Free Proposed Verdict Form - District Court of Arizona - Arizona

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DANIEL G. KNAUSS United States Attorney District of Arizona SUZANNE M. CHYNOWETH Assistant U.S. Attorney Arizona State Bar No. 6835 Two Renaissance Square 40 North Central Avenue, Suite 1200 Phoenix, Arizona 85004-4408 Telephone: (602) 514-7500 Facsimile: (602) 514-7760 E-Mail: [email protected]

UNITED STATES DISTRICT COURT DISTRICT OF ARIZONA Alexander Jung, CIV-04-0429-PHX-MHM Plaintiff, SPECIAL VERDICT FORM v. John Potter, Postmaster General, U.S. Postal Service, Defendant. Nothing said in this Special Verdict Form, which is prepared for your convenience, is meant to suggest or convey in any way or manner what verdict the Court thinks you should reach. It is solely and exclusively your duty and responsibility to decide what the verdict shall be. Question Number 1 Has Plaintiff proven, by a preponderance of the evidence, that he has a physical impairment that substantially limits his major life activities of lifting and walking? YES _____ NO _____ Trial Date: 7/31/07 Time: 9:00 a.m. CTRM: 505 Honorable Mary Murguia

If you answered "yes" to question number 1, then answer question number 2. If you answered "no" to question number 1, then you are finished with this special verdict form. The jury foreperson should date and sign this form and return it to the Court. // //

Case 2:04-cv-00429-MHM

Document 158

Filed 07/24/2007

Page 1 of 2

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Question Number 2 Has Plaintiff proven, by a preponderance of the evidence, that prior to his termination

3 from the Postal Service, effective September 28, 2002, he was able to perform all of the essential 4 functions of his job without a reasonable accommodation? 5 6 YES _____ NO _____

If you answered "yes" to question number 2, then skip question numbers 3 and 4 and

7 answer question number 5. If you answered "no" to question number 2, then answer question 8 number 3. 9 10 Question Number 3 Has Plaintiff proven, by a preponderance of the evidence, that prior to his termination

11 from the Postal Service, effective September 28, 2002, he was able to perform all of the essential 12 functions of his job with a reasonable accommodation? 13 14 YES _____ NO _____

If you answered "yes" to question number 3, then answer question number 4. If you

15 answered "no" to question number 3, then you are finished with this special verdict form. The 16 jury foreperson should date and sign this form and return it to the Court. 17 18 Question Number 4 What is the present cash value of Plaintiff's damages caused by [insert facts after ruling

19 on motions in limine and evidence adduced at trial] (other than lost pay and benefits and 20 attorney fees)? 21 22 $_________________ When the jury has completed its work on this form, the jury foreperson should date and

23 sign this form, and return it to the Court. 24 25 26 27 28 2
Case 2:04-cv-00429-MHM Document 158 Filed 07/24/2007 Page 2 of 2

Dated: __________________ _______________________________________ JURY FOREPERSON'S SIGNATURE