COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : SHORT TITLE: Index No. Calendar No. CASE NUMBER: PLD-PI-001(4) : Plaintiff(s) : JUDICIAL SUBPOENA Page CAUSE -against(number) ATTACHMENT TO OF ACTION--Premises Liability : : : Cross - Complaint Complaint (Use a separate cause of action form for each cause of action.) Prem.L-1. Plaintiff (name): alleges the acts of defendants were the legal (proximate) cause of damages to plaintiff. Defendant(s) : . . . . . . . . . .On .(date): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . plaintiff .was injured on the following premises in the following .. .... ..... .. fashion (description of premises and circumstances of injury): THE PEOPLE OF THE STATE OF NEW YORK TO GREETINGS: Prem.L-2. Count One--Negligence The defendants who negligently owned, maintained, managed and operated the described premises were (names): WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at to County of Does in room , on the day of , 20 , at o'clock in the noon, and at any recessed Prem.L-3. Count Two--Willful Failure as a witness in this action on the defendant owners who willfully or adjourned date, to testify and give evidenceto Warn [Civil Code section 846] The part of the or maliciously failed to guard or warn against a dangerous condition, use, structure, or activity were (names): Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Does to result of your failure to comply. Plaintiff, a recreational user, was an invited guest a paying guest. Witness, Honorabledangerous condition existed were (names): on which a Court in County, day of , 20 Does a. b. Prem.L-5. a. to Prem.L-4. Count Three--Dangerous Condition of Public Property The defendants who owned public property , one of the Justices of the (Attorney must sign above and type name below) The defendant public entity had actual constructive notice of the existence of the dangerous condition in sufficient time prior to the injury to have corrected it. The condition was created by employees of the defendant public entity. Allegations about Other Defendants The defendants who were the agents and employees of the Attorney(s) for other defendants and acted within the scope of the agency were (names): Does b. to Office and P.O. Address The defendants who are liable to plaintiffs for other reasons and the reasons for their liability are described in attachment Prem.L-5.b as follows (names): Form Approved for Optional Use Judicial Council of California PLD-PI-001(4) [Rev. January 1, 2007] Telephone No.: Facsimile No.: E-Mail Address: CAUSE OF ACTION--Premises Mobile Tel. No.: Liability Page 1 of 1 Code of Civil Procedure, § 425.12 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkflow.com