Fill and Sign the Complaint for Assault and Battery Form

-1- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 (Name, Address Of Party or attorney) _____________________________ _____________________________ _____________________________ State Bar No: __________________ (____) _____ - _________________ Attorney for _______ (Or "In Pro Per") SUPERIOR COURT OF THE STATE OF CALIFORNIA COUNTY OF ________ PLAINTIFF(S) NAMES ) CASE NO.: _______ Plaintiffs ) ) v ) ) DEFENDANT(S) NAMES ) Defendants ) ) --------------------------------------------------------- COMPLAINT FOR ASSAULT AND BATTERY Plaintiff complains and for causes of action alleges as follows: FIRST CAUSE OF ACTION (Battery) I. Plaintiff is an individual and is now, and at all times mentioned in this complaint was, a resident of __________ County, California. II. Defendant is an individual and is now, and at all times mentioned in this complaint was, a resident of __________ County, California. III. -2- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 On or about __________ [date], at approximately __________ [time], plaintiff was in __________ [his or her] home reading when he heard very loud music. The music was so loud that it disturbed plaintiff's quiet enjoyment of the evening. IV. Plaintiff wen t to the window at the front of __________ [his or her] home to determine the source of the music, and saw defendant, who is plaintiff's neighbor, and several strangers leaning against defendant's car which was parked in front of plaintiff's home. A large portable stereo, or "boom box" as they are popularly known, sat on the hood of defendant's car and appeared to be the source of the loud music. V. Plaintiff walked out to where defendant and __________ [his or her] companions were standing and politely as ked if defendant would lower the volume of the music. VI. Defendant refused and plaintiff again asked defendant to turn down the volume or __________ [he or she] would call the police. Defendant again refused and plaintiff turned and started back toward _ _________ [his or her] home. VII. Defendant then called plaintiff's name and plaintiff turned and faced defendant. __________ [Describe defendant's threatening conduct, such as: Defendant stood very close to plaintiff, shook __________ (his or her) fist i n plaintiff's face, and, using very foul language, threatened to strike plaintiff if __________ (he or she) called the police.] VIII. Plaintiff began to back away from defendant, moving toward his front door, when defendant struck plaintiff in the face wi th __________ [his or her] fist. Plaintiff returned the blow -3- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 and plaintiff and defendant battled until they were separated by other persons. During the course of the altercation defendant struck and kicked plaintiff numerous times. IX. Defendant intended to cause and did cause a harmful contact with defendant's person. X. Plaintiff did not consent to defendant's act. XI. As a direct and proximate result of defendant's conduct plaintiff suffered __________ [describe plaintiff's injuries]. Plaintiff has a lso suffered extreme mental anguish and physical pain. __________ [If applicable, add: Plaintiff is informed and believes, and on that basis alleges, that plaintiff has suffered a permanent disability.] These injuries have caused plaintiff to suffer genera l damages in __________ [the amount of $__ or, if the action is brought in superior court, an amount to be determined by proof at trial]. XII. As a direct and proximate result of defendant's conduct, plaintiff was required to obtain medical services and treatment in __________ [the amount of $__ or, if the action is brought in superior court, an amount to be determined by proof at trial] ________ __ [if applicable, add: and will, in the future, be compelled to incur additional obligations for medical treatment in an amount to be determined by proof at trial]. XIII. __________ [If applicable, add one of the following allegations, as appropriate] [EITHER] As a further direct and proximate result of defendant's conduct, plaintiff was unable to work for a period of __________ [weeks or months or as the case may be] and, accordingly, lost -4- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 wages in __________ [the amount of $__ or, if the action is brou ght in superior court, an amount to be determined by proof at trial]. [OR] As a further direct and proximate result of defendant's conduct, plaintiff has been, and continues to be, unable to work since the events described in this complaint and has suffe red a loss of earnings in an amount which has not yet been determined, but which will be added by amendment when it is ascertained. XIV. Defendant's act was done knowingly, willfully, and with malicious intent, and plaintiff is entitled to punitive damage s in an amount to be determined by proof at trial. SECOND CAUSE OF ACTION (Assault) XV. Plaintiff incorporates by reference paragraphs 1 -7 inclusive, and paragraphs 11 -14, inclusive, of the First Cause of Action as if fully set forth. XVI. Defendant int ended to cause and did cause plaintiff to suffer apprehension of an immediate harmful contact. WHEREFORE, plaintiff demands judgment against defendant, as follows: General damages in __________ [the amount of $__ or an amount to be dete rmined by proof at trial]; -5- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Medical and related expenses in __________ [the amount of $__ or an amount to be determined by proof at trial]; Past and future lost earnings in __________ [the amount of $__ or an amount to be determined by proof at trial]; Impairment of earning capacity in __________ [the amount of $__ or an amount to be determined by proof at trial]; Punitive damages; Costs of this action; Any other and further relief that the court considers proper. DATE: ____________________ ________ ____________ (Signature) VERIFICATION I, ___, am a ___in the above -entitled action. I have read the foregoing ___and know the contents thereof. The same is true of my own knowledge, except as to those matters which are therein alleged o n information and belief, and as to those matters, I believe it to be true. I declare under penalty of perjury that the foregoing is true and correct and that this declaration was executed at , California. DATE: _______________ _____ ____________________ (Signature) -6- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28