CACI VF-1001 Premises Liability—Affirmative Defense—Recreation Immunity—Exceptions

VF-1001 Premises Liability—Affirmative Defense—Recreation Immunity—Exceptions

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We answer the questions submitted to us as follows:

1.Did [name of defendant] [own/lease/occupy/control] the property?

Yes  No

If your answer to question 1 is yes, then answer question 2. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form.

2.Was [name of defendant] negligent in the [use/maintenance] of the property?

Yes  No

If your answer to question 2 is yes, then answer question 3. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form.

3.Was [name of defendant]’s negligence a substantial factor in causing harm to [name of plaintiff]?

Yes  No

If your answer to question 3 is yes, then answer question 4. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form.

4.Did [name of plaintiff/name of person causing injury] enter on or use [name of defendant]’s property for a recreational purpose?

Yes  No

If your answer to question 4 is yes, then answer question 5. If you answered no, skip question 5 and answer question 6.

5.Did [name of defendant] willfully or maliciously fail to protect others from or warn others about a dangerous [condition/use/structure/activity] on the property?

Yes  No

If your answer to question 5 is yes, then answer question 6. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form.

6.What are [name of plaintiff]’s damages?

[a.Past economic loss

	[lost earnings	$ ]
	[lost profits	$ ]
	[medical expenses	$ ]
	[other past economic loss	$ ]
		Total Past Economic Damages: $ ]

[b.Future economic loss

	[lost earnings	$ ]
	[lost profits	$ ]
	[medical expenses	$ ]
	[other future economic loss	$ ]
		Total Future Economic Damages: $ ]

[c.Past noneconomic loss, including [physical pain/mental suffering:]

$ ]

[d.Future noneconomic loss, including [physical pain/mental suffering:]

After [this verdict form has/all verdict forms have] been signed, notify the [clerk/bailiff/court attendant] that you are ready to present your verdict in the courtroom.

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