ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address):
Telephone No.: Fax No. (Optional):
E-Mail Address (Optional):
ATTORNEY FOR (Name): Bar No:
SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE
Civil Complex Center - 751 W. Santa Ana Blvd., Bldg. 36, Santa Ana, CA 92701-4512
PLAINTIFF / PETITIONER:
DEFENDANT / RESPONDENT:
FOR COURT USE ONLY
CLASS ACTION/B&P 17200 QUESTIONNAIRE
(To be filed by counsel for plaintiff/s within 30 days of filing initial
complaint)
CASE NUMBER:
DEPT:
JUDGE:
STATUS CONFERENCE DATE:
In response to the conflict of interest issues raised in Apple Computer, Inc. v. The Superior Court
of Los Angeles County (2005) 126 Cal. App. 4th 1253, counsel for each proposed class
representative is to provide the following information under oath to the Court:
1. Is any proposed class representative an attorney? Yes ____ No _____
2. Is any proposed class representative a spouse, child or family
member of plaintiff’s counsel or of a partner or associate of the
law firm of which plaintiff’s counsel is a member? Yes ____ No _____
If yes, explain relationship: ______________________________________________
3. Within the last 5 years, has any proposed class representative filed
prior class action lawsuits using the same plaintiff’s counsel or firm
as in the present case? Yes ____ No _____
If yes, explain: ______________________________________________
4. Does any proposed class representative have a business relationship
with plaintiff’s counsel, including but not limited to, the relationship
of law partner, associate, employee, principal, agent, independent
contractor, or professional corporation? Yes ____ No _____
If yes, explain relationship: ______________________________________________
5. If there is co-counsel, have the attorneys been co-counsel
in other class actions? Yes ____ No _____
I declare under penalty of perjury under the laws of the State of California that the foregoing is true
and correct.
____________________ _______________________________________
DATE SIGNATURE OF COUNSEL FOR PLAINTIFF(S)
CLASS ACTION/B&P 17200 QUESTIONNAIRE
Approved for Mandatory Use
L277 [New June 1, 2005]
