14-2-51133-0
UHD



IN THE SUPERIOR COURT OF THE STATE OF WASHINGTON
IN AND FOR THE COUNTY OF FRANKLIN ORIGINAL FILED

 

 

 

 

 

 

 

 

 

 

JAMES ANDERSON, AUG -3 2015

NO- 14'2'51133'0 MICHAEL J. KILLIAN
Plaintiff, FRANKLIN county CLERK
SPECIAL VERDICT FORM 

VS.

SCOTT HAYLES, LORI HAYLES, the
marital community of SCOTT HAYLES and
LORI and their minor children
MATTHEW HAYLES, NATHAN HAYLES,
and ANDREW 

 

Defendants.

We, the jury, answer the questions submitted by the court as follows:
seem:

Were one or more of the Defendants negligent, and thereby proximately
caused damage to plaintiff?

ANSWER: (Write ?yes? or 
QUESTION 2:

Was there a conversion of property committed by
any of the defendants that proximately caused damage to plaintiff?

ANSWER: 4&5 (Write "yes" or 
W:

Was there a fraud committed by any of the defendants that proximately
caused damage to plaintiff?

ANSWER: ad (Write ?yes? or 
QUESTION 4:

(Direction: Answer this question only if you answered ?yes? to either Question 1,
Question 2 or Question 3.)

 

 

 

What is the amount of the plaintiff?s damages for veterinary bills, mileage.
loss of use and intrinsic value?

{/7531

QUESTION 5:

(Direction: Answer this question oniy if you answered ?yes? to either Question 2 or
Question 3.)

What is the amount of the plaintiff?s damages for emotional distress?

ANSWER: c000? (32?

QUESTION 6:

(Direction: Answer this question oniy if you answered ?yes? to Question 1.)

Was there negligence by the plaintiff that was a proximate cause of the
damage to the plaintiff?

ANSWER: {1&5 (Write ?yes? or 

it you answered ?no? to Question 6 or did not answer Question 6, sign
this verdict form. it you answered ?yes? to Question 6, answer Question 7.)

QUESTION T:

Assume that 100% represents the total combined negligence that
proximately caused the plaintiff's damage. What percentage of the
negligence is attributable to the plaintiff?

ANSWER: (>269 ?r6

Sign this verdict form and notify the 

DATE: 

Presiding Juror