Your Name
Your Address
Your City, State, and ZIP
Your Telephone #

SUPERIOR COURT OF CALIFORNIA, COUNTY OF COUNTY NAME
Name of Plaintiff(s),
Plaintiff,
v.
Name of Defendant(s),
Defendant	Case No.: Case Number
RESPONSE TO Special INTERROGATORIES	

ASKING PARTY: Requesting Party's Name
ANSWERING PARTY: Your Name
SET: One

The ANSWERING PARTY hereby responds to the ASKING PARTY’s Special Interrogatories as follows:
Response to Interrogatory 1:

Response to Interrogatory 2:

Response to Interrogatory 3:

I declare under penalty of perjury under the laws of the State of California that the foregoing answers are true and correct.

Dated:				
[ ] Plaintiff  [ ] Defendant