[Your Name]
[Your address]
[Your City, State, and Zip Code]
[Your Telephone Number]
[Plaintiff or Defendant]

SUPERIOR COURT OF CALIFORNIA, COUNTY OF [COUNTY NAME]
[Plaintiff's name],
Plaintiff,
v.
[Defendant's Name],
Defendant	Case No.: [Case Number]
SPECIAL INTERROGATORIES	

PROPOUNDING PARTY: [Your Name]
RESPONDING PARTY: [Party You Want to Answer]
SET: [Set Number]

DEFINITIONS:
a)	YOU OR ANYONE ACTING ON YOUR BEHALF includes you, your agents, your employees, your insurance companies, their agents, their employees, your attorneys, your accountaints, your investigators, and anyone else acting on your behalf.
b)	PERSON includes a natural person, firm, association, organization, partnership, business, trust, limited liability company, corporation, or public entity.
c)	DOCUMENT means a writing, as defined in Evidence Code section 250, and includes the original or a copy of handwriting, typewriting, printing, photostats, photographs, electronically stored information, and every other means of recording upon any tangible thing and form of communicating or representation, including letters, words, pictures, sounds, or symbols, or combinations of them.
d)	ADDRESS means the street address, including the city, state, and zip code.
e)	[Add definitions that you will use on this and subsequent lines. If none, delete this line]

INTERROGATORIES:
1.	[Write your first interrogatory here]
2.	[Write your second interrogatory here]
3.	[Write your third interrogatory here and create a new numbered line for each additional interrogatory. If using less than three interrogatories, delete the unused lines]

Date:			
[Your Name]
[Plaintiff, or Defendant]