Free Pretrial Questionnaire in PDF - Kansas

APPENDIX "C" IN THE DISTRICT COURT OF _________________ COUNTY, KANSAS ___________________________, Plaintiff, Vs. ___________________________, Defendant . PRETRIAL QUESTIONNAIRE (Instructions: This questionnaire must be completed by each attorney of record, the original is to be filed with the Court, and copies mailed to the Judge and all other counsel at least one week prior to pretrial conference. All answers must be typed. If the space provided is not sufficient for your answers, you may type your own questionnaire and answers in accordance with this format.) 1. Present date: _____________________________________________ 2. The name of the party you represent: _______________________________________ 3. Your name and address: _________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ 4. Requests for amendments to pleadings ______________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. Case No. ____________

Pretrial Questionnaire Page 2 5. Theory of your claim, if any (including grounds of negligence if applicable): ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 6. Theory of your defense, if any (including grounds of contributory or comparative negligence, if applicable): ________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. 7. Total amount of damages claimed: _______________________________________. 8. Itemization of damages: _________________________________________________ ______________________________________________________________________________ ____________________________________________________________________________. 9. Other questions of fact: __________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________.

Pretrial Questionnaire Page 3 10. If a personal injury action: a. Are permanent injuries claimed? ____________________________________ ____________________________________________________________________________. b. Have the injuries stabilized? ________________________________________ _____________________________________________________________________________. c. Has the defendant had a physical examination of the plaintiff? ____________. 11. Other questions of law: _________________________________________________ ______________________________________________________________________________ ____________________________________________________________________________. 12. Discovery: a. List discovery you have completed: __________________________________ ______________________________________________________________________________ ___________________________________________________________________________. b. Please specify further discovery contemplated (if discovery is complete, state "none"): ______________________________________________________________________ _____________________________________________________________________________. c. If further discovery is contemplated, state when same will be completed: ____ ______________________________________________________________________________ ____________________________________________________________________________. 13. Motions: a. List motions you have pending: _____________________________________

Pretrial Questionnaire Page 4 b. List motions you intend to file prior to trial: ___________________________ _____________________________________________________________________________. 14. State any procedural problems which you have: _____________________________ ______________________________________________________________________________ _____________________________________________________________________________. 15. List all witnesses you will intent to call at trial. (Note: You must list all witnesses known to you at the present time): _________________________________________________ ______________________________________________________________________________ ____________________________________________________________________________. 16. List all exhibits you intend to offer at trial: _________________________________ ______________________________________________________________________________ ____________________________________________________________________________. 17. Trial assignment: a. Should case receive priority setting, and if so, why: (If due to out-of-town witnesses, please specify.)________________________________________________________ _____________________________________________________________________________. b. Are you requesting court or jury trial? _______________________________. c. If jury trial, would you stipulate to six-member jury?____________________. d. What is estimated time for trial? ____________________________________. 18. What are the prospects for settlement? _____________________________________ _____________________________________________________________________________.

Pretrial Questionnaire Page 5 19. Should a settlement conference be scheduled in this case? _____________________

____________________________________ SIGNATURE I hereby certify that a true and correct copy of the above and foregoing pretrial questionnaire was served upon opposing counsel by depositing a copy of the same in the United States mail, postage prepaid, on the ________ day of __________________, 200___, addressed to:

____________________________________ SIGNATURE