VF-2501. Disparate Treatment--Affirmative Defense--Bona fide Occupational Qualification (Gov. Code, § 12940(a)) Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 We answer the questions submitted to us as follows: 1. Was [name of defendant] an [employer/[other covered entity]]? ____ 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 plaintiff] [an employee of [name of defendant]/an applicant to [name of defendant] for a job/[other covered relationship to defendant]]? ____ 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. Did [name of defendant] [discharge/refuse to hire/[other adverse employment action]] [name of plaintiff]? ____ Yes ____ No If your answer to question 3 is yes, then answer question 4. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form. VF-2501. Disparate Treatment (Gov. Code, § 12940(a))--Affirmative Defense--Bona fide Occupational Qualification Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 4. Was [name of plaintiff]'s [protected status] a substantial motivating reason for [name of defendant]'s [discharge/refusal to hire/[other adverse employment action]]? ____ Yes ____ No If your answer to question 4 is yes, then answer question 5. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form. 5. Was the job requirement regarding [protected status] reasonably necessary for the operation of [name of defendant]'s business? ____ Yes ____ No If your answer to question 5 is yes, then answer question 6. If you answered no, skip questions 6, 7, and 8, and answer question 9. 6. Did [name of defendant] have a reasonable basis for believing that substantially all [members of protected group] are unable to safely and efficiently perform that job? ____ Yes ____ No If your answer to question 6 is yes, then answer question 7. If you answered no, skip questions 7 and 8, and answer question 9. 7. Was it impossible or highly impractical for [name of defendant] to consider whether each [applicant/employee] was able to safely and VF-2501. Disparate Treatment (Gov. Code, § 12940(a))--Affirmative Defense--Bona fide Occupational Qualification 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 efficiently perform the job? ____ Yes ____ No If your answer to question 7 is yes, then answer question 8. If you answered no, skip question 8 and answer question 9. 8. Was it impossible or highly impractical for [name of defendant] to rearrange job responsibilities to avoid using [protected status] as a job requirement? ____ Yes ____ No If your answer to question 8 is no, then answer question 9. If you answered yes, stop here, answer no further questions, and have the presiding juror sign and date this form. 9. Was [name of defendant]'s [discharge/refusal to hire/[other adverse employment action]] a substantial factor in causing harm to [name of plaintiff]? ____ Yes ____ No If your answer to question 9 is yes, then answer question 10. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form. 10. What are [name of plaintiff]'s damages? VF-2501. Disparate Treatment (Gov. Code, § 12940(a))--Affirmative Defense--Bona fide Occupational Qualification 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 [a. Past economic loss [lost earnings [lost profits [medical expenses [other past economic loss Total Past Economic Damages: $ $ $ $ $ ] ] ] ] ] [b. Future economic loss [lost earnings [lost profits [medical expenses [other future economic loss $ $ $ $ ] ] ] ] ] ] Total Future Economic Damages: $ [c. [d. Past noneconomic loss, including [physical pain/mental suffering:] Future noneconomic loss, including [physical $ VF-2501. Disparate Treatment (Gov. Code, § 12940(a))--Affirmative Defense--Bona fide Occupational Qualification 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 pain/mental suffering:] TOTAL Signed: _________________________ Presiding Juror $ $ ] 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 April 2007, December 2010, June 2013, December 2016