VF 3035. Bane Act (Civ. Code, § 52.1)

VF-3035. Bane Act (Civ. Code, § 52.1) Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 We answer the questions submitted to us as follows: 1. Did [name of defendant] make threats of violence against [[name of plaintiff]/ [or] [name of plaintiff]'s property]? ____ Yes ____ No [or] 1. Did [name of defendant] act violently against [[name of plaintiff]/ [and] [name of plaintiff]'s property]? 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 threats cause [name of plaintiff] to reasonably believe that if [he/she] exercised [his/her] right [insert right, e.g., "to vote"] [name of defendant] would commit violence against [[him/her]/ [or] [his/her] property] and that [name of defendant] had the apparent ability to carry out the threat? ____ Yes ____ No [or] 2. Did [name of defendant] commit these acts of violence to [prevent [name of plaintiff] from exercising [his/her] right [insert right, e.g., "to vote"]/retaliate against [name of plaintiff] for having exercised [his/her] VF-3035. Bane Act (Civ. Code, § 52.1) Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 right [insert right]]? 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 conduct 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. 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 $ ] $ $ $ $ $ ] ] ] ] ] VF-3035. Bane Act (Civ. Code, § 52.1) Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 [lost profits [medical expenses [other future economic loss [c. Past noneconomic loss, including [physical pain/mental suffering:] $ $ $ ] ] ] ] ] ] Total Future Economic Damages: $ $ $ $ [d. Future noneconomic loss, including [physical pain/mental suffering:] TOTAL [Answer question 5. 5. Signed: Dated: What amount do you award as punitive damages? $ Presiding Juror ] 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 April 2007, December 2010; Renumbered from CACI No. VF-3015 and Revised December 2012, December 2016