated association and its principal place of business is here By real property thats the subject ofthis action I located here other ¢specity) 8, The folowing causes of action are attaches and the statements above apply to each (each complaint must have one or more causes of action atteched) {A Breach of Contract [I common Counts Totter (spect 8, 2 Other allegations: 410, Plaintf prays for judgment for costs of sit for such eit asi far, just, end equtabe; and for a. [Ed damages of: $ 15,000.00 Gib interest onthe damagés (1) C2) according to proof (2) Qdatthe rate of (specify): 10 percent per year from (date): June 15, 2007 c. CQ) attomey's fees oO) Chors (2) CQ according to proof. dC) other (specify) Date: 5/1/2008 Paul Plaintiff TERR PRR WAT (it you wish to vey this pleading, aff a venfioatin.) COMPLAINT - Contract Pore poate mara lisencePLD-C-001(1) Plaintiff v. Defendant First___________ CAUSE OF ACTION-Breach of Contract ATTACHMENT TO GQ) Complaint (2) Cross-Complaint (Use a soparate cause of action form for each cause of action ) BC-1, Plaintif(namey: Paul Plaintiff alleges that on or about (date). May 15, 2007 2G writen CQ ovat C2 other (specity ‘agreement was made between (name parties fo agreement. Paul Plaintiff, Doug Defendant, DOES 1 to 10 [A copy of the agreement is attached as Exhibit A, or (Co The essential terms of the agreement Care stated in Attachment BC-1 (C) are as follows (specify) BC-2. On or about (datos): June 15, 2007 defendent breached the agreement ey (C) the acts specified in Attachment BC-2 QE the folowing acts (specify) Doug Defendant failed to make his first monthly payment of $1,067.96, and has failed to render any payment to Paul Plaintiff, despite demand for payment. BC-3, Plaintif has performed all obligations to defendant except those obligations plaintiff was prevented or excused from performing, C-4, Plainti sufered damages legally (proximately) caused by defendant’ breach of the agreement (Co es states in Attachment 80-4 QQ) as folows (specify: Paul Plaintiff has loaned $15,000 to Doug Defendant, and is now owed $15,000 plus interest at 10% annually, from June 15, 2007 8C-5.(C) Plaititisenttlod o atomney fees by an agreement or a statute Qas according to proot 80-6. Other “Form apres; Canalo ee CAUSE OF ACTION. Breach of Contract coors (2 Es Faa PLD-C-001(2) GASE NUMBER: SHORT TLE Plaintiff v. Defendant Second.., _ CAUSE OF ACTION-Common Counts ATTACHMENTTO [&J.Complaint (Use e seperate cause of ation form fr each cause of con) 2 crose-complaint CoH, Pleintit (namo): Paul Plaintiff alleges that defendant (name): Doug Defendant; DOES 1 to 10 became incebted to [EX plainstt CA other (name) a. CA witin the lat four years (1) Calon an open book account for money due. @) Cl because an account was stated In writing by and between plaintif and defendant in which it was agreed that defendant was indebted to plant, b. CED withintre last CQ two years EE fouryears (1) CQ for money had and received by defendant for the use and benefit of paint. (2) Cor work, tabor, services and materials rendered atthe special instance and request of defendant and for which defendant promised to pay piaintif CO the sum of s 1 tre reasonable value 2) Tor goods, wares, and merchandise sold and delivered to defendant and for which defendant promised to pay plant Ci the sum ofS Ditte reasonable valve (4) (for money lent by plant to defendant at defendants request. 15) CO for money paid, laid out, and expended to or for defendant at defendant's special instance and request 6) CD other (specify 15,000.00 , whichis the reasonable value, is due and unpald despite plant's demand, coz. 8 percent per year plus prejudgmentinterest () according to proof (XQ atthe rate of 10.00 fiom (date}: June 15, 2007 60-3.) Plainiffis entities to attomey fees by an agreement ora statute Qrots DB according to proot. cc-4. OQ) other Pago 4 ‘Saar Suitconeria CAUSE OF ACTION-Common Counts Ce et eNOEXHIBIT APERSONAL LOAN ‘This is an agreement for a personal loan to be issued by Paul Plaintiff, and to be repaid by Doug Defendant. Paul Plaintiff and Doug Defendant agree to the following: Paul Plaintiff will loan to Doug Defendant $15,000.00 by cashier's check. . This loan shall accrue interest at a rate of 10% annually. 3. Doug Defendant agrees to repay Paul Plaintiff by making 15 monthly payments of $1,067.96 beginning on Junc 15, 2007, and each 15" of the month until paid in full, 4. Inthe event that Doug Defendant fails to make his payment within thirty days of its due date, Paul Plaintiff shall be entitled to repayment of the entire outstanding balance, upon demand. Re Dated: May 1, 2007VERIFICATION 1, Paul Plaintiff, have read the foregoing Complaint-Contract, and know its contents. am a party to this action. ‘The matters stated in the foregoing document are true of my own knowiedge except as to those matters which are stated on information and belief, and as to those matters | believe them to be true, ___ declare under penalty of perjury under the laws of the State of California that the : foregoing is true and correct. Paul PlaintiffSample Pleading 2: Motor Vehicle Accident The following is a sample pleading for a simple motor vehicle accident property damage/personal injury case involving Paul Plaintiff and Doug Sample. Features to notice: ‘© ‘The forms for filing a motor vehicle case are very simple. The purpose of the Complaint is simply to notify the defendant what he or she is being sued for, and the basic factual elements alleged that would constitute a cause of action. © The damages on the Complaint are “according to proof.” Because the complaint does not (and cannot) spell out the amount of damages that are being sought, the Plaintiff must provide notice of the damages to the Defendant, so the maximum requested damages are provided to .¢ Defendant on a Statement of Damages form. This form is not initially filed with the court. ‘Please note that pain and suffering damages cannot be awarded in motor vehicle accidents where the recovering plaintiff driver was not insured at the time of the accident.cm.nt9 Paul Plaintiff 123 Anystreet, Sacramento, CA 95814 TeLSHOW= NO: 916-555-1212 reevo. srronwer ror nen Pro Per SUPERIOR COURT OF GaUFORWA, counTy oF Sacramento srr scones 720 Ninth Street snag roess 720 Ninth Street arya zecoe Sacramento, CA. 95814 eacnne CHV CASE NAME. T laintiff v. Defendant CIVIL CASE COVER SHEET ‘Complex Case Designation —_ | casenwnoe a Co eee ee counter Cl Joinder E Gomended __demandedis | Filed wih fret appearance by defendant | “OE Secoete $25 000) $25.00 less] (a Rules of Court rule 2402) oer :| “toms 1-6 below must be completed (see instructions on page 2) 7. Cheekcone Box balow Tote Gave type that best descrives this case’ Auto Tort, Contract Provisionally Complex Civil Litigation ‘to (22) reach of contrac:iwarranty (08) (Gal. Rules of Court, rules 3400-3403) Unineures meterist 8) ule 3.740 oollectons (08) ‘AntrusTrece reguision (03) ner oalections( CConetrucion detest (10) Other PUPOIWD (Personal InjuryProperty fread Seana ames eer Poste a Other contract (37) Secures Itigation (28) paorerevet Environmental Toxic tr (90) recat neoay 24) en Insurance coverege caine atsing rom he Maciel ralpractoe (45) Eminent domaivinverse aaa eee a Otner PUPDIND (23), ccndomation (14) . ml ‘Wrongful eviton (83) types (at) ther real property (28) Enforcement of Judgment Enforcement of judgment (20) Nor-PUPDIWD (Other) Tort ‘Business torn business practice (07) Cra att (0) ‘nwt Detainee ural (8) Commer Iiscolancous Cv ompaint Pass) feooetal 2) acoeh Itesua ooty 1) ore 8) Eire sant speci eboe) 2 detcagaenipetas tips Judicial Review ‘Miscellaneous Civil Petition } } et oe ee) ‘Asset forfeiture (05) Partnership and corporate governance (21) Employment Fetaunre ataton ewes (it) ED one: petton at poses tov) 6) G "Wren terrinatin (9) tof mares (2) Ober ampere (8) Cer el re 9) 2 Thscase [ED CE) rat conpoxundor alo 3400 of the Cafomia Rulos of Court the cat is complex, mark he Foote tequite excepona fall management SES Taige umber efsoparatcly repeseried pares 4. (5) Large numberof winesses 8 A Eigen ineson lacie asng atoutor novel &. EA) Gostdnaton vith elated aclons pening in one or more cout isouee Vt wi bo une-coneuring fo resowe (rather suns” cate, eranune. ora federal cout c. Cy Substantial amount of documentary evidence 3 ‘Substantial postjudgment judicial supervision Romedies sought. (check al that apply); a. monetary b. Cnonmonetary; declaratory or injunctive relist c. CY punitive Number of causes of action (specify): Triscase Lis Isnot_ a class action sult. Itthere are any Kriown celated cases, Mle and serve a notice of related Bate: 5/1/2008 { NOTICE «Plant must le this over sheet wth the fst paper flint acon o proceeding (xc9pt smal aims cases or cases fled Coto Probate Code, Farly Code, o Welare and nstitons Cage) (al Rules of Cou, rife 3220) Faure to le may rest Imsanctons «+ Fie fis cover sheetin aston to any cover sheet requires by local cout le {fetus cave le compo urdor lo 3400 ot sa ofthe alfa Rules of Cou, you must sere copy af this cover sheet onal bie parses the acon or procaesing « Unet tis w acslocions cave unde le 2.740 or @ complex case, this cover sheet wl be used for latstical puposes only SpE cy ene GIVIL CASE COVER SHEET Gea, TP SSSR” arte ee See aE_suM-100 SUMMONS “FOR COURT UBE ONLY (CITACION JUDICIAL) csol@irina tao tA connm NOTICE TO DEFENDAN (AVISO AL DEMANDADO) : Doug Defendant; and DOES | to 10 YOU ARE BEING SUED BY PLAINTIFF: (LO ESTA DEMANDANDO EL DEMANDANTE) Paul Plaintiff You have 30 CALENDAR DAYS after this summons and legal papers are carved on you to file awrittn response at thie court and have a ‘copy served on the plant, A letter or phone eal will not protect you. Your writen response must be in proper ogal form if you want the ‘courtto hear your case, There may be a court form that you can use for your response. You can find these court forms and more Information at the California Courts Online Sei-elp Center (www.courtinfo.ca.govleelfhelp), your county law library, orthe courthouse nearest you. Ifyou cannot pay the fling fee, ask the court clerk fora feo waiver form. Ifyou do not file your response om time, you may lose the case by default, and your wages, money, and property may be taken without further warning from the court. “There aro other legal requirements. You may want to call an attomey right away. Ifyou do not know an attorney, you may want to call an attorney referral service you cannot afford an attorney, you may be eligible fr free legal services from a nonprofit legal srvices: program. You can locate these nonprofit groups atthe California Legal Services Web site (ww Jawholpealfornia.org), the Califor Courts Online Sett-Help Center {www.courinf.ca.govieelelp), or by contacting your local court or county bar association. Tiane 20 DIAS DE CALENDARIO después de que le etreguen esta citecion y papeles legales para presentar una respuesta por escrito en esta corte y hacer que se entregue una copia al demandante. Una carta © uns lamada telefonica nolo protogen. Su respuesta por escrito tne que estar en formato legal correcto sf desea que procoson su caso en fa corte, Es posible que haya un formutario que usted ‘puede usar para su reepuesta. Puode encontrar estos formularios dela corte y més informacién en el Cantro de Ayuda de tas Cortes de California (www. courtnfo.ca.govrselthelp/espanol), en fa biblioteca de leyes de su condado 0 en la corte que le quede ms cares. Sino puede pagar la cuota de presentacién, pida al secretarfo de la corte que e dé un formulario de exencién de pago de cuotas. Sino presenta ‘Su respuesta a tiempo, puede parder el azo por Incumplimiente y la corte le pedra quitar su euctdo, dinero y blenes sin mds advertencia. Hay otros requisites legales. Es recomendable que lame a un abogado Inmedlataments. Sino conoce a un abogado, puede lamar @ un servicio de remision 2 abogados. Sino puede pagar 9 un abogado, es posible que cumpla con los requisitos para obtener serviclos Jegales gratuites do un programa de servicios legales sin fines de Iucro, Puede encontrar estos grupos sin fos do lucre en al sitio web de California Lagat Services, (www lawholpcalfernia.org), en el Centro de Ayuda de las Cortes de California, (www.courtinfo.ca.gov/selhelplespanol) 0 poniéndose an contacto con ia corte oe! coleglo de abogados locales. ‘Tho name and adress of the courts eee | (El nombre y direcotén de la corto os) tir Ca i Sacramento County Superior Court Civil 720 Ninth Street Sacramento, CA 95814 ‘The name, address, and telephone number of plaints attomey, or plant without an attorney, i (Ei nombre, 1a diroccién y of ndmero de teléfono del abogao del demandante, o del demandante que no tiene abogado, 28) Paul Plaintiff 123 Anystreet Sacramento, CA 95814 916-555-1212 DATE: ter, by _ : Deputy (Fecha) (Seorearo) aajunto) (For proof al sonics oF his sanimons, Use Praot of Sewice of Summons form POS-OTO)) (Para prueba de entrega de este otatién use el formulario Proof of Service of Summons, (POS-010)) op —_ NOTICE TO THE PERSON SERVED: You ate served ea 1 a ‘26 an individual defendant 2. Clas the person sued under the fttious name of (specify) | 3. CA on behat of specity) Under: ‘CCP 416.10 (corporation) cor 41660 (minon ‘GGP 41620 (detunct corporation) GP 416.70 (conservatoo) (Fcc 416.40 (association or partnership) CP 446 80 (authorized person) TO otter speci 4. Cad by personal detvary on fate) meee SUMMONS Ta aC eava a. sa PLD-PI-001 ‘ATTORNEY OF PARTY TOUT ATTORNEY hn Sa Bara ans aas) FoR COURT USE OMY Paul PlaintifT 123 Anystreet, Sacramento, CA_ 95814 | veagorone no: 916-555-1212 [FAX NO {Options a cone ete arromevronare: In Pro Per SUPERIOR COURT OF CALIFORNIA, COUNTY OF Sacramento -smrect «ooress; 720 Ninth Street mun roomess. 720 Ninth Street crvanaze coor: Sacramento, CA 95814 aronc nave Civil —PIANTF: Paul Plain : \ oereNoant: Doug Defendant | (1 boes 170 10 (AMENDED (Number): ‘Type (chock all that apply) QQ motor veHicLe —C) OTHER (specity): Property Damage ) Wrongful Death Personal injury (Other Damages (spocity) ‘Turisdiction (chock all that apply) = NOME (2 AcTiON Is A LIMITED CIVIL CASE Amount demanded [does not exceed $10,000 | (exceeds $10,000, but does not exceed $25,000 (QD ACTION IS AN UNLIMITED CIVIL CASE (exceeds $25,000) (d ACTION Is RECLASSIFIED by this amended complaint 2 from timited to unlimited Fi trom untimited to limited 4, Plaintiff (name or names): Paul Plaintiff alleges causes of action against defendant name or names): Doug Defendant 2. This pleading, including attachments and exhibits, consists ofthe following number of peges: 4 3. Each plainttf named above is « competent acut 2, CA except plant name) (1) Ca 2 corporation qualifies to do business in Callornia (2) GD an unincorporated entity cescrive) 2) 2 public entity describe) (4) aminor Ci) an aduit (2) Co) tor whom a guardian or conservator ofthe estat or @ guardian ad item has been appointed ©) OD other (speci (9D other (speci) ». CO except pint name) (1) CA a corporation qualified to do business in California (2) EA an unincorporated entity (describe) (6) Eo a public entity (describe) @) Ch aminor CQ anadut {@) CO for whom a quardian or conservator ofthe estate or @ quardian ad item has been appointed (b) CY other (specify) (0 other (sp0city [information about additional plaints who are not competent adults is shown in Attachment 3 ee ‘COMPLAINT-Personal injury, Property SasCntomtan 5a Damage, Wrongful Death a iSpiahr it Seam to) SATPLD-PLoOt SHORTTTIE “OASE NUMBER: Plaintiff v. Defendant _ Phan (ame) is doing business under the Rtiious name (specify) ‘and has complied with the fictious business name laws. 5. Each defendant named above isa natural person 2, CA except defendant (name) «. (2 except defendant rare) (1) 1 a business organtzation, frm unknown (1) 2 a business organization, form unknown (2) CY acorporation (2) LQ a corporation ) © an unincorporated entity (describe) (3) © an unincorporated entity (describe) (4) CD a pubic entity (describe) (4) C2 a publ entity (descrbo) (8) CD other (speci) (8) Dotner speci b. Ch except efensiant (name) 6, Ci excopt defendant (narre) (1) C2 abusiness organization, form unknown (1) Da tusiness organization, form unknown (2) Gh acorporation 2) Cha comoration (3) Cl an unincorporated entity (describe) (3) Tax unincorporated entity (describe) (4) CA apubiic entity (descrbe) (4) Ca pubiic entity (describe) (8) Ci other (specityy (8) Clother fspecity (C2 information about adkitfonal defendants who are not natural persons is contained in Attachment 8 6, The true names of defendants sued 2s Does are unknown to plait. &. C2 Doe defendants (specify Doe numbers). ‘were the agents or employees of other named defendants and acted within the Scope of that agency or employment. b. QE ce defendants epectty Doe numbers). 1 10 10, are persons whose capacities are unknown to plains. 7. (2 Defendants who are joined under Code of Civil Procedure section 382 are/names): 8. This courts the proper court because a. [Eat least one defendent now resides ints jriscictional area, &. C2] the principal place of business ofa defendant corporation or unincorporated association sin its juristictonal area. c. GE inury to person or damage to personal property occured in its jureaictional area 4. Ch other (spect 9. C2 Plzinttfis required to comply with a claims statute, and 2 Lay has complied with applicable claims statutes, or b. C2 is excused from complying because (speci) Fb pacifies awe Bia ‘COMPLAINT-Personal Injury, Proporty Paes Damago, Wrongful Death[ SHORTINTE case na : 1 | Plaintiff v. Defendant | 410. The following causes of action are attached and the statements above apply to each (esch complaint must have one or more ‘causas of action attached) TED Motor vehicle (21 General Negligence © iatentional Tort (1 Products Liabiity Promises Liabiity © other (specity) apaoge 411, Plant hes sufered wage loss 1 oss of use of property [Ey hospital and medical expenses [ED general damase (A) property damage 7 oss of earning capacity TF otrer damage (speciy) (1 sted in Attachment 12. Dias totiows: 42. (2d The damages claimed for wrongful death and the relationships of plaintifo the deceased are 2 b 419. The relief sought in this compiaint is within the jurisdiction of this court 414 Plaintif prays for judgment fr costs of sult for such reli as is far, just, and equitable; and for a. (1) (El compensatory damages (2) punitive damages “The amount of damages is casos for personal injury or wrongful death, you must check (1) (1) BQ) according to proof (2) inthe amount of $ 48. [Od The paragraphs ofthis complaint alleges on information and belief are as follows (speciy paragraph numbers) Date: 5/1/2008 Paul Plaintiff = > THEORET IONE) Eau: Dpto er lana 1207 ‘COMPLAINT-Personal injury, Property eect ‘ean Damage: Wrongful Death 2m ee_ i PLD-PLO04(1 | ShorrTme ‘CASE NUMBER, Plaintiff v. Defendant HiDSt_omgey ——-._ CAUSE OF ACTION- Motor Vehicle ATTACHMENT TO LL Complaint (2 Gross-Compiaint (Uso 2 separate cause of scion form for each cause of action) Plains (nome): Paul Plaintiff MV-1, Plaintif alleges the acts of defendants were negigent; the. acts were the legal (proximate) cause of injuries ‘and damages fo plaintif; the acts occurred on (date: June 18, 2007 at place): Interstate 80 Eastbound 200 feet west of Northgate exit. MV-2. DEFENDANTS 2. TE) The defendants who operated a motor vehicle ate names): Doug Defendant I dees 1____ wo 10.__ »b. (XD The defendants who employed the persons who operated a motor vehicle in the course of thelr employment ate (names}: Wi dves 1 to 10 «¢ (El The defendants who owned the motor vehicle which was operated with their permission are(names} Doug Defendant [I Does 10 4. LZ] The defendants who entusted the motor vehicle ae names) does blo [El The defendants who were the agents and employees ofthe other defendants and acted within the scope of the agency were (names): [I does to 10 ay . CA The defendants who are iablo to plaints for other reasons and the reasons forth lability are 1 tisted in attachment mv.2t LA} as fotows: O bees Page 4__ Ea ‘CAUSE OF ACTION - Motor Vehicle co (2) isa faacwv-050 = DO NOT FILE WITH THE COURT - - UNLESS YOU ARE APPLYING FOR A DEFAULT JUDGMENT UNDER CODE OF CIVIL PROCEDURE § 585 - ATTORNEY OR PARTY WETGUT ATTORNEY Peo Teuerronena: | Por counr use ony ie 916-555-1212 | Paul Plaintiff 123 Anystreet Sacramento, CA 95814 arronvey on sm: In Pro Per ‘SUPERIOR COURT OF CALIFORNIA, COUNTY OF Sacramento smeerranoness: 720 Ninth Street sauna socness 720 Ninth Street ervannze coor Sacramento, CA 95814 seanon aut Civil PLAINTIFF Paul Plaintiff? ocrenpantDoug Defendant . ‘STATEMENT OF DAMAGES Pe {Personal injury or Wrongful Death) ‘To (name of one defendant only): Doug Defendant Pint (oame of one plaintif only): Paul Plat seeks damages inthe above-entiled action, a flows: 4. General damages AMOUNT a. EE) Pain, sutering, and inconvenience 3___250,000.00. ».) Emotonal sistress se ©. Loss of consortium ‘ gpaeste uence ete 4. Loss of society and companionship (wrongful death actions ony) $ ©. C0 other (speci) ig eee tC otter (speci) $ 4. Continued on Attachment 1.9 2. Special damages 2. [EJ Medical expenses (to date) $—_9,452.86 . CE Future medical expenses (present value) $25,000.00. ©. ED Loss of earnings (to date) $___35,897.42. 6, [ED Loss of future earning capacity (present value) $_____35,000.00. @. ED Property damage... a 8,700.00. £. CO) Funeral expenses (wrongful death actions ony). gece 9. 2) Future contrbtions (resent value) (wrongful death actions only) 8 eaaaie 1h.) Value of personel service, aves, o training fwronoful death actions only) ge renee 1 CD other repecty - geese 4 CD otner ispo0i99 s—___ (2) Continued on Attachment 2. 2. C2 Punitive damages: Pisntif reserves the right to seck punitive dam ‘when pursuing a judgment inthe sut fled against you Dete: May 1, 2008 Pan! Plaintiff sina! (Prost of service on reverse) aoe ‘STATEMENT OF DAMAGES Caton lbs ciiast oles (Personal Injury or Wrongful Death) ST FSciv.050 PLAINTIFF: Paul Praintilt aR ] [ DEFENDANT-Doug Defendant PROOF OF SERVICE (Atter having the other paity served as described below, with any of the documents identified in tem 1, have the person who served the documents complete this Proof of Service. Pleintif cannot serve these papers.) 4. Tserved the a.) Statement of Damages (Q) Other (speciy) b. on (name) &, byserving (CQ) defendant [] other (name and tite or relationship fo person served) 4. by davery — Ch athome 2 at ousiness (1) date: (2) ine (2 adcess ©. by maiing (8) date: (2) place 2. Manner of sence (check propor box) 2. C2 Persona service By personally delvarng copies. (C0? § 415.10) 5 El Substituted service on corporation, unincorporated association (including partnership), oF public entity. By leaving, during usvel office hours, copies in the office of the perscn served with the person who apparently was in charge and thereafter maiing (by frstclass rai, postage prepaid) copies to the person served atthe Place where the copies were le. (CCP § 415 2040) «c. C2) Substituted sorvice on natural person, minor, conservatee, oF candidate. By leaving copies at he dwelng house, usual lace of abode, or ustal place of business ofthe persan served in the presence of @ competent member af the household or person spparenty in charge of the ofce or place of business, at least 1B years of age, who was informed of the general nalure of the papers, and thereater mailing (by fs-lass mel, postage prepaid) copes tothe peteon served al the place where the copies were lef. (CCP § 416.20 (0) (Attach separate declaration or afidavit Stating acts relied on to establish reasonable diigenc in first attempting personal service) 4. Mail and acknowledgment service. By mating (by first-class mail or airmail, postage prepaid) copies fo the person served, together with two copies of the form of notice and acknowedgment and a retum envelope, postage preps, addressed tothe sender, (CCP § 418.20) (Attach completed acknowledgmont of receipt) ©. Conttiod oF rogistorod mail service. 8y mailing fo an address outside Calfomia (by first-class mai, postage prepaid requitng a return receipt) copies to the person served. (CCP § 416.40) (Attach signed return receipt or other evidence of actual delivery to the porson served.) t. C2 omer (peat code section) () aceitionai page is attached, the time of service | was at lest 18 years of age and nota paty fo this action 4, Fee for service: $ 5. Person serving: 2 C2) California sherif, marshal, or constable Name, address, and telephone number and, if applicable, b. © Registered Calitomia process server ‘county of registration and number: © Employee or independent contractor ofa registered Califia process server d. CO) Nota registered Califomia process server 2. (2) Exempt from registration under Bus. & Prof. Code 6223806), | declare under penal of pay under he tau of he State (For Cattornia short, marshal orconstabo uso only) of Calfrria tat the forgoing sean cet "erty that he oegang tue ane corest Date bat Psessesieeenets = aa eee rd i i a usa enor Of Genie cod euranan ens AT? STL FA (Statement of Damages)Sample Pleading 3: Premises Liability ‘The following is a sample pleading for a simple premises liability case. Paul Plaintiff is the customer in a shop, and Doug Defendant is the sole proprietor of the shop, Happy-Smiley-Mart. Features to notice: © Doug Defendant, a sole proprietor, is sued himself, and dba his business. ¢ The Cause of Action- Premises liability requires more detail than the motor vehicle cause of action. This is so the person being sued knows why he or she is being sued. The Statement of Damages is not initially filed with the Complaintoe Paul Plaintiff 123 Anystreet Sacramento, CA 95814 “exemioxe no; 916-555-1212 aa: srtomvey ron ares In Pro Per “SUPERIOR COURT OF CAUFORNA. CouNTY or Sacramento suneer vores: 720 Ninth Street rune acoreas 720 Ninth Strect cmyainae cove Sacramento, CA 95814 means wane: Civil CASE NAwE: Plaintiff v. Defendant | ee CASE or ‘SHEET | ‘Complex Case Designation ose Nae | Unlimited CL Limited (amount (Amount Oe reteeeeeae Gehanded demanded is_| Filed wih fst appearance by defendant | * ‘Sxcoeds $25,000) $25,000 orless)| (Cal Rules of Court, rule 3.402) ser items 1-6 below must be comploted (see instructions on page 2). 7 Cheek on BOX BOIGW for The Case iype tial best describes ths case: Saerirowt prcccimaneromy — Ep omciens aaa pepsin ea pa oe fey Ea Popey ean Neda! malas (4) CE Eine soneivinverse nore verageclsimo ang fo (Oiher PYPDAWD (23) ‘condemnation (14) ere ee ‘Wrongful eviion (93) pes (ter real property (26) Enforcement of Judgmont | | Rex-brParwo (tne tort CY Enforcement of judgment (20) ‘Business fordunfar bsiness practice (07) ‘vt right (08) Unlawful Detainor Defamation (13) Commercial (1) Migcollancous Civil Complaint Fraud (16) Rescential (32) Reon Intellectual property (19) Drags (38) Cher complaint (nt specified above) (42) Professional wegigence (25) dca Review Miscellaneous Civ Patition ‘Other non-PUPGIWD tort (38) “Asset forfeiture (05) Partnership and corporate governance (21) Employment Peto et arizaton award (1) Othe petton ot speared ove) (43) "Wrongful teranation (25) ‘it f mandate (2) Other employment (15) ther doa review (98) Zo thiscase TED CR wrot complex under rule 3.400 ofthe California Rules of Court. If the case is complex, mark the factors requrtng exceptional judicial management. oP Tage numberof separately represented pares d. (7) Large umbor of witnesses Fy eae oton practice raising dificult or novel ©. CJ Goorination ith related actions pending in one or more courts issues that willbe time-consuming to resolve in other counties, states, ot countnes, orn a federal court c, (2) Substantial amount of documentary evidence ie ‘Substantial postjudgment judicial supervision 3, Renbtles sought. (ehock al that ppiy)" 2. (monetary b. CYmonmonetary; declaratory or injunctive relief. CY punitive 4. Number of causes of action (speci 5, Thiscase Cis isnot a class ection suit 8. ifthere are any known related cases, fle and serve a notice of relates Date: 5/1/2008 Paul Plaintiff yep wer wey ——— | wore | «Plaintiff must fle this cover sheet with the frst paper fled In the action or proceeding (except small claims cases or cases fled caer the Probate Code, Family Gode, or Welfare and Insttutons Code). (Cal. Rules of Court, rule 3.220.) Failure to file may result in sanctions. «+ Fille this cover sheet in adsiton to any cover sheet required by local court rule. 1 itthis case is complex under rule 3.400 et seq, of the California Rules of Court, you must serve a copy ofthis cover sheet on all ‘other parties tothe action or proceeding 1s Unless this is colactions case under Fule 2.740 or @ complex case, this cover sheet wil be used for statistical purposes only Seamer ea (caro, ~ CINIL CASE COVER SHEET FF ELERAT SSN AE SI TE” ee rag ENSSUMMONS (CITACION JUDICIAL) Faxcauni aE omr eal (cokes eA cone NOTICE TO DEFENDANT: (AVISO AL DEMANDADO) Soug Defendant, individually and dbs Happy-Smiley-Mart and DOES 1 to 10 YOU ARE BEING SUED BY PLAINTIFF: (LO ESTA DEMANDANDO EL DEMANDANTE) Paul Plaintiff "You have 30 CALENDAR DAYS afer this summons and legal papers are served on you to flea written response al this court and have @ copy served on the plain. letter or phone call wll not protect you. Your written response mustbe in proper legal frm if you want te Court to hear your case, There may be a court form thatyou can use for your response, You can find these court forms and more, Information at the California Courts Online Self-Help Center (www.courtinf.ca.goviselelp), your county law library, or the courthouse rneareet you. Ifyou eannot pay the filing fee, ask the court clerk fora feo walver form. Ifyou do nat file your response on time, you may Tove the cave by default, and your wages, money, ané property may be taken without further warning from the court, | fan attorney right away, you do net know an attorney, you may want to eall an attorney referal service. Ifyou cannot afford an attorney, you may be eligible for fre legal services from a nonprofit legal services rogram, You ean locate these nonprofit groups at the California Legal Servicos Wab site (www.lawhelpeaiforia.rg), the California | Courts Online Sei-Help Center (www.courtinfo.ca.govieethelp, or by contacting your local court or county bar aseociatin. Tiene 90 DIAS DE CALENDARIO después de que le entreguen esta citacin y papeleslagales pars prosentar una respuesta por escrito ‘on esta corte y hacer que se entregue una copia al demandante. Una carta 0 una llamade telefénica no fo protegen. Su respuesta por tcecrite Kone que estar en formato legal correcto 8! dasea que procesen su caso en la cor, Es posible que haya un fermulario que usted [puoda usar para su respuests, Puede encontrar estes formularos de a corte y més informacion en el Centro de Ayu de ls Cortes de Catfornia {wwe courtingo.ca.goviselfelprespanal), en fa bibioteca de leyes de su condedo 0 en a corte quo fe quede més cores. Sino ‘puede pagar I evots do presantacién, pide al secretario de fa corte que e dé un formularo de exencién de page de cuotas. Sino presenta tu respuesta a tlempo, puede perder el caso por incumplimiento la corte le podrd quitar su sueldo, dinero y bienes sin més advertancia. hay otros requsltoslagaes, Es recomendable que lame a un abogado inmediatamenta. Si no conoce 2 un abogado, puede lamar aun | seid roms aebogdon. sn puede paar au tng wo ‘cumpla eon fos requisitos para obtener servicios Jogeles gratuits de un programa de servicios legals sin fines de lero. Puede encontrar estos grupos sin fines de lucr en el sitfo web de | Cotreria Lege Serves, (ww tswhelpcaforiaor) ene Cento de Ayuaa dla Cores de Calo, | orn courtnca govelfspanol 0 ponlndoae on contact cn corte ol cole de abogades feels ‘The name and adaress of fe cout Sena (Einombre y drecelén de fa corte 6s) iar ca Sacramento County Superior Court faeces a Civil 720 Ninth Street Sacramento, CA 95814 “The name, address, and telephone number of plaintit'sattomey, or plaintiff without an atlomey, is: (El nombro, la dreceién y 6) nimere de toléfono del abogado del demandante, o del demandante que no tiene abogado, es) Paul Plaintiff 123 Anystreet Sacramento, CA 95814 916-555-1212 DATE: Clerk, by | Deputy (Fecha) (Secretario) (Agjunto) ‘Far pico of Sorvce OF Ts Summons, Us8PrOOT oF Sewice oF Summons (orm POS-OTC)) (Para prucba do entrega de esta citation use el formulario Proof of Service of Summons, (POS-010)) NOTICE TO THE PERSON SERVED: You are served +, C2 asan individual defendant 2. Cas the person sued under the fictitious name of (speoity) (a 3, Clon benat of speciy) under: CL]. CCP 416.10 (corporation) cop 418.60 (minor) | (Bi cor 41620 (defunct corporation) (i coe 413 70 (conservatee) {cop 416 40 (essociation or partnership) E] CCP 416.00 (authorizes parson) | E&I otter (specity) | 4 Caley personal delivery on (date) aE reat eS ‘SUMMONS Ta ahs A Sener ean acre oe ik_ eee PLD-PILO04 [ avons on PART? Wir ASTORREY rs St Sr ue ad Ton counr ise ony Paul Plaintiff 123 Anystreet, Sacramento, CA_ 95814 | seceewone no: 916-555-1212 Pan ted EMAIL ASORESS (Onl | sroavey ror nano In Pro Per aa ‘SUPERIOR COURT OF CALIFORNIA, COUNTY OF Sacramento rmeerscneess 720 Ninth Street smsinc avosess. 720 Ninth Street sirvanoze cove Sacramento, CA. 95814 | sracunawe. Civil Ie encore ani ee ee esse | verenoain: Doug Defendant, navigualy and to Happy Sriley-Mart ) ooes +10 10 F COMPLAINT-Personal injury, Property Damage, Wrongful Death SSS | (AMENDED (numbor Type (check all that apply) : COP Motor veHicLe 2] OTHER (specify): Premises Liability | Ca Property Damage CJ Wrongful Death © Personat injury CY Other Damages (specity “Jurisdietion (cheek al that appv): cme a (ACTION IS A LIMITED CIVIL CASE | Amount demanded [_] doos not exceed $10,000 | Gi exceeds $10,000, but does not exceed $26,000 | (2) ACTION IS AN UNLIMITED CIVIL CASE (exceeds $25,000) ACTION Is RECLASSIFIED by this amended complaint (A from timited to unlimited (from untimited to imited 4. Plaintiff (name or names): Paul Plaintiff alleges causes of acon againstdefendant (name or names): Doug Defendant, individually and dba Happy-Sil DOES 1 to 10 This pleading, including attachments and exhibits, consists ofthe folowing nurmber of pages: 4 Each plaintif named above s 2 competent adult a. CO except paint (name) (1) Cal 2 corporation qualifed to do business in California (2) Eo an unincorporated entity (descrive) (@) a public entity (describe) 4) CQ aminor (CA) anadult {@) Cod for whom a querdian or conservator of the estate or a guardian ad kitem has been appointed (b) CY other (specify) (6) other specty) ». CO except plant name) (@) Co 2 corporation qualified to do business in California 2) an unincorporated entity (describe) (2) CA a public entity (descrize) (4) aminor CQ) an adult {@) Lod for whom a guardian or conservator ofthe estat or a quarcian a¢ item has been appointed (©) CA otter (speciy) (5) CA other (specify) [Co information about addtional plaints who ate not competent adults is shown in Attachment 2 Femara Sten uadetag_—___-«-COMPLAINT-Personal Inj Ss he ol OO? Damage, Wrongful Death , Property a i Py, 08,PLD-PI-001 [SHORT mE CaREMAER | Plaintiff v. Defendant 4, CO Praintitf namey is doing business under the fictitious name (speci) and has complied with the fictous business name laws. 5. Each dofendant named above is a natural person 2. CA except defendant (namo) ©. CA except defendant (name) (1) a business organization, frm unknown (1) 2 abusitess organzation, orm unknown ) Gi acorporation 2) G2 acomoraton (3) CC) an unincorporated entity (describe) (3) CC) anunincorporated entity (describe) (4) CA a pubic entity (describe) (8) Cd a public entity (desorbe)= (5) (2) other (specify) (5) (2) other (specify) b. Co oxcopt defendant fname) 4. CA except defendant (name) (t) (2) abusiness organization, form unknown: (1) C2) a business organization, form unknown (2) CD acorporation (2) (LJ a comoration (2) Ed an unincorporated entity (deserbo) (@) Cohan unincorporated entity (describe) @) Di apubiic entity (desote) 6) CHa public entiy (deserve (5) Col other (specify) (8) Co other (specify). [1 information about additional defendants who are not natural persons is contained in Attachment 5. 6. The true names of defendants sued as Does are unknown to plainti. 2. CA) Doe defendants (spocty Doe numbers} "were the agents or employees of other named defendants and acted vthin the Scope ofthat agency oF employment. b. (ED Doe defendants (specily Doe numbers} 1 to 10 “are persons whose capacities are unknown paint. 7. CA Defendants who are jolned under Code of Civil Procedure section 362 are(names): 8. This coutt is the proper court because 2. Wh atleast one defendant now resides in its jurisdictional area, ©. Col the principal place of business of a defendant corporation of unincorporated association i nits jurisdictional area, TE injury to person or damage to personal property occurred in its jurisdictional area. 4. CC) other (specity) 9. COD Plaintit is required to comply wit a claims statute, and 3 [a] has complied with applicable claims statutes, oF , Calis excused trom complying because (speci Ht pe ona OWPLAINT Personal injury, Proper rata veins Damage, Wrongful Death 2) scams anePLD-PI-004 ‘SHORT TLE oe a Plaintiff v. Defendant 410. The following causes of action are attached and the statements ebove apply to each (each complaint must have one or more causes of action attached) a () MotorVehicle >. Co General Negligence © intentional Tor & & Products Liability e. Gl Premises Liability £ Co Other (speci 11. Plaintiff has suffered GO woge oss 1 toss ofuse of property (hospital and medical expenses TD general damage CA property damage (Sp toss of earning capacity TO other damage (specty) 42. The damages claimed for wrongful death and the relationships of piaintf to the deceased are (sted in attachment 12. bv. Cy as follows: 43, The relief sought in this complaint is within the jurisdiction of this court 14. Plaintiff prays for judgment for costs of sul; for such relief as is far, just, and equitable; and for 2. (1) LE) compensatory damages (2) C1 punitive damages “The amount of damages is (in cases for personal injury or wrongful death, you must check (1)): (1) BAD according to proof (2) CA in the amount of: $ 15. (CO The paragraphs ofthis complaint alleged on information and belief are as follows (specify paragraph numbers) Date: 5/1/2008 Pan! Plaintiff, mPa ew OTT ‘COMPLAINT-Porsonal injury, Property 2 a aa Damage, Wrongful DeathPLD-PI.001(4) ‘SHORT ME fase no Plaintiff v. Defendant __First_____________ CAUSE OF ACTION - Premises Liability Page 4 (number) ATTACHMENT TO LEX Complaint (2) Cross-Complaint (Use a separate cause of action form for each cause of action ) PremL-1. Plaintiff (name): Paul Plaintiff aleges the acts of defendants were the legal (proximate) cause of damages to plant. ‘On (date): June 18, 2008 plaintiff was injured on the following premises in the following fashion (descration of premises and circumstances of injury} Paul Plaintiff was a customer at Doug Defendant's business, Smiley-Happy-Mart, a small grocery store. While shopping, the shelving unit next to Paul Plaintiff toppled, falling on top of Paul Plaintiff, pinning him to the ground, breaking his right arm, spine, and two ribs. Prom.L-2. [EQ Count One-Negligence The defendants who negligently owned, maintained, managed and operated the described premises were (names) Doug Defendant (does 1 to 19 __ Prem.t-3. [G) Count Two-Willful Failure to Warn [Civil Code section 846] The defendant owners who willfully or imalciously faled to guard or wam against a dangerous condition, use, stuctue, or actvly were (names): Doug Defendant 1) Does to 10 Pain, a recreations! user, was CQ an invited guest CI) a paying quest. Prem.t-4. [2] Count Three-Dangerous Condition of Public Property The defendants who owned public property on hich a dangerous condition existed were (names): T rces to 2. The defendantpublicenttyhad [CQ actual (2) constructivenotice ofthe existence ofthe dangerous condtion in sucient ime prior tothe injury to have corrected it b. The concition was creatod by employees of the defendant public enti Prem.l-6. a, C2) Allegations about Other Defendants The defendants who were the agents and employees of the other defendants and acted within the scope of the agency were (names) [es -Dowg sees tae », CO) The defendants who are liable to plaintiffs for other reasons and the reasons for their ability are 2 ceserined in attachment PremL-Sb (2) as follows (names) mine aa" CAUSE OF ACTION - Premises Liability ea meeotaee oR Seton Gop semas 2) isc Baciv-050 = DO NOT FILE WITH THE COURT - - UNLESS YOU ARE APPLYING FOR A DEFAULT JUDGMENT UNDER CODE OF CIVIL PROCEDURE § 585 - |. 916-555-1212 Paul Plaintist | 123 Anystreet Sacramento, CA 95814 | scrronney FoR oveme): In Pro Per ‘SUPERIOR COURT OF CALIFORNIA, COUNTY OF Sacramento smrect avoress: 720 Ninth Street wuisc aooness: 720 Ninth Street cirvanoarcooe Sacramento, CA 95814 seein Civil PLAINTIFF: Paul Plainti DEFENDANTDoug Defendant oe oer ‘STATEMENT OF DAMAGES (cxSE RRR (Personal Injury or Wrongful Death) ‘To (namo of one defendant only): Doug Defendant Plaintit (name of one plaintif only): Paul Plaintiff seeks damages in the above-entied action, as follows! 4. Genoral damages eae CQ) Pain, suffering, and inconvenience 5_____250, 000.00 b.C Emotional distress i : 3 ©. LED Loss of consortium s___25, 00.00 4. CO Loss of society and companionship (wrongful death actions ony) ipisteusneneeeasetee eC other specity) aaa £ other (specity) 8 eisaneee C2 Continued on Attachment 4g. 2. Special damages 2. EE] Medical expenses (to date) 3____280,900.36. ». [El Future medical expenses (present value) : 3____350,000.00 ©. EE) Loss of eamings (to date) Seeger a6 £078 4. GD Loss of future earning capacity (present valve) $_____1.500,000.00 ©. Property damage ¢ arcane + CO Funeral expenses (wrongful doath actions only) 9. C2) Future contributions (present value) (wrongful death actions only) s h. CO) Value of personal service, advice, oF training wrongful death actions only). ise 1. other (spect) (gaan i. CA) other (speci s—_________ k CO Continued on Attachment 2k 3. Cd Punitive damages: Piaintif reserves the right to seek punitive damages in the Amount of(specty) ‘when pursuing judgment inthe sut fled against you. / Date: May 1, 2008 Pail Plnbie eee seese ee ¢ TH STAT FrsaTaF wien on evrsa)_ SOE RARTEFOR TERN For Ae agar Uw ‘STATEMENT OF DAMAGES ‘Code of Ca Procedure, £4 426 Beam {Personal Injury or Wrongful Death) 7 ayes >) ESENTAL Fensciv.050 PLAINTIFF: Pal Plaintitt eae NIMBER DEFENDANT:Doug Defendant PROOF OF SERVICE (atter having the other patty served as described below, with any of the documents identified in ‘lem 4, have the person who served the documents complete this Proof of Service, Plaintif cannot servo these papers.) 1. served the a. LL) Statement of Damages (2) other (specity) b. on (namo) 6, by serving (CQ defendant (2) other (name and tte or relationship fo person served) CO by detvery CQ athome (2) at business (1) date: . (2) time: (@) adatess: (2 ty mating (1) date: 2) place: 2. Manner of service (check proper box) 2. LA) Personal service. By personally delivering copies. (COP § 418.10) b. Ed Substituted service on corporation, unincorporated association (including partnership), or public entity. By feaving, during usual office hours, copies in the office of the person served with the person who apparent was in charge and thereafter maling (by frst-class mail, postage prepaid) copies to the person served at the piace where the copies were lefl. (CCP § 415.20(a)) c. Cod Substituted service on natural person, minor, conservatee, of candidate. By leaving copies at the dwelling house, Usual place of abode, or usval place of business of the person served in the presence of @ competent member of the household or a person apparently in charge of the office or place of business, at least 18 years of age, who was informed of the general nalure of the papers, and theresfter maling (by first-class mail, postage prepaid) copies to the person eerved at the place where the copias were left (COP § 415.20 (0)) (Attach separate declaration or affidavit ‘stating acts relfed on to establish reasonable diligence in first attempting personal service.) 4. (OQ Mit and acknowledgment service. By maiing (by frst-lass mail or amall, postage prepati) copies to the person served, together with two copies of the form of notice and acknowledgment and a retum envelope, postage prepaid, ‘addressed to the sender. (CCP § 475.30) (Attach completed acknowledgment of receipt) 2. (2d Certified or ragistered mail service. By maling to an address outside California (by first-class mall, postage prepaid, requiring a return receipt) copies to the person served. (CCP § 416.40) (Attach signed return receipt or other ‘evidence of actual delivery to the person served.) £. (Other (specity code section) (2 additional page is attaches. 3. At the time of service | was at least 18 years of age and not a party to this action. 4. Fee for service: $ 5, Person serving’ a. CA) California sherif, marshal, or constable f. Name, address, and telephone number and, if applicable, ‘b. CO) Registered California process server ‘county of registration and number: c. Cd Employee or independent contractor ofa registered California process server 4. Cy Nota registered California process server 2. Col Exempt from registration under Bus. & Prot. Code § 22350(b) | deere under penaty of parry under he aus of he State (For Calfomia sherit, marshal or constable use ony) of Celfomia tate foregoing is ue and ore rery tat the foregoing ws te and correct Da Date y i > sem ie aie may PROOF OF SERVICE lect vi Pout 65 05 18 EA” ees fen (Statement of Damages)Sample Pleading 4: Product Liability The following is a sample pleading for a product liability case. Paul Plaintiff is purchased an allegedly defective piece of equipment from Mega- Big-Mart, Ine., which was manufactured by Super-Happy, Inc. Features to notice: © Both Defendants are corporations. This is reflected in paragraph 5. «There are handwritten corrections in the caption, paragraph 1, and paragraph 11 of the Complaint. This is acceptable; however, the defendants’ copies of the Complaint must also have those changes in them as well. © This Complaint is asking for punitive damages, and has an exemplary damages attachment. Punitive damages can be awarded only for “malice,” “fraud,” or “oppression,” as they are defined in Civil Code section 3294. Because these words have a very specific legal meaning, it is strongly recommended that you read this section of the Civil Code before requesting punitive damages. © Bach defendant has a separate Statement of Damages.cM-010 TRTORIEY 68 DATY WITHOUT TORVEY Pa, Ss armor Bo AE POR COURT USE On Paul Plaintiff | 123 Anystreet Sacramento, CA. 95814 ‘eusmbone 66: 916-559-1212, anne: arrowerroa gana) In Pro Per SUPERIOR COURTOF cAUFORNR, COUNTY OF Sacramento sorezrazoness 720 Ninth Street nse coress 720 Ninth Strect cwmozresse Syeramento, CA 95814 i wun CASE a ‘SHEET Complex Case Designation ‘CASE NUMBER oe Cl uinnes ioocnne CH res Counter Cond | demanded demanded is Filed with first appearance by defendant ae ee 00 oa] hrc : toms 1-6 below must be complotod (soo instructions on page 2) Check ona bax below Tor Ths case type that best describes tis case: Auto Tort ‘Contract Provisionally Complex Chl Ligation Aut (22) Ceech of conractwarany (98) {6a Rules af Cour, rules 3400-3403) Unineures motors Fie 3740 enlertora (8) ‘AnitustTrade regulation (03) (Other PUPOIWD (PereonatInjury/Proparty jboaoenbiy mae DamageNrongful Death) Tort ‘Other contract (37) ‘Securities litigation (28) aah Environmental Toxe tot (20) Heap ere Insurance coverage claims sising from the Medica ralpracice (46) 1 Eminent dorainnverse aes nlite Caen Other PI/PONWD (23), condemnation (14) eee Non-PUPDAWD (Other) Tort ‘Wronatul evietion {33) types (44) ov Seen (Other real property (28) Enforeement of Judgment Business tovunfar business prectoo (07) Se ca ‘cat ans (08) Untawtut Detaner Detaraton (13) ‘Commercial (31) Miscellanoous Civil Complaint Fra (18) Resin (22) Rico (a7) Inlet ropery (19) rug 38) ‘Omer complaint ot spaced above) (42) Professional negligence (25) Judicial Review Miscellancous Civil Petition Ce ee ‘Asset forfeiture (05) Partnership and corporate governance (21) Employment Paitin abivabonewerd (11) Cine pation oo pected etove) (43) \Wrongtl termination (25) Wt manaate (2) Other rmpoyment (8) Otner deal revew (39) | 2 Thscase CQ GDisnot —_complaxunder rule 3.400 ofthe California Rules of Cour. Ite case is complex, mark the factors requitng exceptional judicial management 2° tes rambo: tsepacly repeseredpates | o. Flats number of winsaes 8) CCl Exdensive motion practice raising dificutor novel ©. CO Coordination with related actions pending in one or more courts igeves that wil be time-consuming fo resoNe inother ‘federal court c. Co) Substantial amount of documentary evidence tial postiataqe en Remedies sought (check al that apply): a Sd monetary b. (nos Number of causes of action (specify) | Trisease CD is isnot. a class action sult. IMthere are any Known related cases, fle and serve a notice of Date: 5/1/2008 onetaty; deciarato NOTICE + Plaintiff must fe this cover sheet wth the frst paper fled in the action of proceeding (except small claims cases or cases filed Under the Probate Cade, Family Code, or Welfare and Institutions Code). (Cal. Rules of Cour, rule 3.220.) Failure to fle may result in sanctions. ‘+ Fit this cover sheet in addition to any cover sheet required by local coutt rule 1 ifthis case fs complex under rula 3.400 et seq, of the California Rules of Court, you must serve a copy of this cover sheet on all other petles fo the action or proceeding 1+ Uniess this is a collections case under rule 3.740 or a complex case, this cover sheet will be used for stestcal purposes only Ree ope, CIVIL CASE COVER SHEET SARE Ee? Bia ae SonecM-o10 INSTRUCTIONS ON HOW TO COMPLETE THE COVER SHEET To Plaintiffs and Others Filing First Papers. If you are fling @ fist paper (for example, a complaint} ng civil case, you must complete arte, along wi your fst pape, ine, Cv Gaso Cover Sheet, contained on page, Thi information ll pe used to comple Stalisties about the types and numbers of cases fled. You must complete items 1 through 6 on the sheet. In item 1, you must check ‘one box for the case type that best ceseribes the Case. IT the case fits both a general and 2 more specific type of case listed in item 1, ‘heck the more epecite one, ITthe case has multiple causes of action, check the box that best indicates the primary cause of action. ‘elas youl complsng iv shel example he cago al belong Und oat cate pan fem ae provided io, A ver Sheet must be filed only with your iilal paper. Failure fo flea cover shset wth the first paper fled in a civil case may subject a party, its counsel, of both to sancbone under ules 2.20 and 3.220 of the California Rules of Cour. ‘To Parties in Rule 3.740.Collections Cases. \ "collections case" under rule 3,740 is defined as an action for recovery of money Owed in a sum stated fo be certain that is not more than $28,000, exclusive of interest and attorney's fees, arising from a transaction in which propery, services, money was acaured on ced A calectons case coos not nclude an aston backing hs folowing (1) fk amages, (2) puntve damages 3) recovery of ea propery. 8) recovery personal property. oC) a peda nent wit of attactiment. The identification of & case as a rule 3.740 collections cage on this farm means that it will be exemp from the genera time-for-servios requirements and case managerient rules, unless a defendant files 2 responsive pleading. A rule 3.740 collections ‘case mill be Subject fo the requirements for Service and obtaining a Judgment in rule 3.741 ‘To Patties in Complex Cases. in complex cases only, patties must also use the Civil Case Cover Shect to designate whether the cases complex Ia plaintiff believes the case is complex Under rule 3.400 of the Califor Rules of Court, this must be incicated by completing the appropriate Doves in toms T and 2a plant signals a case as complex. the cover chest must be served wih tre ‘Complaint on all parties to the action. A Gefendant may fle and serve no later than the time of ts frst appearance a Joinder in the plaintiff's cesignation, a counteredesignation that ine case is Not complex, of, tte plaintiff has made no designation, a designation that fhe case is complex, ‘Auto Tort "AUS (22}-Persona! InuyPropery ‘Damagerrengtul Death Uninsured kotor (46) (rte ‘case Involves an uninsured ‘motors! claim subject fo ‘rattan, chook his tom Instead of to) ther PYPDIWD (Personal Injury! Property DamageMrongtul Dean) "Asbestos (04) ‘Asbestos Property Darrege: ‘Asbestos Persoral Inu ‘Wrongful Death Product Lab (so! asbestos or ‘Duvenvronmental) (24) Medical Malpractice (8) Medical Malpractice Physicians & Surgeons Other Professional Heath Care Naloracice ther PUPDIWD (23) Premises Litly (6. st ‘and fal) Intetione! Boa injury/P DAD {ecg assault, vandalism) Intentional atcion of Emotoral Distress Noglgentinficion of Emotona Distress otmee PIPDIWD ‘Non-PUPDIWD (Other) Tort ‘usiness TorvUnfae Business Practica (07) CCl Righ's (eg, iseriinstion, fae ares!) (rot oul resement) (8) Defamation (ag. sander, ib!) Infllestual Property (9) Professional Negligence (28) Lega Malacice Other Professianal Malpractoe {aot madcl or fog (ther Non-PHIPOIWD Tort (35) Employment "Wongful Toxmintion (35) ‘Other Employment (1) EET cy @)csomt ten CASE TYPES AND EXAMPLES Contract ‘Breach of ContraciWaranty (08) ‘Breach of ReslalLease Cartract. (nat unianfl detainer ‘or wrongful eviction) ContractWarranty Breach Seller Paint not rave er negligence) Negligent reach of Contact) Warranty Oper Breach of ContactWarranty collections (e.g, money owed, open took accourts} (9) Colecion Case-Seter Plainttt (Other Promissory NotaCalecions ‘Case Insurance Coverage (not prevsionaly complex) (18) ‘Rule Subrogation Other Coverage other Contact (37) ‘Contagtuel Prous Giher Contact Dispute Real Property 'Emaent Domainiwverse Condemnation (14) \irongfl Evleson (3), Dither Real Property (@9., qu tie) 26) “Wl ot Possession of Real Property Morigage Foreciosure Quiet Tle ther Real Property (not eminent oman, landoratenant, or forosiosure) Unlawful Detainor ‘Commercial (31) Resteentel 32) Drugs (38) if ne caso involves legal rugs, cheok tis tom, otherwise, report as Commercial ar Reider) Judicial Revi iF lon Re: Arbtration Award (11) Wet of Mandate (02) Wricadmilsraive Mandamus \Wichandamus on Umvted Court Case Matter \wire-Other Lined Court Case Revew ‘other susie Review (38) Review of Healt Ofte Order Notice of Appeal-Labor ‘Commesioner Appea's CIVIL CASE COVER SHEET Provisionaly Complex Civil Litigation (Cal. Rules of Court Rules 3400-3403) “Ants Trade Reguiaton (02) Conetuction Detect (19) ‘Clams Invaiing Mase Tort (40) Seountos Utgaton (28) Ennronmental Tose Tot (30) Insurance Coverage Ciams. farsing fom provisionally complex ‘case type sted above) (41) Enforcement of Judgment Enforement of Judgment (20) ‘Abstac\ of Juogrent (Cut of ‘County Confession of Judgment (non domoste rlatone) Siete State uagrent ‘aministaive Agony Award {hot unpaid faxes) PettonGertreaton of Envy of “ludgmerton Ungaid Taxes otner Enforcorrent of Judgment ‘Other Complaint (nt specified ‘tow (42), Declaratory Robot Onty Inuntnva Ralet On (non- Tharecomond Mechanies Ln Other Commercial Complaint ‘Case fnn-ortinon-complox) ote Cia Complaint {non-ornon-compl) Misesllancous Civil Petition Partnership ard Corporate ‘Governance (21) tre Pein not specified ‘atove) (43) Geil Harasement Werkplace Violence ExderDependert Adult ‘Abuse lection Contest Potion for Nare Change Pttion for Rate fem Lato ‘Clam ‘omer Cv PeltonsUM-100. SUMMONS [arcmin omen (CITACION JUDICIAL) (moto pana mo aE A Cone NOTICE TO DEFENDANT: | (AVISO AL DEMANDADO) : Super-Happy, Inc.; Mega-Big Mar, ine. DOES 1 to 50 YOU ARE BEING SUED BY PLAINTIFF: (LO ESTA DEMANDANDO EL DEMANDANTE) + aul Plaintiff [7 Yeu have 30 CALENDAR DAYS after this eummons and legal papors are served on you to file a written response at thie court and have a copy served on the plaintt A letter of phone call will not protect you. Your wrttn reeponée must be in proper legal form if you want the court to hear your ease, There may be a court form that you can use for your response. You can find these court forms and more information a the California Courte Online Self Help Cantor (www.courtinfo.ca.govlselthelp), your county law library, or the courthouse ‘nearest you i you cannot pay the filing fee, ask the court clerk fora fee waiver fon. I you do net file your response on time, you may lose the case by default, and your wages, money, and property may be taken without further warning from the cour. ‘There are other legal requirements. You may want to eal an attorney right away. if you do not know an atomey, you may want o call an attorney referral service, if you cannet afford an attorney, you may be eligible for fre legal services from a nonproft legal services program. You can locate these nonprofit groups at the California Legal Services Web site (www-lawhelpealifornia.org), the California. Courts Online Self-Help Center (www.courtinfo.ca.govisaheip), oF by contacting your local court or county bar association. Tone 30 DIAS DE CALENDARIO después de que lo entroguen asta ctacién y papeles legates pare presentar una respuesta por ascrito ‘en esta corte y hacer que se entrequo una copia sf demandante. Una carta una llamada teefénica nolo protegen. Su respuesta por ‘escrito tiene que estar en formato legal correcto si dasea que procesen su caso en ls corte. Es posible que haye um formulario quo usted [pueda usar para su respuesta. Puede encontrar estos formularos de fa corte y mas Informacién en of Contra de Ayuda de as Cortes de California (wav. courtinfo.ce.goviselthelplespanol), en la biblioteca do ayes do su condaco o en la corte que le quede més cerca, Sino ‘puede pagar la cuota de presentacton, pda al secreario de fa corte quo le dé un formulario de exencion de pago de cuotas. Si no presenta ‘50 respuesta a tiempo, puede perder al caso por incumplimiento y fa corte fe podrs quitar su sueldo,dinoro y Blanes sin mas advertancia, Hay otros requisites lageles. Es recomendable que lame a un abogado inmedfatamante. Sino conoce @ un abogado, puede llamar a un “servicio de remision a abogedos, Sino puede pagar a un sbogad, es posible que cumpla con los requisites para obtener servicios Tegales gratultes de un programa do servicios egales sin fines de lucro, Puede encontrar estos grupos sin fines de lucro en a stio wab do California Logal Services, (www iawholpealfornla.org), en el Contro de Ayuda de las Cortes de Caltfrnic, (ww courtinfe.ca.gov/selfelpfespanol) 0 poniéndose en contacto com la corte o ol calagio de abogados icales. ‘The name and adress of the courts ease (El nombre y direccién de ta corte es): ee Sacramento County Superior Court vil 720 Ninth Street Sacramento, CA 95814 ‘The name, address, and telephone number of paints attome, or plaitif without an attomey, is {(Elnombre, la dieccién y of numere de telefono del ahogado del demandants, 0 del demendante que na tiene abogad, es): Paul Plaintiff 123 Anystreet Sacramento, CA 95814 916-555-1212 DATE: Clerk, by : | Deputy (Fecha) (Secretaria) (édjunto) (For prooT oF sorvice of tis suTamons, Use Pract of Service of Surman form POSDIOV (Para pruoba de entraga de esta citation use el formulario Proof of Serviee of Summons, (POS-010) NOTICE TO THE PERSON SERVED: You are served 1. (es an individual defendant 2, Cas the person sued under the fettious name of (specify) [sear 3. Chon behatt of spocity) under: CCCP 418.10 (corporation) Cicer 446.80 (minor) | {coe 416 20 (defunct corporation) (51 coe 478.70 (conservates) | {Gi cc 418 40 {essociation or partnership) 1] CCP 416.90 (authorized person) Ty otter specity | 4, (2 by personal delivery on (date) 2 eae tots Dee ‘SUMMONS ee en AEAPLD-PI-004 "RTIEY GR RT WRT ATTORNEY oS ar cow ea Fen coURT USF ONY Paul Plaintiff 123 Anystreet Sacramento, CA 95814 seLewone no: 916-555-1212 xn eet EAL ADDRESS (Ont srroancr ron ere: _In Pro Per ‘SUPERIOR COURT OF CALIFORNIA, COUNTY OF Sacramento staserscoaess, 720 Ninth Street aunic noness 720 Ninth Street cirvasoemccoe: Sacramento, CA 95814 pancunane Civil Flamtire Paul Plaintiff DEFENDANT. Super Happy, Ine; WeyanBig~ Mart Inc | [ oors 17050 COMPLAINT -Personal Injury, Preperty Damage, Wrongful Death | (Cy AMENDED (Number) : Type (check all that apply): CO Motor VEHICLE — [K) OTHER specity): Product Liability C1 Property Damage [Wrongful Death [Personal injury © other Damages (specify) : ‘Jurisdiction (check all that apply) = ‘ASE NNEC (2 AcTION IS A LIMITED CIVIL CASE Amount demanded (} does not exceed $10,000 exceeds $10,000, but does not exceed $25,000 [ZI] ACTION Is AN UNLIMITED CIVIL CASE (exceeds $25,000) (1 ACTION IS RECLASSIFIED by this amended complaint 1 trom umimitod to tite 4. Plaintitf name or names): Paul Plaintiff aileges causes of acton against defendant name ornamest: Super-Hapry, Inc., M ega-Big- Mw, /nc., ant DOES |= 50 ee 2 2. This pleading, inctuding atachments and exhibits, consists of the following number of pages 3, Ezoh plant ned above i a competent asult 2 Cd except plant rame) : (1) CQ a corporation qualified to do business in California (2) LJ anunincorporated entity (describe) (3) Col a public entity (descrito) (@) CQ aminor CO anadutt (a) () for whom a guardian or conservator of the estate or a guardian ad litem has been appointed (©) CY other (specify): (8) other fapecty) b. CO except plant (name): (1) CA comoration quatfied to do business in California (2) Dan unincorporated entity iescrbe) (8) a public entty (descrine) (4) arinor CA) an adult (@) CO for whom a guardian or conservator ofthe estate or guardian ad item has been appointed (b) CE] other (specify) ©) C0 other (specify) (C2 information about additional plaintiffs who are not competent adults is shown in Attachment 3 moot ‘COMPLAINT Personal Injury, Property etc bget $a8, ee eee RE Re SSeS ETL FR ‘Damage, Wrongful Death‘SHORT THE SENET Plaintiff y. Super-Happy, Inc. _ | Td Piaintitt (name) is doing business under the fictitious name spesty) and has complied withthe fettious business name laws, 5, Each defendant named above is @ natural person 2, [Ey except defendant (name) cc (A except defendant (name) Super-Happy, Inc. (1) © a business organization, form unknown (1) (2 a business organization, form unknown (2) Bd a corporation 2) G2) acorporation @) CO anunincorporated entity (describe) @) GO anunincomporated entity (describe (4) Ca public entity (cescribe) (4) CO a pute entity (desenbe) ©) Dotter ‘specity (8) (2 other éspecity) b, [ED except defendant (name) 4. (2 except defendant (nama) ‘Mega-Big-Mart, Inc. (1) Cla business organization, form unknown (1) Cla business organization, form unknown (@) Bl a comoration 2) a corporation (3) Coan unincorporated entity (describe) (@) Dan unincorporated entity (describe) 4) Ca public entity (descrive) (4) Ca public entity (describe) (6) Cather (speci) (8) Chater (pacity [2 internation about addtional defendants who are not natural persons is contained in Atachment 68. The true names of defendants sued as Does are unknown to aint. a. ELD Doe defendants (specity Dos numbers) 1 to 25 were the agents or employees of other niemed defendants and acted within the Scope of that agany or employment b. CED. Doe defendants /specty Doe numbers): 26 to 50__ ‘are petsons whose capacities are unknown to plaintit 7. Cad Defendants who are joined under Code of Givi Procedure section 282 are(names). 8 This courts the proper court because (CA at least one defendant now resides In its jurisdictional area. [i the principal place of business of a defendant corporation or unincorporated association isin its jurisdictional area, [injury to person or damage to personal property occurred in its jurisdictional area. CA other (speci) 9. Col Piaintit is required to comply with a claims statute,and & Lad has complied with applicable claims statutes, or tb. Col is excused from complying because (speci): ROD HAH Pew. danccy 12007 ‘COMPLAINT-Personal Injury, Property Pagezts et Damage, Wrongful Death: PLD-PLO0t SHORT THLE crs Plaintiff v. Super-Happy, Inc. } 40. The following causes of action are attached and the statements above apply to each (each complaint must have one or more causes of action attached) A Motor Vehicle. 1) Genera! Negiigence A Intentional Fort 1 Products Lisity Dy Premises Liaitty otter (speci 11. Ptaintéthas suffered DD wage toss: (boss of use of property (hospital and medical expenses BSI general damage a property damage Foss of earning capecty {Cd other damage (specify) listed in Attachment 12 42, (QQ The damages claimed for wrongiul death and the relationships of plant tothe deceased are a b. Cl) as follows: 43, The relief sought in this complaint is within the jurisdiction ofthis cour. +4. Plaintiftprays for judgment for costs of sul for such reli ass fair, just, end equitable: an for a. (1) QE) compensatory damages (2) GA punitive damages “Tne amount of damages ifn ca90s for personal njryor wrong death, you must check (1): (1) [QR according to proof 2) 0 nthe amount of 45. (CO) The paragraphs ofthis complaint alleged on information and belie are as ecty paragraph numbers) Date: 5/1/2008 Paul Plaintiff TnFROR PANT NA TROT AE oF PAF OF AT Ss PLD PLO0T (Rew January 1.20071, ‘COMPLAINT-Personal Injury, Property ape Demage, Wrongful Dost OS itscmut a= cenaeeeaatPLD-PL0015) ‘SHORT TITLE: essere + Plaintiff v. Super-Happy, Inc. ___First_ ___________ CAUSE OF ACTION- Products Liability Page 4 (rumeer) ATTACHMENT TO LE) Compiaint (CJ Cross-Complaint (Use a separate cause of action form for each cause of action ) Plsintiff (name): Paul Plaintiff Prod, L-1. On or about (date): June 18, 2007 plaint was injured by the following product: Super-Happy Widget Weaver Model WW-501 Prod, L-2. Each of the defendants knew the product would be purchased and used without inspection for defects. The product was defective when it lef the control of each defendant. The product at the time of injury was being [G1 used in the manner intonded by the defendants. [used in @ manner that was teasonably foreseeable by defendants as involving a substantial danger not reakily apparent. Adequate warnings of the danger were not given. Prod, L-3, Plaintittwas 2 [ED purchaser ofthe product [BD user of the product (ED bystander to the use of the product, O other ¢specity: PLAINTIFFS INJURY WAS THE LEGAL (PROXIMATE) RESULT OF THE FOLLOWING: Prod, LQ) Count One-Strct lability of the folowing deferdants who 2. ED manufactured or assembled the product (names) Super-Happy, Ine I does to S0___ ©, UD designed and manufecturod component parts supplied fo the manufacturer (nares) does 1 50. ©. [ED sold the product the public names}: Mega-Big-Mart, Inc. ED Does. to St Prod. L-5. (J. Count Two-Negligence ofthe following defendants who owed a duty fo plaintif (names) Super-Happy, Inc.; Mega-Big-Mart, Inc. Kd does Ls w& Prod, LS. KJ Count Three-Breach of warranty by the following defendants (names): Super-Happy, Inc. I does, to 50 a (2) who breached an implied warranty tb. GE who breached an express warranty which was writen OD. ora! Prod. L-7. CQ) The defendants who are liable to plaints for other reasons and the reasons for the liblity are (CO istea in Attachment-Prod. L-7 () as follows: attra tara (CAUSE OF ACTION - Products Liability ea at SSBF unas) tay 12071 a) sen aosPLD-P1-004(6) SHORT TTL [ersenomer Plaintiff v. Super-Happy, Inc. et al Exemplary Damages Attachment Page ATTACHMENT TO UE}Complaint [_}Cross-Compiaint EX, As addtional damages against defendant (name) ‘Super-Happy, Inc.; Mega-Big-Mart, Inc.; Plaintif alleges defendant was gulty of ED matice Oi raus C2 oppression {35 dofnod in Civil Code section 3294, and plaintif should recover, n addition to actual damages, damages to make an example of and o punish defendant EX:2. The facts supporting plaints claim are as follows: Plaintiff purchased stom Mega-BigrMart, Inc. a Supper-Happy Widget Weaver Mode! WW-501 from Megg-Big-Mart, Inc. on May 8, 2007. While using the Super-Happy Widust Weaver in ts intended manner on June 18,2007, it exploded. causing laming widgets 0 stil to Plant? ands, arms, and treo, casing numerous third and second degree burns requiring skin grafts. Paul Plaintiff secks punitive damages against Supper-Happy, Inc. and Mega-Big-Mart, Inc. for the following reasons: 1. Super-Happy knew that the Widget Weaver Model WW-501 was designed in such a manner that some of the units were likely to explode, causing flaming widgets to be ejected. This was well- established because oer companies manufacturing widget weavers, such as Slightly-Peppy, In. which hhad a similar design five years earlier, had similar explosions and subsequently modified their design to substantially reduce the risk of exploding widgets, and contain a secondary containment unit to prevent flaiming widgets from being ejected at te user. 2, Despite knowing tat their product posed ap explosion rik far in excess of competing prodicts, Supertlappy advertised their Widget Weaver Model WW-501, by stating “Enjoy safest, quictest, ‘widget weaving experience ever with the Widget Weaver Model WW-501.’ 3, Moge-Big Mary Inc continued to sell and promote the Widget Weaver Model WW-501 despite ‘several incidents of customers being injured by the Widget Weaver Model WW-501 in similar incidents, 4, Soper-Happy Ine hs total vlug of $49 illo, and Megs-Big-Mart, Ino; has ta value of $215 Billion. ‘The damages the Paul Plaintiff has experienced are inconsequential to them, and they are likely to continue to manufacture, market, and sell this exceptionally dangerous product to others, unless ive damages are assessed. 1EX-3, The amount of exemplary damages sought is a. LED not shown, pursuant to Cade of Civil Procedure section 425.*0, os Paap ttt Fenians pea Exemplary Damages Attachment Coorong in aren 2071 (seam faaciv-080 = DO NOT FILE WITH THE COURT - - UNLESS YOU ARE APPLYING FOR A DEFAULT JUDGMENT UNDER CODE OF CIVIL PROCEDURE § 585 - ‘ATORNEY Of FARTY WHTIOUT ATTORNEY Mane ne fess) TELEPHONE WO, FOR COURTUSE ONLY fs 916-555-1212 Paul Plaintist 123 Anystreet Sacramento, CA. 95814 arrome ron ana) In Pro Per | SUPERIOR COURT OF CALIFORNIA COUNTY OF 3 staceraconess. 726 Ninth Street wun acoaesa 720 Ninth Street orty ano ze cone. Sacramento, CA 95814 cance Civil puawmire Paul Plaintiff eFenoantSuper-Happy, Inc.; aan ae] STATEMENT OF DAMAGES eee (Personal Injury or Wrongful Death) “To (name of one detendant ony): Super-Bappy, Inc Plaintiff (name of one plaintiff only): Paul Plaintiff cooks damages inthe above-entes acto, 28 flows amount 4. General damages 2 Pai, sutteing, and inconvenience. » OD Emotional distress ©, CO Loss of consortium 4. Loss of society and companionship (wrongful death actions oni). © C0 Other specify) £ Cl Other (specity) @ C2 Continued on Attachment 1.2 ee nw 2. Special damages 3 OE] Medical expenses jlo dst} $.___147, 680.00 b. CO) Future medical expenses (present value), $e c. LED Loss of eainings (to date) $—__8,700.46 2 Loss of future earning capacity resent vaiue) 8 © CD Property damage. 8. 1. LAV Funes! expenses (wrong! death actions only) 8 49. LA Future contributions (present value) (wrongful death actions only) $ h, CO Value of personal service, advice, oF training fwrangiul death actions ony). 5 1. Cy Other (specity). . + CD Otter specity) s. CO Continues on tachment 2 ao 3. CE Punitive damages: Piainti reserves the right lo sock punitive dantages in 0 aroun oi $___As Court Sees Fit when pursuing a judgment in the sult fled against you. aaa Date 5/1/2008 ae SER RATT ee oe PP can orm Apert wa ‘STATEMENT OF DAMAGES: “Sate fC Procell §6425.1. 428 156 ‘diaeresis "wen courtréa ca 96° SOLER es nt 1.2871 (Personal Injury of Wrongful Death) sat Fas"ctv-050 PLAINTIFF: Paul Plaintitt SE Mae EFENDANT Super-Happy, Inc.; PROOF OF SERVICE {After having the other party served as desorbed below, with any of the documents identifed in tem 4, have the person who served the documents complete this Proof of Service, Piaintif cannat serve these papers } 1. Iserved the 2.2 Statement of Damages (1) other (sper b. on fname} c. by soning (AB eefendant (2 other (name anu ttle or relationship to persan served} 6.12 bydeivery 2) athome Cp at business (8) date: {2)time (3) address: © by mating (Gh date (2) place 2. Manner of sence (check sroper box) 2. Co) Personal service. By personaly delverng copies. (COP § 418-19) 8. EA Substituted service on corporation, unincorporated association (Including partnership), or public entity. By ieaving, during usval offce hous, copies in the offee of the person served with the person who appacenly was in charge snd thereafer maiing (by frstciass mall, postage Prepaid) copies fo te person served al the place where the copies were left, (COP § 415 20(6)) «C2 Substituted service on natural person, minor, conservatee, or candidate, By leaving copies atthe dweling house Usual place of abode, or usual place of business of the pefscn served inthe presence of 2 competent member of the household or a person apparently m charge ot the offee oF place of business, at loast 18 years of age, who was informed of the general nature of the papers, and thereafter main (by fst-cass mail, postage prepaid) cops to the person served at the place where the copies were left. (CCP § 415.20 (b}} (Attach separate declaration or affidavit stating acts relied on to establish reasonable diligence in first attempting personal service.) 4. Q Mail and acknowledgment service. Sy mailing (by first-class mal or alrmall, postage prepaid) copies to the person served, together with two copies of the form of natice and acknowledgment and a retum envelope, postage prevail, dressed to the sender. (CCP § 415.20) (Attach completed acknowledgment of receipt.) 2 CO Certified or registered mail service, By mailing to an address outside California (by first-class mail, postage prepaid, requiring a retum receist) copies to the person served. (CCP § 415.40) (Attach signed return receipt or other ‘evidence of actual delivery to the person served.) 1. Ld other (epecity code section) 2 soditional page is attached 2. Atthe time of service Iwas at least 18 years of age and not a party to this action. 4, Fee for service: $ 5, Person serving: 2 CA California shent, marshal, or constable f. Name, address, and telephone number and, if applicable, b. Gl Reglsteres Califomia process server county of registration and number: ¢ (2) Employee or independent contractor of a registered Califor process server 6. (Nota registeres California process server 2 Ch Exempt from registration under Bus. & Prof, Code § 22350(b) I declare under penalty of perjury under the laws of the State (For California sheriff, marshal or constable use only) ‘of California that the foregoing is true and correct. | cetity that the foregoing is true and carrect. Date: ate: » b senTR TlGnATURED ‘ivosa ren dna 20M PROOF OF SERVICE Comalaa Pace, $5425 108 He e ESTA FORMS” (Statement of Damages)civ.050 - DO NOT FILE WITH THE COURT - UNLESS YOU ARE APPLYING FOR A DEFAULT JUDGMENT UNDER CODE OF CIVIL PROCEDURE § 585 - | 916-555-1212 Paul Plaintiff 123 Anystreet Sacramento, CA 95814 artonncy FOR ynrm)_In Pro Per. “SUPERIOR COURT OF CALIFORNIA, COUNTY OF Sacramento srnect aopness: 720 Ninth Street aime aporess 720 Ninth Street cnvaso2e cove Sacramento; CA 95814 snnsernane Civil [gira ml aia fees ea EFENDANTSuper-Happy, Inc., ‘STATEMENT OF DAMAGES (Personal Injury or Wrongful Death) ‘To (name of one defendant ony): Mewa-Big-Maat, Inc. Plaintif (came of one plaint only) Paul Plaintiff seeks damages in the above-entiled action, as follows: 7 1. General damages fence 2 G2) Pain, suffering, and inconvenience. b CA Emotional aistress. | © (1 Loss otconsortium 4. C2 Loss of society and companionship wrongful death actions only) eC) Otter (specity). £, CA) Other (specity) CA Continued on Attachment 1 we one 2. Special damages 2 CE] Medical expenses (fo date) $_____147, 680.00. b. EO) Future mecical empenses (present value) gan eesesenenenene © (ED Loss of earings (o date) girder 700.46 4: CO Loss ot ture earring capaci (oso value) 3 ©. CA Property damage 3 1. (2) Funeral expenses (wrongful! death actions only) s 4.2) Future contributions resent value) (wrongful death actions ony) 8 [Cd Value of personal service, advice, or traning (wrongful death actions oniy) 3 1 Cotter rspeniy) 3 1 Comer speci) 8 C21 Continues on attachment 2 Pa 3, Bi Punitive damages: Pisin reserves the right to seek punitive damages wpe ‘amount when pursuing augment inthe Sut les against you / Date: 5/1/2008 TES RTI PROT sae a E813 (Proof of service on Taverse) epagrescerersnin ‘STATEMENT OF DAMAGES eM stte ane 87 (Pereonal Injury oF Wrongful Death? 2 setcwv.0s0, PLANTIFE Paul Plaintif ene AER EFENDANT Super-Happy, Ine.: PROOF OF SERVICE (Alter having the other party served as described below, with any of the documents identified in tern 1, have the person who served the documents completa this Proof of Service. Plaint cannot serve these papers) +. Vserved the a. LAD Statement of Damages [3 Other spectty) b. on fname) by serving COP defendant (2) other (name and tile or relationship to person served) 4 CA bycetvery Cy athome (2) atbusiness (1 date (2) time: (3) adatess: © A by mating (ate: ) place: 2. Manner of sence (check proper box) 2. LO Personal service. Sy personally delvering copies, (CCP § 418.10) b, (] Substituted service on corporation, unincorporated association (including partnership), or public entity. Sy leaving, during usual office hours, copies in the office of the person served with the person who apparently was in charge and thereafter maling (by fst-class mail, postage prepaid) coples to the person served ot the place where tho copies wore lef. (CCP § 415 20(a)) © CAV Substituted service on natural person, minor, conservatee, or candidate. By leaving copies at the aweling house, usual place of abode, or usual place of business of the person served in the presence of a competent member of te household or @ person apparently in charge af the offce or place of business, at least 18 years of age, who was informed of te general nature of the papers, and thereafter mailing (by frstlass mal, postage prepaid) copes to the person served at he place where the copes were lef. (CCP § 415 20 ()) (Attach separate declaration or affidavit Stating acts relied on to establish reasonable diligence In first attempting personal service.) 4. mall and acknowledgment service. By mailing (by first-class mall or ata, postage prepsid) copies to the person served, together with two copies of the form of notice and acknowledgment and a retum envelope, postage prepaid Aadaressed to the sender. (COP § 415.30) (tach completed acknowledgment of receipt.) = Cl Certified or registered mail service. By maling to an adefess outside Califonia (by frstclass mail, postage prepaid, requiring @ return receipt) copies to the person served, (CCP § 41540) (Attach signed return receipt or other ‘evidence of actual delivery to the person served.) £ CA diver (specty code section) TA adsitional page is atached 3. Althe time of service | was at least 18 years of age and not a party to this action. Fee for service: $ 5. Person serving a © California sheriff, marshal, ot constable £ Name, adgross, and telephone number and, if applicable, b. CO Registered Calfornia process server county of registration and number: &. [) Employee or independent contractor of a registered California process server d. Lo} Not a registered California process server fe. EE Exempt fom registration under Bus. & Prof Code 5222800) | declare under penalty of perjury under the laws of the State (For California sheriff, marshal or constable use only) of Cafoma athe regan cue and cect (ery at he oregorg ue an cect bate bate > > a aa ‘Giv.0s0|Rev danuary 7, 2007) PROOF OF SERVICE (cade af vt Procagve, 952017 ETD 2 tie {Statement of Damages)