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Pretrial Memorandum Appendix H - Illinois
|Pretrial Memorandum Form. This is a Illinois form and can be used in General Winnebago Local County .||
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STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE 17TH JUDICIAL CIRCUIT COUNTY OF WINNEBAGO ) ) ) ) ) ) ) ) ) Defendant (s) PRETRIAL MEMORANDUM The information required in this Memorandum should be full, complete, typewritten, and in triplicate and mailed or delivered to all attorneys of record and filed with the Winnebago County Circuit Clerk's Office not less than seven (7) days before the date of the pretrial conference. 1. Plaintiff's law firm: Lead attorney: Address: Phone: 2. Defendant No. 1: Law firm: Lead attorney: Address: Phone: Defendant No.2: Law firm: Lead attorney: Address: Phone: Defendant No.3: Law firm: Lead attorney: Address: Phone: 3. Plaintiff's Name 4. Plaintiff's Age & Marital Status: 5. Plaintiff's Occupation: 6. Date, hour and place of occurrence: No. INITIAL PRETRIAL DATE: Plaintiff (s) vs. A-8 APPENDIX H 04/95 2002 © American LegalNet, Inc. APPENDIX H - Continued 7. Statement of facts: 8. Plaintiff's theory of liability: 9. Defendant's theory of liability: 10. Plaintiff's description of injuries: 11. Plaintiff's present complaints if any: 12. Third-party claims, if any: DAMAGES MEDICAL EXPENSES: Hospital ER and outpatient Inpatient Attending Physician(s): Consulting Physician(s): X-ray Laboratory: Physical Therapy: Medical Aids (describe): Future medical: Ambulance: Other: DATES: NAMES: AMOUNT: $ $ $ $ $ $ $ $ $ $ $ $ Medical Sub-total: $ A-8.1 APPENDIX H 04/95-22002 © American LegalNet, Inc. APPENDIX H - Continued LOSS OF EARNINGS: From From to to employed at employed at $ $ Future loss of earnings: Earnings Sub-total: PERMANENT DISABILITY, if any: $ MISCELLANEOUS DAMAGES: $ $ $ Miscellaneous Sub-Total: TOTAL SPECIAL DAMAGES: $ $ Plaintiff's Demand: Defendant's No. 1 Offer: Defendant's No. 2 Offer: $ $ $ A-8.2 APPENDIX H -3- 04/95 2002 © American LegalNet, Inc.