EXHIBIT A 

Case 3:17-cv-00600-LB Document 120-1 Filed 09/06/19 Page 1 of 4
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 Case No. 3:17-cv-00600-LB

PLAINTIFF’S PROPOSED VERDICT FORM 

MIRIAM KIM (State Bar No. 238230)] 

miriam.kim@mto.com 

SKYLAR D. BROOKS (State Bar No. 310707)] 

skylar.brooks@mto.com 

EMILY C. CURRAN-HUBERTY (State Bar No. 293065) 

emily.curran-huberty@mto.com 

MUNGER, TOLLES & OLSON LLP 

560 Mission Street 

Twenty-Seventh Floor 

San Francisco, California 94105-2907 

Telephone: (415) 512-4000 

Facsimile: (415) 512-4077 

Attorneys for Plaintiff 

RENEE LEPAGE 

UNITED STATES DISTRICT COURT 

NORTHERN DISTRICT OF CALIFORNIA, SAN FRANCISCO DIVISION 

RENEE LEPAGE, an individual, 

Plaintiff, 

vs. 

COUNTY OF NAPA; COUNTY OF NAPA 

SHERIFF’S DEPARTMENT; AND DEPUTY 

TIMOTHY REID, 

Defendants. 

 Case No. 3:17-cv-00600-LB 

PLAINTIFF’S PROPOSED VERDICT 

FORM

 

 

Case 3:17-cv-00600-LB Document 120-1 Filed 09/06/19 Page 2 of 4
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 -2- Case No. 3:17-cv-00600-LB

PLAINTIFF’S PROPOSED VERDICT FORM 

Claim of Excessive Force (42 U.S.C. § 1983 and Fourth Amendment) 

1. Did defendant Timothy Reid use excessive force against the plaintiff Renee LePage in 

violation of the Fourth Amendment to the U.S. Constitution? 

Yes: ____________ No: ____________ 

Proceed to Question 2. 

Claim of Violation of Civil Rights (Cal. Civ. Code § 52.1, known as the Bane Act) 

2. Did defendant Reid interfere with or attempt to interfere with the plaintiff’s enjoyment of 

her right to be free from unreasonable seizure in violation of the Bane Act? 

Yes: ____________ No: ____________ 

Proceed to Question 3. 

Battery Claim 

3. Did defendant Reid commit a battery against the plaintiff? 

Yes: ____________ No: ____________ 

Proceed to Question 4. 

Claim of Negligence 

4. Was defendant Reid negligent? 

Yes: ____________ No: ____________ 

Proceed to Question 5. 

Damages 

5. Did you answer yes to at least one of the following questions: 1, 2, 3, or 4? 

Yes: ____________ No: ____________ 

If your answer is No, you have reached a verdict, and you must stop here, and have the 

presiding juror sign and date this form. If your answer is Yes, then proceed to Question 6. 

6. If you answered Yes to question 1, 2, 3, and/or 4, what amount of damages do you award 

to the plaintiff? 

$ _____________________ 

Proceed to Question 7. 

7. If you answered Yes to question 1 or 2, was Reid’s conduct malicious, oppressive or 

committed in reckless disregard of the plaintiff’s rights? 

Yes: ____________ No: ____________ 

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 -3- Case No. 3:17-cv-00600-LB

PLAINTIFF’S PROPOSED VERDICT FORM 

If your answer is No, you have reached a verdict, and you must stop here, and have the 

presiding juror sign and date this form. If your answer is Yes, then proceed to Question 8. 

8. If you answered Yes to question 7, what amount of punitive damages do you award to the 

plaintiff? 

$ _____________________ 

Please have the presiding juror sign and date the form. 

Signed: _______________________________________ (Presiding Juror) 

Dated: ________________________________________ 

Case 3:17-cv-00600-LB Document 120-1 Filed 09/06/19 Page 4 of 4