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Interrogatories From Defendant To Plaintiff Form. This is a Kansas form and can be use in 3rd Judicial District (Shawnee County) Local District Court.
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Tags: Interrogatories From Defendant To Plaintiff, Kansas Local District Court, 3rd Judicial District (Shawnee County)
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:
Index No.
:
F 3.201(2)B
Plaintiff(s)
Calendar No.
:
JUDICIAL SUBPOENA
-against:
(Interrogatories from Defendant to Plaintiff)
:
1.
Please provide the following information:
:
Defendant(s)
:
......................................................
a.
Your full name and any other names or nicknames that you have
used or gone by
THE PEOPLE OF THE STATE OF NEW YORK
b.
If your name has ever been legally changed state when, where and
TO
through what procedure and provide your original name;
GREETINGS:
c.
Your date of birth;
d.
Your place all business and excuses being laid aside, you and each of you attend before
WE COMMAND YOU, that of birth;
,
the Honorable
at the
Court
e.
Your social security number;
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date,f. testify and driver’s license number. in this action on the part of the
to
Your give evidence as a witness
ANSWER:
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
2.
State comply.
result of your failure to your present residential address and the period during which you have resided
at this address. List all other addresses at which you have resided duringone of theten (10) of the and
Witness, Honorable
, the past Justices years
Court in
County,
day of
, 20
the dates during which you resided at each address.
ANSWER:
3.
(Attorney must sign above and type name below)
State the name and address of each school, college, or educational institution you have
Attorney(s) for
attended, listing the dates of attendance for each.
ANSWER:
4.
Office and P.O. Address
State your present marital status; if you have previously been married, please list the
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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:
:
Index No.
Calendar No.
:
names and last known address of all former spouses, the dates of suchJUDICIAL SUBPOENA
marriages, the manner in which
Plaintiff(s)
-against:
the former marriages were terminated and the caption of any divorce proceedings you have been
:
involved in. Please list the name, date of birth and current residential address of each of your
:
children.
Defendant(s)
:
......................................................
ANSWER:
THE PEOPLE OF THE STATE OF NEW YORK preceding the date of the filing of this lawsuit state:
5.
For the ten (10) years immediately
TO
a.
The names and addresses of each of your employers;
b.
The dates of commencement and termination of each such
GREETINGS:
employment;
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
Provide a detailed description of the services or work performed for
,
the Honorable c.
at the
Court
each employment;
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date,d. testify and average weekly a witness in this action on each place the
to
Your give evidence as wages or earnings from the part of of
employment;
e.
For each employer, whether a physical a contempt of court and will
Your failure to comply with this subpoena is punishable asexamination was required, make you liable to
the party on whose behalfand if so, state was date, place and personpenalty of $50 and all damages sustained as a
this subpoena the issued for a maximum giving the physical
examination;
result of your failure to comply.
f.
For
Witness, Honorable each employer, whether or not you made of therepresentations in
, one any Justices of the
writing or answered in writing any questions concerning your physical
Court in
County,
day of
, 20
condition;
g.
ANSWER:
6.
The name of your immediate supervisor, foreman, above and type name below)
(Attorney must sign boss or other
superior to whom you were or are responsible at each of the places of
employment.
Attorney(s) for
Do you allege that you have lost any income from your business or occupation and/or
Office and P.O. Address
any loss of earning capacity as a result of the occurrence referred to in your pleadings? If so, state
the following:
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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:
Index No.
Calendar No.
The specific nature of your alleged: injury that has caused such loss of
JUDICIAL SUBPOENA
Plaintiff(s)
income and/or loss of earning capacity;
a.
-against-
:
b.
The number of days of income lost and the specific dates;
c.
The specific amount of any wages or :
income lost;
:
Defendant(s)
d.
The specific amount of any alleged loss of earning capacity;
:
......................................................
e.
The amount of time, in your best judgment, that you will lose in the
future;
THE PEOPLE OF THE STATE OF NEW YORK
f.
Set forth in detail the formula or method of computation of the alleged
lost earnings, income or earning capacity;
g.
Provide the name and address of your supervisor who can verify each of
these claims.
TO
GREETINGS:
ANSWER:
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
County of
Withthe
in room 7.
, on respect to each of the past five (5) at
day of
, 20
, years, provide the the
o'clock in following: and at any recessed
noon,
or adjourned date, to testify and give evidence as a witness in this action on the part of the
a.
Your gross income as reported on your income tax return;
b.
The name and address is the person, a contempt of court and will custody
Your failure to comply with this subpoena of punishable asfirm, or corporation havingmake you liable to
the party on whose behalfof any papers pertaining to your income for each of these years;
this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
c.
The regional office of the Director of Internal Revenue with which each
of your income tax returns was filed;
Witness, Honorable
, one of the Justices of the
Court in
County,
day of
, 20
d.
The state tax authority or authorities with whom you filed income tax
returns;
e.
The amount of tax shown to be due on each federal and state return.
ANSWER:
8.
(Attorney must sign above and type name below)
Attorney(s) for
Please state the name, address, business address, and telephone number of each
Office and P.O. Address
individual likely to have discoverable information relevant to disputed facts alleged in the pleadings
and identify the subject of the information.
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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:
ANSWER:
Plaintiff(s)
-against-
9.
Calendar No.
:
JUDICIAL SUBPOENA
:
Please identify your current health insurance carrier and all past health insurance
:
carriers for the past ten (10) years and provide their address, telephone number, and the policy or
:
Defendant(s)
group number for your policy with each carrier and the dates you were covered by each carrier.
:
......................................................
ANSWER:
THE PEOPLE OF THE STATE OF NEW YORK
TO
10.
Please state in detail the injuries and diseases you claim that you suffered as a result
of the occurrence referred to in your pleadings.
GREETINGS:
ANSWER:
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
11.
State the name, address and telephone numberCourt
of each doctor, hospital, clinic,
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
institution, social worker, counselor or other health care or mental health care professional whom you
or adjourned date, to testify and give evidence as a witness in this action on the part of the
have consulted or by whom you have been examined or treated for any physical, mental or emotional
Your failure to you claim this subpoena is punishable as a contempt of court and and state the
injury, damage or losscomply withto have been caused by any defendant in this action 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
result of your failure to comply.
date of each contact with each such health care provider and provide a description of the injury or
malady Witness, Honorable
for which examination or treatment was sought.
Court in
County,
day of
, one of the Justices of the
, 20
ANSWER:
(Attorney must sign above and type name below)
12.
If you have incurred any bills or expenses in connection with the injuries, diseases or
damages you suffered because of the occurrence referred Attorney(s) pleadings, itemize the amount
to in your for
of each such bill or expense, describe the service for which the bill or expense was incurred, provide
Office and P.O. Address
the date such expense was incurred and the identity and address of the person who rendered the bill
or who was involved in the expense.
ANSWER:
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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:
13.
Index No.
Calendar No.
Except for the injuries complained of in the :present lawsuit, have you at any time
JUDICIAL SUBPOENA
Plaintiff(s)
-againsteither before or after the date of the occurrence referenced in :your pleadings, been injured, disabled
:
or suffered an illness of any nature? If so, please state the following for each such illness, injury or
:
disability:
Defendant(s)
:
......................................................
a.
The date, location and circumstance of the injury disability or illness;
b.
The precise nature of the injury, illness or disability;
THE PEOPLE OF THE STATE OF NEW YORK
c.
The names, addresses and telephone numbers of all hospitals, persons or
medical providers who examined or treated you for those injuries,
illnesses or disabilities; and
TO
If the injury, disability or illness was caused by an accident, the names,
addresses and telephone numbers of any other parties or witnesses
involved.
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
GREETINGS:
d.
,
the Honorable
at the
Court
located at
County ofANSWER:
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
14.
State the name, address and telephone number of each doctor, hospital, clinic,
institution, social worker, counselorthisother health care or mentalahealth care professional whom you liable to
Your failure to comply with or subpoena is punishable as contempt of court and will make you
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
have consulted or to comply.
result of your failureby whom you have been examined or treated at any time, both before and after the
occurrence in question, other than those by whom you have been examined or treated for injuries
Witness, Honorable
, one of the Justices of the
Court in
County,
day of
, 20
alleged to have been sustained in this incident. State the date of each contact with each such health
care provider and provide a description of the injury of malady for which above and type name treatment
(Attorney must sign examination or below)
was sought.
ANSWER:
15.
Attorney(s) for
Office and P.O. Address
Have you made any claim for any type of benefits under any type of insurance policy
relating to injuries arising out of this occurrence (including, but not limited to health insurance,
Telephone No.:
Facsimile No.:
personal injury protection benefits, medical pay coverage, Medicare, Medicaid, etc.)? If so, state the
E-Mail Address:
Mobile Tel. No.:
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:
following:
Plaintiff(s)
a.
Calendar No.
:
JUDICIAL SUBPOENA
-againstThe name, address and telephone : number of the insurance company
or organization to whom the claim was made;
:
b.
The date of the claim or application; :
c.
The claim number Defendant(s)
and policy number;:
......................................................
d.
The disposition of each such claim including the total amount
received from any insurance company on any claim.
THE PEOPLE OF THE STATE OF NEW YORK
ANSWER:
TO
16.
Except for the present lawsuit, please state whether you have ever had or made any
GREETINGS:
other claim or suit for injury or disability. (This includes, but is not limited to, any claim or suit for
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
workers compensation benefits, social securityat the
benefits, disability benefits, etc.). If your answer is
,
the Honorable
Court
located at
County of
inyes, please state, for the such claim or suit: , 20
room
on each
day of
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
a.
The approximate date of the claim or suit;
b.
The nature of the claimed punishable as a contempt of court and will make you liable to
Your failure to comply with this subpoena isinjury or disabilities;
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
c.
The name, address and telephone number of each person, firm,
result of your failure to comply.
corporation, or other organization against whom such claim or suit
was
Witness, Honorable filed;
Court in
County,
day of
, one of the Justices of the
, 20
d.
The name, address and telephone number of the court, commission
or other body with which said claim or suit was filed;
e.
The amount, by way of settlement, judgment or otherwise, you
obtained from each such claim or suit.
(Attorney must sign above and type name below)
ANSWER:
17.
Attorney(s) for
Please list the names, addresses and telephone numbers of all persons from whom
Office and P.O. Address
anyone, according to your best information and belief, obtained statements or factual memoranda
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
(whether hand written, oral, typewritten, court reporter recorded or otherwise) pertaining to the facts
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Index No.
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:
related in any way to the claim or claims upon which this suit is based. With respect to each, please
JUDICIAL SUBPOENA
Plaintiff(s)
:
furnish a brief description-againstof the statements or memoranda sufficient to identify it, including type, date
:
and to whom given.
:
ANSWER:
Defendant(s)
:
......................................................
18.
Have you, or has anyone on your behalf, conducted any investigations of the
THE PEOPLE OF THEthe subject matter YORK lawsuit? If your answer is yes, identify:
occurrence which is STATE OF NEW of this
TO
a.
Each person and the employer of each person who conducted any
investigation;
b.
The date of the investigation;
c.
All notes, reports, statements or other documents prepared during
GREETINGS:
or as a result of the investigation and identify the person or persons
who have possession thereof.
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
County ofANSWER:
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
19.
If you have been arrested, charged with and/or convicted of any crimes (including
traffic offenses), felonycomply with this subpoena is punishable as a contempt of court and statemake you liable to
Your failure to or misdemeanor, by any city, state or federal authorities, please will for each
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
arrest, charge and/or conviction:
result of your failure to comply.
a.
A description of the crime charged:
Witness, Honorable
Court in
County,
day of
, 20
, one of the Justices of the
b.
The disposition of the charge;
c.
A description of the court case filed, includingabove and type name below) the
(Attorney must sign but not limited to,
name of the county and state, the case number, etc.;
d.
The date of each.
Attorney(s) for
ANSWER:
Office and P.O. Address
20.
If you have completed any statement of health or physical condition or have been
examined by a physician or other medical practitioner Telephone No.: with any application for
in connection
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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:
Index No.
Calendar No.
:
employment, application for insurance, Plaintiff(s)
or otherwise, within the past ten (10) years, state the
JUDICIAL SUBPOENA
-against:
approximate date and place of making or filing any such application or statement including the name
:
of the person or entity to whom the statement was given, the address of that person or entity and the
telephone number of that person or entity.
:
Defendant(s)
:
......................................................
ANSWER:
THE PEOPLE OF THE STATE OF NEW YORK
21.
State whether you have filed any application for unemployment compensation within
TO
the last ten (10) years with any state agency. If so, state the date of application, the agency at which
it was filed and the agency file number.
GREETINGS:
ANSWER:
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
County of
22.
With respect to each person whom you expect to call as an expert witness at trial,
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
please state:
a.
Name and address;
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalfThe subject matter issued for a maximumis expected$50testify; any
this subpoena was on which the expert penalty of to and all damages sustained as a
b.
result of your failure to comply.
treatment rendered to the plaintiff and the extent of any injuries;
Witness, Honorable substance of the facts and opinions to whichone of the Justices of the
, the expert is
c.
The
Court in
County,
day of
, 20
expected to testify;
d.
A summary of the grounds and opinions of each expert;
(Attorney must sign above and type name below)
e.
Whether written report has been or will be prepared by the expert.
Attorney(s) for
ANSWER:
23.
State whether or not the vehicle in which you were riding was repaired? If so state:
Office and P.O. Address
a.
The date of the repairs;
b.
Telephone No.:
The name and address of the person or corporation making such
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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:
repairs;
Plaintiff(s)
c.
-againstThe nature of such repairs;
d.
The cost of such repairs;
Calendar No.
:
JUDICIAL SUBPOENA
:
:
:
e.
If written records or memoranda were made of such repairs, state
where, when andDefendant(s) and addresses of the person making such
the names
:
......................................................
records or memoranda, the present whereabouts of the memoranda,
and the name and address of the person in possession or custody of
such records or memoranda;
THE PEOPLE OF THE STATE OF NEW YORK
f.
If the vehicle was not repaired, state whether or not an estimate o f
the necessary repairs was made and, if so, state the name and
address of the person making such estimate;
g.
State the value of the vehicle immediately before and immediately
after the accident;
TO
GREETINGS:
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
If you were the owner of the vehicle, state the date you purchased
,
the Honorable h.
at
Court
the vehicle, the name and address of the person or entity from whom
located at
County of
on that
in room
, on theyou purchased the vehicle and the sales price of thethe
day of
, 20
, at
o'clock in vehiclenoon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
date.
ANSWER:
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
24.
Please state
result of your failure to comply.in detail your version of how the occurrence complained of in your
pleadings took place.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
ANSWER:
25.
(Attorney must sign above and type name below)
Please state the total amount of damages that you are claiming as a result of this
occurrence including an itemization of each specific elementAttorney(s) for you are claiming and the
of damage that
corresponding monetary amount that you are attributing to each specific element of damage in
accordance with the provisions of K.S.A. 60-249a.
Office and P.O. Address
ANSWER:
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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:
26.
Index No.
Calendar No.
:
Have you sustained any Plaintiff(s) financial losses as a result of the occurrence
additional
JUDICIAL SUBPOENA
-against:
complained of other than those covered by the preceding interrogatories? If so, state:
:
a.
The nature and amount of such losses;
b.
The date of these alleged losses;
:
Defendant(s)
:
......................................................
c.
The names, addresses and telephone numbers of any persons to
whom any money so claimed as an additional loss was paid.
THE PEOPLE OF THE STATE OF NEW YORK
ANSWER:
TO
27.
Please list all medicine purchased or used by you in connection with the treatment of
the injuries complained of, the cost thereof, and the store or stores from which the medicine was
GREETINGS:
purchased. COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
WE
,
the Honorable
at the
Court
located at
County ofANSWER:
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
28.
Did you consume any alcoholic beverage or any type, or any sedative, tranquilizer or
other drug, medicine or pill during this subpoena is (48) hours as a contempt preceding the occurrence liable to
Your failure to comply with the forty-eight punishable immediately of court and will make you
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
referred to failure pleadings?
result of your in yourto comply. If so, state:
a.
The
Witness, Honorable nature, amount and type of item consumed; one of the Justices of the
,
Court in
County,
day of
, 20
b.
The amount of time over which it was consumed;
c.
The names, addresses and telephone numbers of any and all persons who
(Attorney must sign above and type name below)
have any knowledge concerning the consumption of these items.
ANSWER:
29.
Attorney(s) for
Have you ever served in the Armed Forces or performed services for any branch of
any governmental agency? If so, state:
a.
Office and P.O. Address
The name of each such organization and the particular branch for whom
Telephone No.:
you performed services;
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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:
:
b.
c.
d.
e.
f.
g.
Index No.
Calendar No.
:
The dates and places of such services;
JUDICIAL SUBPOENA
Plaintiff(s)
Your serial or identification number;
A-against- description of the services :performed;
detailed
Whether or not a physical examination was required, and if so, the dates
:
and places of such examinations;
The date of termination of such services;
:
A detailed description of the reason why the services were discontinued
Defendant(s)
and/or the condition for the discharge.
:
......................................................
ANSWER:
THE PEOPLE OF THE STATE OF NEW YORK
30.
Please provide either copies of or a description by category and location of all
TO
documents, date compilations, and tangible things in your possession, custody, or control that are
relevant to disputed facts alleged in the pleadings.
GREETINGS:
ANSWER:
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
County of
Withthe
is liable the
in room 31.
, on respect to your contention ,that the,defendanto'clock in for damages, please state
day of
20
at
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
the following with specificity:
a.
The factual basis for your contention including claims and will or other
Your failure to comply with this subpoena is punishable as a contempt of court of fault make you liable to
the party on whose behalfbasessubpoena was issued for a maximum penalty of $50 and all damages sustained as a
this of liability;
b.
The name, address and telephone number of each individual who has
result of your failure to comply.
relevant knowledge concerning the contention;
c.
Identify any and all documents known to you thatthe Justices of the the
Witness, Honorable
, one of are relevant to
contention. of
Court in
County,
day
, 20
ANSWER:
(Attorney must sign above and type name below)
32.
Is it contended that the incident alleged in the petition was caused in whole or in part
Attorney(s) for
by a violation of a statute, regulation or code provision? If so, state:
a.
The citation for each;
b.
The specific manner in which it is alleged that each such provision was
not complied with or violated.
ANSWER:
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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:
33.
:
Please state with respect to decedent:
Plaintiff(s)
a.
-againstFull name;
b.
Date of birth;
c.
Social Security Number;
Calendar No.
JUDICIAL SUBPOENA
:
:
:
Defendant(s)
:
......................................................
d.
Date of marriage(s) and name of spouse(s);
e.
Children’s names and dates of birth.
THE PEOPLE OF THE STATE OF NEW YORK
ANSWER:
TO
34.
List all addresses at which decedent resided in the ten years prior to death. Include
GREETINGS:
dates resided at each address and the names of the persons with whom the decedent resided at each
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
address.
,
the Honorable
at the
Court
located at
County of
in room ANSWER: the
, on
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
35.
With regard to the decedent’s employment for the five years preceding death, state:
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalfThe names and addresses for each employer;
this subpoena was issued of a maximum penalty of $50 and all damages sustained as a
a.
result of your failure to comply.
b.
The nature of the duties with each employer;
d.
The rate of pay or salary at the time of termination of each employment;
Witness, Honorable
Court in
, 20
c. County, dates dayeach employment;
The
of of
, one of the Justices of the
(Attorney must sign above and type name below)
e.
ANSWER:
36.
The reason for termination of each employment.
Attorney(s) for
For each hospital in which the decedent had been treated for ten years before death
Office and P.O. Address
for any medical condition, including mental conditions, state:
a.
Telephone No.:
The name and address of each facility;
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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:
Index No.
Calendar No.
b.
:
The date or approximate date of treatment at each facility;
JUDICIAL SUBPOENA
Plaintiff(s)
c.
-againstThe condition for which the decedent: was treated during each
hospitalization.
:
ANSWER:
:
Defendant(s)
:
......................................................
37.
For each physician or practitioner of the healing arts by whom the decedent was
treated for ten (10) years before death for any medical condition, including mental conditions, state:
THE PEOPLE OF THE STATE OF NEW YORK
a.
GREETINGS:
The name and address of each physician or practitioner;
b.
TO
The date or approximate date the decedent was treated by each;
c.
The conditions for which the decedent was treated by each.
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
ANSWER:
,
the Honorable
at the
Court
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
38.
Please state with respect to decedent for the past five (5) years:
or adjourned date, to testify and give evidence as a witness in this action on the part of the
a.
Gross income as reported on any income tax returns;
Your failure to comply with this subpoena of punishable as firm or corporation havingmake you liable to
b.
The name and address is the person, a contempt of court and will custody
the party on whose behalfof any papers pertaining to decedent’s income for each andthese years; sustained as a
this subpoena was issued for a maximum penalty of $50 of all damages
result of your failure to comply.
c.
The regional office of the Director of Internal Revenue with which each
d.
The state tax authority or authorities with whom the decedent filed income
tax returns;
Witness, Honorable
of these income tax returns was filed;
Court in
County,
day of
, 20
, one of the Justices of the
(Attorney must sign above and type name below)
e.
ANSWER:
39.
The amount of tax shown to be due on each federal and state return.
Attorney(s) for
Did the decedent during the last five (5) years of life contribute money or other
Office and P.O. Address
tangible benefits to you? If so, please specify the date of each contribution, the reason for each
Telephone No.:
contribution, the amount or value of each contribution, and describe anything of value decedent
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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:
received in exchange for such contribution.
Plaintiff(s)
ANSWER:
-against-
Calendar No.
:
JUDICIAL SUBPOENA
:
:
40.
State whether or not the decedent performed services for you during the last five (5)
:
Defendant(s)
years of life and, if so, for each such service, please state: :
......................................................
a.
A description of each service performed;
THE PEOPLE OF THE STATE OF NEW YORKdecedent performing the service per year, and the
b.
Total time spent by
frequency with which the decedent performed each service;
TO
c.
GREETINGS:
The date decedent last performed each such service;
d.
Compensation, if any, decedent received for performing each service;
e.
The name, all business relationship to laid aside, you and each of you attend
WE COMMAND YOU, that address andand excuses beingdecedent to each person or agency before
compensating decedent at the
for each service; Court
,
the Honorable
located at
County of
f. on theThe total of
in room
,
day cost of getting others to perform each service performed by
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
decedent.
ANSWER:
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
41.
If to have received personally or have benefited from another’s receipt of money or
result of your failureyoucomply.
servicesWitness, Honorable a result of the decedent’s death, please state: of the Justices of the
from any source as
, one
Court in
County,
day of
, 20
a.
The source of such money for services;
b.
The amount of money or description of services soabove and type name below)
(Attorney must sign received;
c.
The dates of all such payments.
Attorney(s) for
The question is intended to include medical, life or other insurance proceeds, social security
benefits, pension benefits, gratuitous monies or services, etc.
ANSWER:
42.
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
Please describe specifically and in detail the education of the decedent, a description
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:
:
Index No.
Calendar No.
of any special or unusual skills, talents or abilities, occupational: training, employment experience, and
JUDICIAL SUBPOENA
Plaintiff(s)
-against:
whether decedent was licensed by any agency, governmental or non-governmental, to perform any
profession, trade or occupation.
ANSWER:
:
:
Defendant(s)
:
......................................................
43.
How many hours per day and per week did you regularly spend with the decedent in
THE PEOPLE (5) years STATE OF NEW YORK
the last five OF THE of life?
TO
ANSWER:
44.
GREETINGS:
What hobbies, sports, games, cultural activities, vocational activities and other
interests did you share with thethat all business and excuses being laiddecedent? and each of you attend before
WE COMMAND YOU, decedent or enjoy in common with aside, you
,
the Honorable
at the
Court
located at
County ofANSWER:
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
45.
State specifically and in detail all facts and evidence that you are aware of to lead you
to believe that the decedent experienced conscious pain and as a contempt of court and will make you liable to
Your failure to comply with this subpoena is punishable suffering.
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
ANSWER:
result of your failure to comply.
Witness, Honorable
, one of the Justices of the
State specifically day of detail all facts and circumstances to support your claim that
and in
Court in 46.
County,
, 20
you suffered a pecuniary loss as a result of the death of the decedent and, in regard to your claim for
(Attorney must sign above and type name below)
pecuniary loss, itemize specifically and in detail your pecuniary damages and losses and set forth the
method used in computing such losses.
Attorney(s) for
ANSWER:
47.
Office and P.O. Address
Have any of the costs of treatment of the alleged injuries been paid for by coverage
through a federal employee benefits program or a benefits program governed by ERISA? Will any
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
such costs be submitted for payment to a federal employee benefits program or a benefits program
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:
:
Index No.
Calendar No.
:
governed by ERISA? If the answer is “yes” to either question, please state the title of the program,
JUDICIAL SUBPOENA
Plaintiff(s)
who is the named insured-against- program, who administers: the program and what payments have
under the
been made through the program.
:
ANSWER:
:
Defendant(s)
:
. . . . . . . . 48. . . . .List . . . facts that.support . . . . .allegation that. Defendants knew of would have known
...
. . . all . . . . . . . . . . . . . your . . . . . . . . . . . . .
about the defects in the subject real estate.
ANSWER:
THE PEOPLE OF THE STATE OF NEW YORK
TO
49.
List the name, address and phone number of any witness who has knowledge of the
alleged defects in the subject real estate.
GREETINGS:
ANSWER:
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
50.
State your opinion as to the actual value of the real estate at the time of your purchase
located at
County of
of of
be at and at any recessed
inand your opinion on the valueday the property as20
room
, of the
, such property was represented to noon, the time of
, at
o'clock in the
or adjourned date, to testify and give evidence as a witness in this action on the part of the
your purchase.
ANSWER:
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
51.
State comply.
result of your failure to all facts that support your allegations of fraudulent misrepresentation by any of
the Defendants, specifically identifying which Defendants made what specific fraudulent
Witness, Honorable
misrepresentation. County,
Court in
, one of the Justices of the
day of
, 20
ANSWER:
(Attorney must sign above and type name below)
52.
List all facts which support your allegation that Defendant(s) did not exercise
reasonable care in obtaining and/or communicating information concerning the condition of the
Attorney(s) for
subject real estate, specifically identifying each such item with each specific Defendant.
ANSWER:
Office and P.O. Address
53.
List any inspections you requested which were not performed prior to your purchase
of the subject real estate.
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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:
ANSWER:
Plaintiff(s)
-against-
54.
Calendar No.
:
JUDICIAL SUBPOENA
:
Do you contend Defendants had any knowledge of the real estate which they withheld
:
from the Plaintiffs? If so, specify which Defendant withheld any such knowledge from the Plaintiffs
and the specifics of such knowledge which was withheld.
:
Defendant(s)
:
. . . . . . . . ANSWER:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
..........
55.
With regard to your claims under the Kansas Consumer Protection Act, specify all
THE PEOPLE OF THE STATE OF NEW YORK
deceptive acts and practices which you contend the Defendants engaged in, specifically setting forth
TO
which Defendant violated which specific provision of the Kansas consumer Protection Ace, the nature
of the violation and the facts which support such contention.
GREETINGS:
ANSWER:
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at
Court
56.
With regard to your claims underthe Kansas Consumer Protection Act, specify all
the
located at
County of
inunconscionable acts and practices which you contend theat
room
, on the
day of
, 20
, Defendants engaged in, specifically at any recessed
o'clock in the
noon, and setting
or adjourned date, to testify and give evidence as a witness in this action on the part of the
forth which Defendant violated which specific provision of the Kansas consumer Protection Act, the
nature of the violation and the facts which support such contention.
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
ANSWER:
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
57.
Describe in detail each act or omission on the part of Defendants which you contend
Witness, Honorable
, one of the Justices of the
constituted negligent misrepresentation and was a contributing cause of the damages alleged by you.
Court in
County,
day of
, 20
In response to this Interrogatory, list each Defendant separately, with specific acts or omissions.
ANSWER:
58.
(Attorney must sign above and type name below)
Identify all persons or entities who have inspected thefor estate that is the subject
real
Attorney(s)
matter of this lawsuit during the period of your ownership, including in your answer any written
documentation of such inspections and/or factual descriptions of the findings of any such inspections
which have not been reduced to writing.
Office and P.O. Address
ANSWER:
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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:
59.
Index No.
Calendar No.
:
Identify any and all documents in your possession or under your control which
JUDICIAL SUBPOENA
Plaintiff(s)
document income and expenses from the real estate (Rental :Property).
-againstANSWER:
:
:
Defendant(s)
:
......................................................
THE PEOPLE OF THE STATE OF NEW YORK
TO
GREETINGS:
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
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
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
result of your failure to comply.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
Revised: 5-19-99
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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