VF-3404. Horizontal Restraints (Use for Direct Competitors)-- Group Boycott--Per Se Violation Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 We answer the questions submitted to us as follows: 1. Did [name of defendant] [and [name of alleged co-participant]] agree to [specify claimed refusal to deal, e.g., "refuse to sell to [name of plaintiff]"]? ____ Yes ____ No If your answer to question 1 is yes, then answer question 2. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form. 2. Was [name of defendant]'s conduct a substantial factor in causing harm to [name of plaintiff]? ____ Yes ____ No If your answer to question 2 is yes, then answer question 3. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form. 3. What are [name of plaintiff]'s damages? Presiding Juror $ Signed: ___________________________ Dated: ___________________ After [this verdict form has/all verdict forms have] been signed, notify the [clerk/bailiff/court attendant] that you are ready to present your verdict in the courtroom. _____________________________________________________________________________ New September 2003; Revised December 2010, December 2016