Fill and Sign the Judgment Personal Injury Form

IN THE ______________ COURT OF ______________ COUNTY STATE OF ________________       ) )       ) Petitioner/Plaintiff, ) ) ) NO.       Vs. ) )       ) Respondent/Defendant ) ) OFFER OF JUDGMENT COME NOW the Defendants, _________________________ and ________________________, by and through their attorneys, and, pursuant to Rule ____ of the ________________ Rules of Civil Procedure, make this offer to allow judgment to be taken against said Defendants and in favor of the Plaintiffs, ______________________ and ________________________ on the Complaint filed by said plaintiffs with costs now accrued, as follows: 1. That judgment be entered in favor of the Plaintiffs against the Defendants in the total sum of $_______________, with costs now accrued, in full and final settlement and release of all claims, injuries and demands specifically set forth in the Complaint filed herein. 2. This offer is not an admission of liability, and if said offer is not accepted within the time allowed by law, it shall be deemed withdrawn and evidence thereof will not be admissible in any proceeding except in a proceeding to determine costs herein. DATED this _____ day of ______________, 20____. - 1 - 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 -