VF 3101. Financial Abuse Employer Defendant Only (Welf. Inst. Code, §§ 15610.30, 15657.5(b))

VF-3101. Financial Abuse--Employer Defendant Only (Welf. & Inst. Code, §§ 15610.30, 15657.5 (b)) Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 We answer the questions submitted to us as follows: 1. Was [name of plaintiff/decedent] [65 years of age or older/a dependent adult] at the time of the conduct? ____ 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. Did [name of defendant]'s employee [take/hide/appropriate/obtain [or] retain] [name of plaintiff/decedent]'s property [for a wrongful use/ [or] with the intent to defraud [or] by undue influence]? ____ 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 the employee's conduct a substantial factor in causing harm to [name of plaintiff/decedent]? ____ Yes ____ No If your answer to question 3 is yes, then answer question[s] 4 [and 5]. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form. Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 4. What are [name of plaintiff/decedent]'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. [d. Past noneconomic loss, including [physical pain/mental suffering:] Future noneconomic loss, including [physical $ Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 pain/mental suffering:] TOTAL [5. $ $ ] Did [name of plaintiff] prove by clear and convincing evidence that the employee acted with [recklessness/malice/oppression/ [or] fraud]? ____ 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 were [name of decedent]'s damages for noneconomic loss for pain, ] suffering, or disfigurement incurred before death? $ Signed: Presiding Juror Dated: ______________ 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. _____________________________________________________________________________ New September 2003; Revised June 2005, April 2007, April 2008, October 2008, April 2009, December 2010, December 2016