N.C.P.I.—Civil 804.12

STATE OF NORTH CAROLINA IN THE GENERAL COURT OF JUSTICE

SUPERIOR COURT DIVISION

COUNTY OF _______________ xx CVS xxxx

PLAINTIFF )

)

)

vs. ) VERDICT

)

DEFENDANT, )

)

We, the jury, unanimously answer the following issues:

Issue 1: Was the defendant acting under color of state law when he

arrested the plaintiff?

ANSWER: _________________________________________

(If you answer Issue 1 “Yes,” then proceed to Issue 2. If you answer Issue 1

“No,” then you will not consider the remaining issues.)

Issue 2: Did the defendant use force to arrest the plaintiff?

ANSWER: ________________________________________

(If you answer Issue 2 “Yes,” then proceed to Issue 3. If you answer Issue 2

“No,” then you will not consider the remaining issues.)

Issue 3: Was the defendant’s arrest of the plaintiff unlawful?

ANSWER: ________________________________________

(Proceed to Issue 4.)

Issue 4: Was the amount of force used by the defendant to arrest the

plaintiff excessive?

ANSWER: _________________________________________

(If you answer “Yes” to Issue 3 or Issue 4, or both, then proceed to

Issue 5. If you answer Issue 3 and 4 “No,” then you will not consider

the remaining issue(s).)

Issue 5: What amount is the plaintiff entitled to recover as a result of the

defendant’s use of excessive force in violation of the plaintiff’s constitutional rights?

AMOUNT: $_______________.

NOTE WELL: Issue 6 should be included on the Verdict

Sheet only if the issue of punitive damages is

submitted to the jury. If the issue of punitive damages

is to be submitted, place this parenthetical guidance at

the end of Issue 5:

(Proceed to Issue 6.)

Issue 6: What amount of punitive damages, if any, does the jury in its discretion

award to the plaintiff?

AMOUNT: $_______________.

This the _____ day of _______________, ____.

Printed Name of Foreperson: _________________________.

Signature of Foreperson: _________________________.