IN THE COURT OF COMMON PLEAS OF BUTLER COUNTY, PENNSYLVANIA

 

__________________________________________,           :  CASE NO. _______________

                        vs.                                 Plantiff(s),      :

__________________________________________,           :

                                                          Defendant(s).    :

 

PRETRIAL STATEMENT ADDENDUM

                        Counsel for each party or the parties representing themselves, if not represented, must complete this Pretrial Statement Addendum.  If the information is unknown, so state.

 

Name of party you represent (or are): ____________________________ Plaintiff ____

                                                                                                            Defendant _____

NATURE OF CASE:  (i.e. auto, contract, slip and fall, or otherwise)___________________________________ __________________________________________________________________________________________

SPECIAL/ECONOMIC DAMAGES (please specify as medical, wages, property, or otherwise)_____________ __________________________________________________________________________________________

GENERAL/NON-ECONOMIC DAMAGES EXPECTED IF LIABILITY IS FOUND:____________________

__________________________________________________________________________________________

LIENS: (Holder and amount)__________________________________________________________________

__________________________________________________________________________________________

HAVE THERE BEEN ANY NEGOTIATIONS WITH THE LIEN HOLDER(S)?_________________________
__________________________________________________________________________________________

EXPECTED ALLOCATION OF COMPARATIVE FAULT, IF APPLICABLE:__________________________
__________________________________________________________________________________________

OTHER FACTORS AFFECTING THE DISPOSITION OF THIS CASE:_______________________________
__________________________________________________________________________________________

WHAT IS IMPEDING SETTLEMENT:__________________________________________________________
__________________________________________________________________________________________

STATUS OF NEGOTIATIONS:________________________________________________________________

__________________________________________________________________________________________

IS INSURANCE COVERAGE AVAILABLE TO YOUR CLIENT?_________________________________
________________________________________________________________________________________
IF SO, WHAT IS THE AMOUNT OF INSURANCE COVERAGE AVAILABLE?_____________________

________________________________________________________________________________________

HOW CAN THE COURT HELP FACILITATE SETTLEMENT?___________________________________

________________________________________________________________________________________
________________________________________________________________________________________