COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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: Index No.
PLD-PI-001(4)
SHORT TITLE: CASE NUMBER:
: Calendar No.
:
Plaintiff(s) JUDICIAL SUBPOENA
CAUSE
-against- OF ACTION—Premises Liability
: Page
(number)
ATTACHMENT TO Complaint Cross - Complaint :
(Use a separate cause of action form for each cause of action.)
:
Prem.L-1. Plaintiff (name):
Defendant(s)
alleges the acts of defendants were the legal (proximate) cause of damages to plaintiff.
:
.. .... ..... ..
. . . . . . . . . .On .(date): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . plaintiff .was injured on the following premises in the following
fashion (description of premises and circumstances of injury):
THE PEOPLE OF THE STATE OF NEW YORK
TO
GREETINGS:
Prem.L-2. Count One—Negligence The defendants who negligently owned, maintained, managed and
operated the described premises were (names):
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
the Honorable at the Court ,
County of Does
located at to
in room , on the day of , 20 , at o'clock in the noon, and at any recessed
Prem.L-3. Count Two—Willful Failure as a witness in this action on the defendant owners who willfully
or adjourned date, to testify and give evidenceto Warn [Civil Code section 846] The part of the
or maliciously failed to guard or warn against a dangerous condition, use, structure, or activity were
(names):
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
Does to
result of your failure to comply.
Plaintiff, a recreational user, was an invited guest a paying guest.
Prem.L-4. Count Three—Dangerous Condition of Public Property The defendants who owned public property
Witness, Honorabledangerous condition existed were (names):
on which a , one of the Justices of the
Court in County, day of , 20
Does to
a. The defendant public entity had (Attorney must sign above and type name below)
actual constructive notice of the existence of the
dangerous condition in sufficient time prior to the injury to have corrected it.
b. The condition was created by employees of the defendant public entity.
Prem.L-5. a. Allegations about Other Defendants The defendants who were the agents and employees of the
Attorney(s) for
other defendants and acted within the scope of the agency were (names):
Does to
Office and P.O. Address
b. The defendants who are liable to plaintiffs for other reasons and the reasons for their liability are
described in attachment Prem.L-5.b as follows (names):
Telephone No.:
Facsimile No.:
E-Mail Address: Page 1 of 1
Form Approved for Optional Use
Judicial Council of California
Liability
CAUSE OF ACTION—Premises Mobile Tel. No.: Code of Civil Procedure, § 425.12
www.courtinfo.ca.gov
PLD-PI-001(4) [Rev. January 1, 2007]
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