Note: A footer showing the title of the paper in at least 10-point type, divided from the rest of the

page by a printed line, is required on every page below the page number. See Cal Rules of Ct 2.110. _ _[Name of attorney; State Bar number]_ _ _ _[Address]_ _ _ _[Telephone number]_ _ _ _[Optional fax number; e-mail address]_ _ Attorney for _ _[plaintiff/defendant]_ _, _ _[name]_ _

Superior Court, County of _ _ _ _ _ _ _ _[Name(s)]_ _, Plaintiff(s) vs _ _[Name(s)]_ _, Defendant(s) ____________ ) ) ) ) ) ) ) ) ) ) No. _ _ _ _ _ _ RESPONSE TO INTERROGATORIES

RESPONDING PARTY: _ _[Plaintiff/Defendant]_ _, _ _[name]_ _ SET NO: _ _[Number]_ _ PROPOUNDING PARTY: _ _[Defendant/Plaintiff]_ _, _ _[name]_ _ _ _[Response/Supplemental Response]_ _ _ _[Plaintiff/Defendant]_ _, _ _[name]_ _, _ _[responds/makes a supplemental response]_ _ to interrogatories, set no. _ _[number]_ _, served on _ _[him/her/it]_ _ by _ _[defendant/plaintiff]_ _, _ _[name]_ _, as follows: Response no.: _ _[State answer to interrogatory.]_ _ Response no.: _ _[Plaintiff/Defendant]_ _, _ _[name]_ _, objects to this interrogatory on the grounds that _ _[state all grounds for objection, e.g., the question calls for

information that is protected by the attorney-client privilege and is irrelevant to the subject matter of this action]_ _. Date: _ _ _ _ _ _ __[Signature]__ _ _[Typed name]_ _ Attorney for _ _[name]_ _ VERIFICATION I am the _ _[e.g., plaintiff]_ _ in this action. I have read the above responses to interrogatories, set no. _ _[number]_ _, and know their contents. The responses are true of my own knowledge except for matters stated on my information and belief, and as to those matters, I believe them to be true. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: _ _ _ _ _ _ __[Signature]__ _ _[Typed name]_ _