CASE Document 136 Filed 03/09/16 Page 1 of 2 UNITED STATES DISTRICT COURT DISTRICT OF MINNESOTA Lisa Scott, Plaintiff, v. Civil No. 13-2616 SPECIAL VERDICT FORM CSL Plasma, Inc., Defendant. We, the jury, answer the questions put to us on this Verdict Form as follows: Question 1. Did Plaintiff Lisa Scott prove by the greater weight of the evidence that Defendant CSL Plasma, Inc. refused to do business with her because she is transgender? ES es or No Note: Complete the following question only ifyour answer to Question I is ?Yes. if your anmer to Question I is ?no, have yonrforeperson sign and date this form because you have completed your deliberation. meetion 2. Did Defendant CSL Plasma, Inc. prove by the greater weight of the evidence that it deferred the Plaintiff as a plasma donor beea of a legitimate business purpose? es or No Note: Complete the following questions only ifyour answer to Question 2 is ?No. 13?" your enmer to Question 2 is ?yes, have yourforeperson sign and dare iizisform because you have completed your deliberation. Question 3. We ?nd the Plaintiff?s compensatory damages to be: Actual damages: (State the amount or, if none, write the word ?none.?) Multiplier: (State a not less than 1 or greater than 3.) 56W NE MAR 4.2015 us qgamt COURT was CASE Document 136 Filed 03/09/16 Page 2 of 2 Question 4. We ?nd the Plaintiff?s damages for mental anguish or su?ering to be: 3 (State the amount or, if none, write the word SIGI SIGNATURE BEDAGTEIJ SIGN AND DATE THIS FORM. Dated: SIGN SIGNATURE BEIJAGTED