HAYLEY JOHNSEN VS BIANCA LISSETTE ARANDA, ET AL

Complaint Information

PLD-PI1-001

SHORT TITLE: CASE NUMBER

JOHNSEN v. ARANDA, et. al. CIV 515054

4. [_] Piaintiff (name): is doing business under the fictitious name (specify):

and has complied with the fictitious business name laws. 5. Each defendant named above is a natural person

a. [__] except defendant (name): c. [_] except defendant (name): (1) [__] a business organization, form unknown (1) [__] abusiness organization, form unknown (2) ] a comporation . (2) [_] a corporation (3) [__] an unincorporated entity (describe): (3) [C_] an unincorporated entity (describe)- (4) (] a public entity (describe): (4) [_] a public entity (describe): (5) [[_] other (specify): (5) (] other (specify): b. [_] except defendant (name): d. [_] except defendant (name): (1) ] a business organization, form unknown (1) ] abusiness organization, form unknown (2) [__] a corporation (2) [__] a corporation (3) ] an unincorporated entity (describe): (3) [_] an unincorporated entity (describe): (4) ] a public entity (describe): (4) [_] apublic entity (describe): (5) [_] other (specify): (5) [__] other (specify):

[_] Information about additional defendants who are not natural persons is contained in Attachment 5.

6. The true names of defendants sued as Does are unknown to plaintiff.

a. Doe defendants (specify Doe numbers): 1-12 were the agents or employees of other named defendants and acted within the scope of that agency or employment.

b. Doe defendants (specify Doe numbers): 13-25 are persons whose capacities are unknown to plaintiff. 7. [_] Defendants who are joined under Code of Civil Procedure section 382 are (names):

8. This court is the proper court because a. at least one defendant now resides in its jurisdictional area. b. [_] the principal place of business of a defendant corporation or unincorporated association is in its jurisdictional area. c. injury to person or damage to personal property occurred in its jurisdictional area.

d. [_] other (specify):

9 [] Plaintiff is required to comply with a claims statute, and a. [__] has complied with applicable claims statutes, or ~b. [_] is excused from complying because (specify):

PLD-PI-001

SHORT TITLE: CASE NUMBER

JOHNSEN v. ARANDA, et. al. CIV 515054

Date: JULY 19,2012

The following causes of action are attached and the statements above apply to each (each complaint must have one or more causes of action attached):

. Motor Vehicle

. General Negligence

[ Intentional Tort

[_] Products Liability

[_] Premises Liability

[ ] Other (specify):

~0ao0ow

Plaintiff has suffered

. [_] wage loss

[ loss of use of property

hospital and medical expenses general damage

[_] property damage

loss of eaming capacity

: other damage (specify):

Past and future pain and suffering

@0 a0 oW

(] The damages claimed for wrongful death and the relationships of plaintiff to the deceased are a. [__] listed in Attachment 12. b. [_] as follows:

The relief sought in this complaint is within the jurisdiction of this court.

Plaintiff prays for judgment for costs of suit; for such relief as is fair, just, and equitable; and for a. (1) compensatory damages (2) (] punitive damages The amount of damages is (in cases for personal injury or wrongful death, you must check (1)): (1) according to proof (2) ] in the amount of- $

[ The paragraphs of this complaint alleged on information and belief are as follows (specify paragraph numbers):

ANNE VERNON {TYPE OR PRINT NAME) (SIGNATURE OF PLAINTIFF OR ATTORNEY)