Fill and Sign the Requests for Admissions 497426740 Form

IN THE ______________ COURT OF ______________ COUNTY STATE OF ________________       ) )       ) Petitioner/Plaintiff, ) ) ) NO.       Vs. ) )       ) Respondent/Defendant ) ) REQUESTS FOR ADMISSION Comes now, ___________, Inc., the Defendant in the above-styled cause and, pursuant to Rule ___, _____. R.Civ.P., propounds the following Requests for Admission to the Plaintiff: (1) Admit that the attached medical records from Dr. ___________ (Exhibit 1) are a true and accurate copy of your treatment with this physician. In the event you deny this statement, please explain the reason for your denial. RESPONSE: (2) Admit that the attached medical records from __________ Hospital (Exhibit 2) are a true and accurate copy of your treatment at this medical facility. In the event you deny this statement, please explain the reason for your denial. RESPONSE: (3) Admit that you were aware of the presence of the water on the floor of the store - 1 - prior to the time you fell. RESPONSE: (4) Admit that there were “wet floor” signs posted in the area where you fell. RESPONSE: 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 -