United States District Court

Northern District Of Illinois

Local Rules

LR16.1.2. Form of Pretrial Memorandum for Use in Personal Injury Cases


IN THE UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF ILLINOIS

[indicate Eastern or Western] DIVISION

 

Plaintiff,

v. 

Defendant. 

Civil Action No.

Judge [Insert name of assigned judge]

 

PRETRIAL MEMORANDUM

Plaintiff's Name: ________________________

Age: ________________________

Occupation: ________________________

Marital status: ________________________

Attorney for plaintiff [indicate name and phone number of trial attorney]:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Attorney for defendant [indicate name and phone number of trial attorney]:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Summary of injuries [note especially any permanent pathology]:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Date, hour, and place of occurrence:

______________________________________________________________________________

Attending physicians:

______________________________________________________________________________

Hospitals:

______________________________________________________________________________

Place of employment:

______________________________________________________________________________

______________________________________________________________________________

Part A. Compensatory Damages [Parts A & B are to be completed by plaintiff’s counsel.]

  1. Liquidated Damages:

(a) Medical fees $_____________

(b) Hospital bills $_____________

(c) Loss of income $_____________

(d) Miscellaneous expenses $_____________

TOTAL $_____________

  1. What is the total amount of compensatory

damages claimed in this action? $_____________

Part B. Punitive Damages

a. Does the plaintiff claim punitive damages?

Yes ? No ? If yes, how much? $_____________

Brief Statement of Circumstances of Occurrence:

Plaintiff’s view:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Defendant’s view:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

[At the direction of the court the parties are to attach to this memorandum any medical reports or other materials useful for discussion at the pretrial conference.]