ComplaintCal. Super. - 3rd Dist.September 14, 2018PLD-PI-001 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY Timothy T. Wright (State Bar # 179247) The Wright Law Firm 3400 Douglas Blvd, Ste. 255 Roseville, CA 95661 TELEPHONE NO: (9 ] 6) 789-9477 FAX NO. (Optional): (9 1 6) 789-2058 E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): Jessica Stribik, Plaintiff SUPERIOR COURT OF CALIFORNIA, COUNTY OF PLACER STREET ADDRESS: ]()820 Justice Center Drive MAILING ADDRESS: P.O), Box 619072 city AND zip codE: Roseville 95678 BRANCH NAME: Bill Santucci Justice Center Fe I L. E PLAINTIFF: Jessica Stribik SUPERIOR COURT OF CALIFORNIA ER H4 35 , DEFENDANT: Jeremey Lynch and Does | to 10 SEP 14 2018 Cm JAKE CHATT DOES 1 TO 10 EXECUTIVE OFFICER & CLERK COMPLAINT-Personal Injury, Property Damage, Wrongful Death By: C. Vallan-Brown, Deputy [__] AMENDED (Number): Type (check all that apply): MOTOR VEHICLE _[__] OTHER (specify): Property Damage [__ | Wrongful Death Personal Injury [__] Other Damages (specify): Jurisdiction (check all that apply): CASE NUMBER: [___] ACTION IS A LIMITED CIVIL CASE Amount demanded [__]| does not exceed $10,000 [__] exceeds $10,000, but does not exceed $25,000 ACTION IS AN UNLIMITED CIVIL CASE (exceeds $25,000) 8 C Vy : [__] ACTION IS RECLASSIFIED by this amended complaint 0 0 4i 7% 2 L__] from limited to unlimited [__] from unlimited to limited 1. Plaintiff (name or names): Jessica Stribik alleges causes of action against defendant (name or names): Jeremey Lynch and Does | to 10 2. This pleading, including attachments and exhibits, consists of the following number of pages: 3. Each plaintiff named above is a competent adult a. [___] except plaintiff (name): (1) [__] a corporation qualified to do business in California (2) [___] an unincorporated entity (describe): (3) [___] a public entity (describe): (4) [__] aminor [__] an adult (a) [__] for whom a guardian or conservator of the estate or a guardian ad litem has been appointed (b) [___] other (specify): (5) [__] other (specify): b. [__] except plaintiff (name): (1) [__] a corporation qualified to do business in California (2) [__] an unincorporated entity (describe): (3) [__] a public entity (describe): (4) [__] aminor [__] an adult (a) [__] for whom a guardian or conservator of the estate or a guardian ad litem has been appointed (b) [__] other (specify): (5) [__] other (specify): L__] Information about additional plaintiffs who are not competent adults is shown in Attachment 3. paneqers Form Approved for Optional Use el i Code of Civil Procedure, § 425.12 “hides! Coun of California COMPLAINT-Personal Injury, Property www. courtinfo.ca.gov PLD-PI-001 [Rev. January 1, 2007] Damage, Wrongful Death LexisNexis® Automated California Judicial Council Forms PLD-PI-001 SHORT TITLE: Stribik v. Lynch CASE NUMBER: 4. [__] Plaintiff (name): is doing business under the fictitious name (specify): and has complied with the fictitious business name laws. 5. Each defendant named above is a natural person a. [__] except defendant (name): (1) [__] a business organization, form unknown (2) [___] acorporation (3) [___] an unincorporated entity (describe): (4) [__] a public entity (describe): (5) [__] other (specify): b. [__] except defendant (name): (1) [__] a business organization, form unknown (2) [__] a corporation (3) [__] an unincorporated entity (describe): (4) [__] a public entity (describe): (5) [__] other (specify): c. [__] except defendant (name): (1) [__] a business organization, form unknown (2) [__] acorporation (3) [__] an unincorporated entity (describe): (4) [__] a public entity (describe): (5) [___] other (specify): d. [__] except defendant (name): (1) [__] a business organization, form unknown (2) [__] a corporation (3) [__] an unincorporated entity (describe): (4) [|__| a public entity (describe): - (5) [__] other (specify): Ife 9. [___] Information about additional defendants who are not natural persons is contained in Attachment 5. The true names of defendants sued as Does are unknown to plaintiff. a. Doe defendants (specify Doe numbers): 1 to 10 were the agents or employees of other named defendants and acted within the scope of that agency or employment. b. Doe defendants (specify Doe numbers): 1 to 10 plaintiff. [___] Defendants who are joined under Code of Civil Procedure section 382 are (names): are persons whose capacities are unknown to This court is the proper court because a. [___] atleast one defendant now resides in its jurisdictional area. . [__] the principal place of business of a defendant corporation or unincorporated association is in its jurisdictional area. injury to person or damage to personal property occurred in its jurisdictional area. [__] other (specify): a o [__] Plaintiff is required to comply with a claims statute, and a. [___] has complied with applicable claims statutes, or b. [___] is excused from complying because (specify): PLD-PI-001 [Rev. January 1, 2007] Page 2 of 3 COMPLAINT-Personal Injury, Property Damage, Wrongful Death LexisNexis® Automated California Judicial Council Forms PLD-PI-001 SHORT TITLE: CASE NUMBER: Stribik v. Lynch 10. The following causes of action are attached and the statements above apply to each (each complaint must have one or more causes of action attached): a. Motor Vehicle b. [___] General Negligence c. [__] Intentional Tort d. [__] Products Liability e. [__] Premises Liability f. [___] Other (specify): 11. Plaintiff has suffered wage loss loss of use of property hospital and medical expenses general damage property damage loss of earning capacity other damage (specify): Prejudgement Interest a m o 9 a o 0 o m 12. [___] The damages claimed for wrongful death and the relationships of plaintiff to the deceased are a. [__] listed in Attachment 12. b. [__] as follows: 13. The relief sought in this complaint is within the jurisdiction of this court. 14. Plaintiff prays for judgment for costs of suit; for such relief as is fair, just, and equitable; and for a. (1) compensatory damages (2) [__] punitive damages The amount of damages is (in cases for personal injury or wrongful death, you must check (1)): (1) according to proof (2) [__] in the amount of: $ 15. The paragraphs of this complaint alleged on information and belief are as follows (specify paragraph numbers): MV1, MV2 Date: September 13, 2018 Timothy T. Wright b Se (TYPE OR PRINT NAME) (SIGNATURE OF PLAINTIFF OR ATTORNEY) PLD-PI-001 [Rev. January 1, 2007] COMPLAINT-Personal Injury, Property Page 3 of 3 Damage, Wrongful Death LexisNexis® Automated California Judicial Council Forms PLD-PI-001(1) SHORT TITLE: CASE NUMBER: Stribik v. Lynch ONE CAUSE OF ACTION-Motor Vehicle (number) ATTACHMENT TO Complaint [_] Cross - Complaint (Use a separate cause of action form for each cause of action.) Plaintiff (name): Jessica Stribik MV- 1. Plaintiff alleges the acts of defendants were negligent; the acts were the legal (proximate) cause of injuries and damages to plaintiff; the acts occurred on (date): April 4, 2017 at (place): North Cirby and East Roseville Parkway, Placer County MV- 2. DEFENDANTS a. The defendants who operated a motor vehicle are (names): Jeremey Lynch and Does | to 10 Does 1 to 10 b. The defendants who employed the persons who operated a motor vehicle in the course of their employment are (names): Does | to 10 Does 1 to 10 C. The defendants who owned the motor vehicle which was operated with their permission are (names): Does 1 to 10 Does l to 10 d. The defendants who entrusted the motor vehicle are (names): Does 1 to 10 Does l to 10 e. The defendants who were the agents and employees of the other defendants and acted within the scope of the agency were (names): Does | to 10 Does 1 to 10 f. The defendants who are liable to plaintiffs for other reasons and the reasons for the liability are [__] listed in Attachment MV-2f [__] as follows: Dos 1 to 10 Page 4 Page 1 of 1 d for Optional U fansl i Code of Civil P dure 425.12 reludigal Counel of Galforia CAUSE OF ACTION-Motor Vehicle oe enw courtinfo. C8, gov PLD-PI-001(1) [Rev. January 1, 2007] LexisNexis® Automated California Judicial Council Forms _ a, SUMMONS (SOLO PARA USO DE LA CORTE) (CITACION JUDICIAL) NOTICE TO DEFENDANT: (AVISO AL DEMANDADO): Jeremey Lynch and Does | to 10 SUM-100 YOU ARE BEING SUED BY PLAINTIFF: (LO ESTA DEMANDANDO EL DEMANDANTE): Jessica Stribik NOTICE! You have been sued. The court may decide against you without your being heard unless you respond within 30 days. Read the information below. You have 30 CALENDAR DAYS after this summons and legal papers are served on you to file a written response at this court and have a copy served on the plaintiff. A letter or phone call will not protect you. Your written response must be in proper legal form if you want the court to hear your case. There may be a court form that you can use for your response. You can find these court forms and more information at the California Courts Online Self-Help Center (www.courtinfo.ca.gov/selfhelp), your county law library, or the courthouse nearest you. If you cannot pay the filing fee, ask the court clerk for a fee waiver form. If you do not file your response on time, you may lose the case by default, and your wages, money, and property may be taken without further warning from the court. There are other legal requirements. You may want to call an attorney right away. If you do not know an attorney, you may want to call an attorney referral service. If you cannot afford an attorney, you may be eligible for free legal services from a nonprofit legal services program. You can locate these nonprofit groups at the California Legal Services Web site (www./awhelpcalifornia.org), the California Courts Online Self-Help Center (www.courtinfo.ca.gov/selfhelp), or by contacting your local court or county bar association. NOTE: The court has a statutory lien for waived fees and costs on any settlement or arbitration award of $10,000 or more in a civil case. The court's lien must be paid before the court will dismiss the case. jAVISO! Lo han demandado. Si no responde dentro de 30 dias, la corte puede decidir en su contra sin escuchar su version. Lea la informacién a continuacion. Tiene 30 DIAS DE CALENDARIO después de que le entreguen esta citacion y papeles legales para presentar una respuesta por escrito en esta corte y hacer que se entregue una copia al demandante. Una carta o una llamada telefonica no lo protegen. Su respuesta por escrito tiene que estar en formato legal correcto si desea que procesen su caso en la corte. Es posible que haya un formulario que usted pueda usar para su respuesta. Puede encontrar estos formularios de la corte y mas informacion en el Centro de Ayuda de las Cortes de California (www.sucorte.ca.gov), en la biblioteca de leyes de su condado o en Ia corte que le quede mas cerca. Si no puede pagar la cuota de presentaci6n, pida al secretario de la corte que le dé un formulario de exencién de pago de cuotas. Si no presenta su respuesta a tiempo, puede perder el caso por incumplimiento y la corte le podra quitar su sueldo, dinero y bienes sin mas advertencia. Hay otros requisitos legales. Es recomendable que llame a un abogado inmediatamente. Si no conoce a un abogado, puede llamar a un servicio de remision a abogados. Si no puede pagar a un abogado, es posible que cumpla con los requisitos para obtener servicios legales gratuitos de un programa de servicios legales sin fines de lucro. Puede encontrar estos grupos sin fines de lucro en el sitio web de California Legal Services, (www.lawhelpcalifornia.org), en e! Centro de Ayuda de las Cortes de California, (www.sucorte.ca.gov) 0 poniéndose en contacto con la corte o el colegio de abogados locales. AVISO: Por ley, la corte tiene derecho a reclamar las cuotas y los costos exentos por imponer un gravamen sobre cualquier recuperacion de $10,000 6 mas de valor recibida mediante un acuerdo o una concesi6n de arbitraje en un caso de derecho civil. Tiene que pagar el gravamen de la corte antes de que la corte pueda desechar el caso. The name and address of the court is: CASE NUMBER: El nombre y direccion de la corte es): (Ndmero de! Caso): UPERIOR COURT OF CALIFORNIA, COUNTY OF PLACER Bill Santucci Justice Center 10820 Justice Center Drive, Roseville, CA 95678 The name, address, and telephone number of plaintiffs attorney, or plaintiff without an attorney, is: Fi nombre, 1? direccion y el Rumero % foveyono del abogado del demandante, o del demandante que no tiene tS eo 058 imothy T. Wright © (Bar # 179247) Fax No The Wrig ht Law Firm Phone No.: (916) 789-9477 3400 iygueee Blvd, Ste. 255, Roseville, CA 95661 Clerk, by , Deputy (Fecha) (Secretario) (Adjunto) (For proof of service of this summons, use Proof of Service of Summons (form POS-010). ) (Para prueba de entrega de esta citation use el formulario Proof of Service of Summons, (POS-01 O)). NOTICE TO THE PERSON SERVED: You are served SeAH 1. as an individual defendant. 2. [__] as the person sued under the fictitious name of (specify): 3. L__] on behalf of (specify): under: L__] CCP 416.10 (corporation) [__] CCP 416.60 (minor) [___] CCP 416.20 (defunct corporation) [___] CCP 416.70 (conservatee) [___] CCP 416.40 (association or partnership) [__] CCP 416.90 (authorized person) [] other (specify): 4. [__] by personal delivery on (date): Page 1 of 1 Form Adopted for Mandatory Use SUMMONS Code of Civil Procedure §§ at 20, 465 Judicial Council of California www.courtinfo.ca.gov LexisNexis® Automated California Judicial Council Forms SUM-100 [Rev. July 1, 2009]
