Submit a Verdict & Settlement Report Submit a Verdict & Settlement Report Type of action:Injuries alleged:Name of case:Court:Case no.:Tried before:N/AJuryJudgeMediationArbitrationName of judge or mediator: Date resolved: Date Format: MM slash DD slash YYYY Special damages:Demand:Offer:Verdict or settlement:VerdictSettlementArbitration AwardAmount:Attorney(s) for plaintiff (and city):Attorney(s) for defendant (and city):Plaintiff's experts:Defendant's experts:Insurance carrier:Description of CaseUpload PhotosSubmitted ByPerson Submitting Report* Email* Phone** required This iframe contains the logic required to handle Ajax powered Gravity Forms. Share this:PrintEmailFacebookTwitterLinkedInGoogle 2013-03-18 Sarah Rodriguez