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Sample California request for statement of damages

This request for statement of damages for California is pursuant to Section 425.11 of the Code of Civil Procedure, and is to be used by a defendant in a personal injury or wrongful death case in California. The author is a freelance paralegal who has worked in California and Federal litigation since 1995 and has used this sample for many years. Note that the author is NOT an attorney and no guarantee or warranty is provided.

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1   Any Attorney or Party
     Any Street
 2   Any Town, CA 99999

 3   555-555-5555

 4   Any Attorney or Party

 5

 6

 7

 8                                  Superior Court of the State of California

 9                                     For the County of ____________

10

11   Any Plaintiff,                                 )   Case No.
                                                    )
12                    Plaintiff,                    )   REQUEST FOR STATEMENT OF DAMAGES
                                                    )
13            vs.                                   )
                                                    )
14   Any Defendant,                                 )
                                                    )
15                    Defendants.                   )
                                                    )
16                                                  )
                                                    )
17

18
              To subscribe to my FREE California weekly legal newsletter visit
19

20   http://www.legaldocspro.net/newsletter.htm and enter your e-mail
21
     address. Be sure to remove this notice before using this document.
22

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              TO PLAINTIFF, ____________________ AND THEIR ATTORNEYS OF RECORD:
24
              NOTICE IS HEREBY GIVEN that Defendant, _________________________________
25
     pursuant to Code of Civil Procedure Section 425.11, hereby requests that you provide a Statement of
26

27   Damages setting forth the nature and amount of the damages being sought against Defendant,

28   __________________in the above-entitled action.

                                                  - 1 -
                                    REQUEST FOR STATEMENT OF DAMAGES
1          Said Statement of Damages must be in writing and served on the requesting party within 15
 2   days of the date of service of this Request for Statement of Damages.
 3

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     Dated________________                _______________________________________________
 5                                        ANY ATTORNEY OR PARTY
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                                                 - 2 -
                                   REQUEST FOR STATEMENT OF DAMAGES
1                                           PROOF OF SERVICE
 2          I am over the age of 18 and not a party to this action.
 3
            I am a resident of or employed in the county where the mailing occurred; my
 4   business/residence address is: ADDRESS OF PERSON SERVING PAPERS.
 5        On ____________________ I served the foregoing document(s) described as: REQUEST
 6
     FOR STATEMENT OF DAMAGES to the following parties:

 7   NAME AND ADDRESS OF ATTORNEY FOR OTHER PARTY OR OTHER PARTY

 8

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                    [X] (By U.S. Mail) I deposited such envelope in the mail at ___________California,
                         with postage thereon fully prepaid. I am aware that on motion of the party
10                       served, service is presumed invalid if postal cancellation date or postage meter
                         date is more than one day after date of deposit for mailing in affidavit.
11

12
              I declare under penalty of perjury under the laws of the State of California that the foregoing
13   is true and correct.

14   DATED: ______________
15
                                                           _______________________________________
16                                                         NAME OF PERSON SERVING PAPERS

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                                                   - 3 -
                                     REQUEST FOR STATEMENT OF DAMAGES
1                                           PROOF OF SERVICE
 2          I am over the age of 18 and not a party to this action.
 3
            I am a resident of or employed in the county where the mailing occurred; my
 4   business/residence address is: ADDRESS OF PERSON SERVING PAPERS.
 5        On ____________________ I served the foregoing document(s) described as: REQUEST
 6
     FOR STATEMENT OF DAMAGES to the following parties:

 7   NAME AND ADDRESS OF ATTORNEY FOR OTHER PARTY OR OTHER PARTY

 8

 9
                    [X] (By U.S. Mail) I deposited such envelope in the mail at ___________California,
                         with postage thereon fully prepaid. I am aware that on motion of the party
10                       served, service is presumed invalid if postal cancellation date or postage meter
                         date is more than one day after date of deposit for mailing in affidavit.
11

12
              I declare under penalty of perjury under the laws of the State of California that the foregoing
13   is true and correct.

14   DATED: ______________
15
                                                           _______________________________________
16                                                         NAME OF PERSON SERVING PAPERS

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                                                   - 3 -
                                     REQUEST FOR STATEMENT OF DAMAGES
1                                           PROOF OF SERVICE
 2          I am over the age of 18 and not a party to this action.
 3
            I am a resident of or employed in the county where the mailing occurred; my
 4   business/residence address is: ADDRESS OF PERSON SERVING PAPERS.
 5        On ____________________ I served the foregoing document(s) described as: REQUEST
 6
     FOR STATEMENT OF DAMAGES to the following parties:

 7   NAME AND ADDRESS OF ATTORNEY FOR OTHER PARTY OR OTHER PARTY

 8

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                    [X] (By U.S. Mail) I deposited such envelope in the mail at ___________California,
                         with postage thereon fully prepaid. I am aware that on motion of the party
10                       served, service is presumed invalid if postal cancellation date or postage meter
                         date is more than one day after date of deposit for mailing in affidavit.
11

12
              I declare under penalty of perjury under the laws of the State of California that the foregoing
13   is true and correct.

14   DATED: ______________
15
                                                           _______________________________________
16                                                         NAME OF PERSON SERVING PAPERS

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                                                   - 3 -
                                     REQUEST FOR STATEMENT OF DAMAGES
1                                           PROOF OF SERVICE
 2          I am over the age of 18 and not a party to this action.
 3
            I am a resident of or employed in the county where the mailing occurred; my
 4   business/residence address is: ADDRESS OF PERSON SERVING PAPERS.
 5        On ____________________ I served the foregoing document(s) described as: REQUEST
 6
     FOR STATEMENT OF DAMAGES to the following parties:

 7   NAME AND ADDRESS OF ATTORNEY FOR OTHER PARTY OR OTHER PARTY

 8

 9
                    [X] (By U.S. Mail) I deposited such envelope in the mail at ___________California,
                         with postage thereon fully prepaid. I am aware that on motion of the party
10                       served, service is presumed invalid if postal cancellation date or postage meter
                         date is more than one day after date of deposit for mailing in affidavit.
11

12
              I declare under penalty of perjury under the laws of the State of California that the foregoing
13   is true and correct.

14   DATED: ______________
15
                                                           _______________________________________
16                                                         NAME OF PERSON SERVING PAPERS

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                                                   - 3 -
                                     REQUEST FOR STATEMENT OF DAMAGES
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Sample California request for statement of damages

  • 1. 1 Any Attorney or Party Any Street 2 Any Town, CA 99999 3 555-555-5555 4 Any Attorney or Party 5 6 7 8 Superior Court of the State of California 9 For the County of ____________ 10 11 Any Plaintiff, ) Case No. ) 12 Plaintiff, ) REQUEST FOR STATEMENT OF DAMAGES ) 13 vs. ) ) 14 Any Defendant, ) ) 15 Defendants. ) ) 16 ) ) 17 18 To subscribe to my FREE California weekly legal newsletter visit 19 20 http://www.legaldocspro.net/newsletter.htm and enter your e-mail 21 address. Be sure to remove this notice before using this document. 22 23 TO PLAINTIFF, ____________________ AND THEIR ATTORNEYS OF RECORD: 24 NOTICE IS HEREBY GIVEN that Defendant, _________________________________ 25 pursuant to Code of Civil Procedure Section 425.11, hereby requests that you provide a Statement of 26 27 Damages setting forth the nature and amount of the damages being sought against Defendant, 28 __________________in the above-entitled action. - 1 - REQUEST FOR STATEMENT OF DAMAGES
  • 2. 1 Said Statement of Damages must be in writing and served on the requesting party within 15 2 days of the date of service of this Request for Statement of Damages. 3 4 Dated________________ _______________________________________________ 5 ANY ATTORNEY OR PARTY 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 - 2 - REQUEST FOR STATEMENT OF DAMAGES
  • 3. 1 PROOF OF SERVICE 2 I am over the age of 18 and not a party to this action. 3 I am a resident of or employed in the county where the mailing occurred; my 4 business/residence address is: ADDRESS OF PERSON SERVING PAPERS. 5 On ____________________ I served the foregoing document(s) described as: REQUEST 6 FOR STATEMENT OF DAMAGES to the following parties: 7 NAME AND ADDRESS OF ATTORNEY FOR OTHER PARTY OR OTHER PARTY 8 9 [X] (By U.S. Mail) I deposited such envelope in the mail at ___________California, with postage thereon fully prepaid. I am aware that on motion of the party 10 served, service is presumed invalid if postal cancellation date or postage meter date is more than one day after date of deposit for mailing in affidavit. 11 12 I declare under penalty of perjury under the laws of the State of California that the foregoing 13 is true and correct. 14 DATED: ______________ 15 _______________________________________ 16 NAME OF PERSON SERVING PAPERS 17 18 19 20 21 22 23 24 25 26 27 28 - 3 - REQUEST FOR STATEMENT OF DAMAGES
  • 4. 1 PROOF OF SERVICE 2 I am over the age of 18 and not a party to this action. 3 I am a resident of or employed in the county where the mailing occurred; my 4 business/residence address is: ADDRESS OF PERSON SERVING PAPERS. 5 On ____________________ I served the foregoing document(s) described as: REQUEST 6 FOR STATEMENT OF DAMAGES to the following parties: 7 NAME AND ADDRESS OF ATTORNEY FOR OTHER PARTY OR OTHER PARTY 8 9 [X] (By U.S. Mail) I deposited such envelope in the mail at ___________California, with postage thereon fully prepaid. I am aware that on motion of the party 10 served, service is presumed invalid if postal cancellation date or postage meter date is more than one day after date of deposit for mailing in affidavit. 11 12 I declare under penalty of perjury under the laws of the State of California that the foregoing 13 is true and correct. 14 DATED: ______________ 15 _______________________________________ 16 NAME OF PERSON SERVING PAPERS 17 18 19 20 21 22 23 24 25 26 27 28 - 3 - REQUEST FOR STATEMENT OF DAMAGES
  • 5. 1 PROOF OF SERVICE 2 I am over the age of 18 and not a party to this action. 3 I am a resident of or employed in the county where the mailing occurred; my 4 business/residence address is: ADDRESS OF PERSON SERVING PAPERS. 5 On ____________________ I served the foregoing document(s) described as: REQUEST 6 FOR STATEMENT OF DAMAGES to the following parties: 7 NAME AND ADDRESS OF ATTORNEY FOR OTHER PARTY OR OTHER PARTY 8 9 [X] (By U.S. Mail) I deposited such envelope in the mail at ___________California, with postage thereon fully prepaid. I am aware that on motion of the party 10 served, service is presumed invalid if postal cancellation date or postage meter date is more than one day after date of deposit for mailing in affidavit. 11 12 I declare under penalty of perjury under the laws of the State of California that the foregoing 13 is true and correct. 14 DATED: ______________ 15 _______________________________________ 16 NAME OF PERSON SERVING PAPERS 17 18 19 20 21 22 23 24 25 26 27 28 - 3 - REQUEST FOR STATEMENT OF DAMAGES
  • 6. 1 PROOF OF SERVICE 2 I am over the age of 18 and not a party to this action. 3 I am a resident of or employed in the county where the mailing occurred; my 4 business/residence address is: ADDRESS OF PERSON SERVING PAPERS. 5 On ____________________ I served the foregoing document(s) described as: REQUEST 6 FOR STATEMENT OF DAMAGES to the following parties: 7 NAME AND ADDRESS OF ATTORNEY FOR OTHER PARTY OR OTHER PARTY 8 9 [X] (By U.S. Mail) I deposited such envelope in the mail at ___________California, with postage thereon fully prepaid. I am aware that on motion of the party 10 served, service is presumed invalid if postal cancellation date or postage meter date is more than one day after date of deposit for mailing in affidavit. 11 12 I declare under penalty of perjury under the laws of the State of California that the foregoing 13 is true and correct. 14 DATED: ______________ 15 _______________________________________ 16 NAME OF PERSON SERVING PAPERS 17 18 19 20 21 22 23 24 25 26 27 28 - 3 - REQUEST FOR STATEMENT OF DAMAGES