SUPERIOR COURT OF THE STATE
OF CALIFORNIA
COUNTY OF ________
- [PLAINTIFF(S) NAMES]
- Plaintiffs,
- v.
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- [DEFENDANT(S) NAMES]
- Defendants
- ________________________________
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- CASE NO: _______
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- 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.
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DATED: _______________ |
__________________________________________ |
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(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: _________________ ___________________________________
