Kern — SUP CRT 580 9410 CI-12

Source: https://www.kern.courts.ca.gov/system/files/general/sup-crt-580-9410-ci-12-issue-memorandum-rev-11999.pdf

ATTORNEY OR UNREPRESENTED PARTY (Name, state bar number, and address): FOR COURT USE ONLY

TELEPHONE NO.: FAX NO.: (Optional):

E-MAIL ADDRESS (Optional):

Representing (Name) Telephone Number:

NATURE OF CASE

Plaintiff: = Personal Injury, Property Damage or Wrongful Death, Involving Motor Vehicle = All Other Personal Injury, etc. Defendant: = Family Law = Eminent Domain = Other Civil: NOTE: Eminent domain actions must show parcel number. Submit one copy of this form for each parcel and for each case if consolidated actions. = AT-ISSUE MEMORANDUM CASE NUMBER:

PARCEL NO.: = AMENDED = COUNTER AT-ISSUE

1. What date was the action filed?
2. What date was the first answer filed?
3. Jury trial requested: = Yes = No
4. Time estimated for trial: Days Hours
5. Case entitled to preference: = Yes = No = Under code section:
6. Is discovery = completed = partially completed not yet begun 7. Is any law and motion matter pending or contemplated? == Yes = No
7. Will such law and motion matter be heard within 90 days? = Yes = No
8. Is equitable relief sought? = Yes = No
9. Do you claim an exemption from mandatory arbitration pursuant to Rule 1600.5, California Rules of Court? = Yes = No Specify exemption:
10. Does the amount in controversy exceed $25,000 as to any Plaintiff? = Yes = No
11. Do you object to the matter being ordered to Arbitration? = Yes = No
12. Are you willing to stipulate to Arbitration, regardless of the amount in controversy? = Yes = No
13. If Personal Injury: a. Nature and extent of injuries: b. Total medical expenses to date: c. Future medical expenses: d. Loss of earnings to date: e. Future loss of earnings: f. Other special or general damages:
14. Other: a. Nature of damages: b. Amount of damages: c. Relief sought:
15. Indicate below names of party being represented and trial counsel.

Plaintiff Defendant Attorney Attorney Firm Firm Address Address

Telephone Telephone

AT-ISSUE MEMORANDUM Superior Court 580 9410 CI-12 (Optional Form) (Rev. 1-99) Front

Party Party Attorney Attorney Firm Firm Address Address

Telephone Telephone

Party Party Attorney Attorney Firm Firm Address Address

Telephone Telephone

Party Party Attorney Attorney Firm Firm Address Address

Telephone Telephone

For additional parties, attach a separate sheet and check here. = I hereby represent to the court that all essential parties have been served with process or have appeared herein and that this

case is at issue as to all such parties; that no amended or supplemental complaint or cross-complaint or other affirmative pleading remains unanswered; that to my knowledge no other parties will be served with a summons prior to the time of trial, and I know of no further pleading to be filed. Dated:

Attorney(s) for

ANY PARTY NOT IN AGREEMENT WITH THE INFORMATION OR ESTIMATES GIVEN IN THE AT-ISSUE MEMORANDUM

SHALL WITHIN TEN DAYS AFTER SERVICE THEREOF SERVE AND FILE A MEMORANDUM IN HIS BEHALF.

PROOF OF SERVICE BY MAIL (C.C.P. 1013a)

I served the At-Issue Memorandum by depositing a copy thereof (enclosed in sealed envelope(s), postage prepaid) in the

United States mail, addressed to each party or to his attorney as shown in such memoranda, on at , California.

At the time of service, I was at least 18 years of age, (employed/residing) in the county

where the mailing occurred, and not a party to the action. My (residence/business) address is:

I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct and this

declaration is executed on (date): at (place)

(SIGNATURE OF DECLARANT)

(TYPE OR PRINT NAME)

AT-ISSUE MEMORANDUM Superior Court 580 9410 CI-12 (Optional Form) (Rev. 1-99) Back