Fill and Sign the Injury Auto Accident Form

IN THE ______________ COURT OF ______________ COUNTY STATE OF ________________       ) )       ) Petitioner/Plaintiff, ) ) ) NO.       Vs. ) )       ) Respondent/Defendant ) ) PLAINTIFF'S FIRST SET OF INTERROGATORIES PROPOUNDED TO DEFENDANTS PURSUANT TO RULE ____ OF THE ________ RULES OF CIVIL PROCEDURE COME the Plaintiff and propounds these, her First Set of Interrogatories to the Defendants, _______________ and _______________, pursuant to Rule ___ of _________ Rules of Civil Procedure to be answered under Oath within __________ (___) days from the date served on the Defendants, and answer to be served on the attorneys for Plaintiff. INTERROGATORIES INTERROGATORY NO.1: State the name, address and telephone number of all witnesses known to you or your attorneys, agents or representatives who saw the collision between the ___________ vehicle _______________ was driving and the ____________ automobile driven by _______________ which is the subject of this action. INTERROGATORY NO.2.: - 1 - State the names of all persons, giving their addresses and telephone numbers, who have knowledge of discoverable matters relevant to the collision, the injuries and death of _______________. Respectfully submitted, Dated: Name:       Title:       Address: Address: City, State, Zip: Phone: Fax: E-Mail: Attorney No.: CERTIFICATE OF SERVICE I, ______________________________, do hereby certify that I have this day mailed, U.S. Mail, postage prepaid, a true and correct copy of the above and foregoing to __________________________________, at the following address; ___________________________________________________________________ THIS the ____ day of _____________, 20____. - 2 -