Kinsey Law Offices 
Complaint For Emotional Distress
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    (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]
Plaintiffs,

 

v.

 

 
[DEFENDANT(S) NAMES]
Defendants
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CASE NO: _______
 
COMPLAINT FOR
INTENTIONAL AND NEGLIGENT EMOTIONAL DISTRESS

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Plaintiff complains and for causes of action alleges as follows:

FIRST CAUSE OF ACTION

(Intentional Infliction of Emotional Distress against ___)

<>. Defendant__, ___ is__, and at all times herein mentioned was__, a resident__ of the City of ___, County of __, State of California.

<>. Defendant__, ___, is__, and at all times herein mentioned, was__ a Corporation organized and existing under the laws of the State of California with principle offices located at ___, in the City of ___, County of ___.

<>. Plaintiff__ is__ ignorant of the true names and capacities of defendants sued herein as DOES I through X, inclusive, and therefore sues__ these defendants by such fictitious names. Plaintiff__ will amend this complaint to allege their true names and capacities when ascertained.

<>. Plaintiff__ is__ informed and believes__ and thereon alleges__ that, at all times herein mentioned, each of the defendants sued herein was the agent and employee of each of the remaining defendants and was at all times acting within the purpose and scope of such agency and employment.

<>. ____[---Allege facts showing relationship of parties giving rise to defendant's duty to exercise due care towards plaintiff or, if action arises out of defendant's breach of contract with plaintiff, allege execution and relevant terms of contract----]


<>. ___[---Allege defendant's act or omission to act constituting breach of duty or breach of contract---]


<>. ___[---Allege intent to cause emotional distress, e.g., Defendant ___'s conduct was intentional and malicious and done for the purpose of causing Plaintiff to suffer humiliation, mental anguish, and emotional and physical distress.----]


<>. As a proximate result of defendant's ____[---act or omission ---], ___[---specify consequences of breach support claim----].


<>. As a further proximate result of defendant____ ____[---specify act---] and the consequences proximately caused by it, as hereinabove alleged , plaintiff suffered severe humiliation, mental anguish, and emotional and physical distress, and has been injured in mind and body as follows: _____, all to ___ damage in the sum of $_____.


<>. [---Continue, alleging in this and subsequent paragraphs each item of special damages, if any, suffered by plaintiff, including any loss of wages and medical and related expenses incurred or paid.----]

 

FIRST CAUSE OF ACTION

(Negligent Infliction of Emotional Distress against ___)

<>. ____[---Allege facts showing relationship of parties giving rise to defendant's duty to exercise due care towards plaintiff or, if action arises out of defendant's breach of contract with plaintiff, allege execution and relevant terms of contract----]


<>. Defendant___ knew, or should have known, that ___ failure to exercise due care in the performance of ____[---act to be done or terms of the contract---] would cause plaintiff___ severe emotional distress.


<>. ___[---Allege defendant's act or omission to act constituting breach of duty or breach of contract---]


<>. As a proximate result of defendant's ____[---act or omission ---], ___[---specify consequences of breach support claim----].


<>. As a further proximate result of defendant____ ____[---specify act---] and the consequences proximately caused by it, as hereinabove alleged , plaintiff suffered severe emotional distress and mental suffering, all to ___ damage in the sum of $_____.


<>. [---Continue, alleging in this and subsequent paragraphs each item of special damages, if any, suffered by plaintiff, including any loss of wages and medical and related expenses incurred or paid.----]

WHEREFORE, plaintiff prays judgment against defendant as follows:


1. For general damages for severe emotional distress and mental suffering in the sum of $_____;
2. [---For medical and related expenses in the sum of $____[---or according to proof---];
3. [---For lost wages in the sum of $____---];
4. [---For _____---]
5. For costs of suit herein incurred; and
6. For such other and further relief as the court may deem proper.

 DATED: _______________  __________________________________________
   (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 on 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 Long Beach, California.

 

 

DATED: _________________ ___________________________________

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