When practicing family law here in New Jersey, one of the most fact sensitive areas for an attorney to handle is a child custody case. Very early on during into the case, our lawyers are sure to prepare our clients for the types of questions they shall face not only in a child custody plenary hearing (i.e., trial), but even before the trial begins. Your lawyer should advise you that the first round of questions come in the form of “Child Custody Interrogatories.” If you are potentially facing a child custody dispute here in New Jersey, my experience as a family law attorney dictates that you should familiarize yourself with the following questions so that you are prepared in case you end of in a New Jersey Family Court.

If you are looking for a lawyer to discuss this with further, please do not hesitate to contact my law firm. Thank you.

_______________________ Attorney ID #___________

LAW OFFICES OF EDWARD R. WEINSTEIN, LLC

Weinstein Professional Building

214 Highway 18 North, Suite 2A

East Brunswick, New Jersey 08816

Telephone: 732-246-0909

Attorneys for __________________

_________________________,

Plaintiff,

v.

_________________________,

Defendant.

SUPERIOR COURT OF NEW JERSEY

CHANCERY DIVISION – FAMILY PART

______________ COUNTY

DOCKET NO.: FM-

CIVIL ACTION

CHILD CUSTODY INTERROGATORIES

TO BE ANSWERED BY DEFENDANT

TO: ______________________

Demand is hereby made by the Plaintiff, ____________________________, of the Defendant, ___________________________, to provide answers, under oath or certification to the following Child Custody Interrogatories within the time and in the manner prescribed by the Rules of this Court.

LAW OFFICES OF EDWARD R. WEINSTEIN, LLC

Attorneys for and on behalf of the Plaintiff

Dated: By: _____________________________________________ GENERAL INSTRUCTIONS

A. When answering the following Interrogatories, provide any and all information either in your possession, under your control, within your dominion or available to you, regardless of whether this information is in your personal possession or possessed by your agents, servants, employees, representatives or others with whom you have a relationship and from whom you are capable of deriving information, documents or material.

B. If any Interrogatory is not answered in full, state the precise reason for failing to complete the answer. The answer “not applicable” is not acceptable. If a legal objection is made with respect to any Interrogatory, you should set forth the specific reason for such objection. If only a portion of an Interrogatory cannot or will not be answered, provide the fullest answer to the Interrogatory and thereafter specifically set forth (a) the fact that the answer is incomplete and (b) the reason or grounds for any omission and/or refusal to complete.

C. All Interrogatories require an answer even if the context of the question seeks only an affirmative response and the response you intend is not affirmative. Thus, if any answer is left blank, it shall be deemed to be “none.”

D. All headnotes in the within Interrogatories are for reference only and are not intended to qualify or limit context of any question appearing thereunder.

DEFINITIONS

As used herein the following terms shall have the meanings indicated:

1. “Document” shall mean the original and any copy, regardless of origin or location, of any book, pamphlet, periodical, letter, memorandum, telegram, report, records, study, handwritten note, working paper, chart, photograph, index, tape data sheet or data processing card or any other written, recorded, transcribed, punched, taped, filmed or graphic matter, however produced or reproduced, to which you have had access.

2. The term “reliance” includes any use of such documents including but not limited to, the following:

  • (i) Reference to any such document by any witness as a basis for establishing any fact upon which reliance is made; or
  • (ii) Reference to any such document by any expert witness as a basis for his opinion; or
  • (iii) Introduction into evidence for any purpose; or
  • (iv) Reference to any such document by any witness or by your attorney for the purpose of cross-examination, to refresh the recollection of a witness, to impeach the credibility of any witness or for any other purpose.

3. “Person” shall mean all individuals and entities including but not limited to natural persons, sole proprietorships, firms, associations, companies, partnerships, joint ventures, corporations, trusts and estates, governmental agencies and legal or investment advisors. The term “Person” may be set in lower case throughout the Instructions, Definitions and Interrogatories.

4. “Oral Communication” shall mean any utterance heard by another person, whether in person, by telephone or otherwise.

5. “Identify” when used in reference to an individual person shall mean state his full name, residence address, present or last known position and business affiliation and his position and business affiliation at the time in question.

“Identify” when used in reference to a corporation shall mean state its full name and the address of its principal office.

All requests to “identify” any document require the answer to include a description of each document, a summary of the content thereof, the name of each person, firm, corporation or other entity signing or executing the same and the date thereof. If the document is commercially printed or published, the name and address of the printer or publisher are required. Any document containing images (i.e. charts, photographs, etc.) shall contain a description thereof.

6. The term “You” or “Your” refers to the Defendant, __________________ and shall mean any of his consultants, experts, officers, former officers, agents, former agents, employees, former employees, assignees or successors, parent organizations, affiliates, or subsidiaries, or any and all other persons or entities acting on his behalf or with his authorization. The term “You” or “Your” may be set in lower case throughout the General Instructions, Definitions and Interrogatories.

7. The term “Defendant” as used herein refers to ___________________________.

8. The term “Plaintiff” as used herein refers to ___________________________.

CUSTODY INTERROGATORIES

1. State:

  • (a) Your full name;
  • (b) Your present home address;
  • (c) Your date of birth; and
  • (d) Your place of birth.

2. State the names and addresses of all persons known to the Defendant/Plaintiff to possess knowledge of any relevant facts relating to this case.

3. Will the Defendant/Plaintiff rely on expert testimony at time of trial?

If so, for each expert state:

  • (a) Name and address of each person;
  • (b) File of expertise;
  • (c) Full and detailed qualifications, training, professional and practical experience, education, and academic degrees, including date and/or years of each item;
  • (d) The name and address of each institution attended; nature of business at each place which experience or training was received;
  • (e) Names of professional organizations or societies including dates of membership to which each expert belongs;
  • (f) Title of all publications, articles or books authored by each expert including date, name and address of publisher and publication.

4. Annex hereto a copy of each written report (or detailed resume if report was oral) of every expert retained or consulted by the Defendant/Plaintiff including any person who has conducted an examination pursuant to R.4:9 (or as it may be amended) whether or not you intend to use such expert at time of trial.

5. Forward any reports (or resumes or oral reports) received by the Defendant/Plaintiff after these answers to interrogatories were served.

6. Is any person(s) known to the Defendant/Plaintiff to possess knowledge of any relevant facts relating to this case, or any expert witness(es) related by blood, marriage, law, contract, employment or in any other way to the person(s) of their counsel, to whom these questions are addressed:

If so, state:

  • (a) the name(s) of such person(s);
  • (b) how they are related to you.

7. Are there any photographs, motion pictures or sound recordings taken or made by the Defendant/Plaintiff or on your behalf, of any scene, object, incident, conversation or matter connected with this litigation?

If so, state:

  • (a) when they were made;
  • (b) what the subject matter was;
  • (c) by whom they were made and their address;
  • (d) in whose possession are they now.

8. Attach a copy of each such photograph, motion picture or sound recording hereto at our reasonable cost and expense.

9. Has the Defendant/Plaintiff attended educational institutions higher than high school?

If so, state:

  • (a) the name and address of each educational institution;
  • (b) the years of attendance;
  • (c) certificates or degrees awarded, if any, with respect to each educational institution attended by you.

10. Does the Defendant/ Plaintiff have any brothers or sisters?

If so, state:

  • (a) their names;
  • (b) date of birth;
  • (c) present resident addresses.

11. Was the Defendant/Plaintiff ever expelled, suspended or otherwise disciplined at any educational institution?

If so, state:

  • (a) when this occurred;
  • (b) what were the circumstances;
  • (c) the nature of punishment.

12. Does the Defendant/Plaintiff believe in corporal punishment by parents against children?

If so, state:

  • (a) to what extent and for what types of infractions;
  • (b) what are your reasons?

13. In terms of (1) strong, (2) moderate, or (3) weak, describe the Defendant/Plaintiff as to the following categories:

  • (a) personality;
  • (b) self-control;
  • (c) tolerance of inferiority in others;
  • (d) charitableness;
  • (e) ability to get along with others;
  • (f) modesty;
  • (g) conceit;
  • (h) interest in self;
  • (i) interest in family;
  • (j) interest in job or profession;
  • (k) interest in remaining a residence of the State of New Jersey.

14. In respect to the Plaintiff, compare yourself as to the following categories in terms of being (1) equal, (2) superior, (3) inferior:

  • (a) self-confidence;
  • (b) intelligence;
  • (c) interest in self;
  • (d) interest in others;
  • (e) disciplinarian;
  • (f) provider;
  • (g) mental stability;
  • (h) need to relate to others;
  • (i) need to relate to child/children;
  • (j) interest in child’s/children’s welfare;
  • (k) sensitivity;
  • (l) excitability;
  • (m) control of emotions under stress;
  • (n) how well suited to care for child/children;
  • (o) more outgoing;
  • (p) range of interest outside of profession, business or occupation;
  • (q) ability to run a household;
  • (r) financial acumen;
  • (s) health;
  • (t) affection toward the plaintiff.

15. What are the five most important things to the Defendant/Plaintiff in life in descending order?

16. Has there been any history of mental or emotional sickness in the Defendant’s/Plaintiff’s extended family?

If so, state:

  • (a) when this sickness occurred;
  • (b) the name of person and relationship to you;
  • (c) the nature and extent thereof.

17. Has there been any history of hospitalization for mental and/or emotional sickness in the Plaintiff’s extended family?

If so, state:

  • (a) by whom;
  • (b) when it occurred, giving dates of admission and discharge;
  • (c) name and address of institution;
  • (d) the cause thereof;
  • (e) the relationship of the person to you.

18. Has there been any history of suicide or attempted suicide in the Defendant’s/Plaintiff’s extended family?

If so, state:

  • (a) who the person(s) was;
  • (b) when it happened;
  • (c) describe the incident;

19. Does the Defendant/Plaintiff use drugs or have you used drugs in the past 10 years?

If so, state:

  • (a) what drug or drugs;
  • (b) when they were taken, giving dates;
  • (c) extent of use.

20. Has the Defendant/Plaintiff been treated for drug use?

If so, state:

  • (a) when you were treated;
  • (b) where the treatment was administered;
  • (c) by whom;
  • (d) nature of treatment.

21. Has the Defendant/Plaintiff ever been confined to any institution because of drug use?

If so, state:

  • (a) where, giving name and address;
  • (b) date of confinement;
  • (c) nature of treatment received.

22. Does the Defendant/Plaintiff tolerate the use of drugs in others?

If so, state:

  • (a) which drugs;
  • (b) extent to use which you tolerate.

23. In addition to your time at work, do you have any other work-related obligations and commitments?

If so, what are they?

24. At what address(es) and/or place(s) do you practice your vocation?

State:

  • (a) your usual working hours;
  • (b) if your working hours are divided between different places;
  • (c) specify what hours at each place.

25. Has the Defendant/Plaintiff ever been examined or treated by a psychiatrist or psychologist?

If so, state:

  • (a) the name and address of the person who examined and/or treated you;
  • (b) the professional capacity of the person examining and/or treating you;
  • (c) the date of each examination and/or treatment;
  • (d) the reason for same;
  • (e) if a report was made, when and to whom was it given;
  • (f) attach a copy thereof hereto;
  • (g) the purpose of each such examination and/or treatment.

26. Was a diagnosis ever made of the Defendant’s/Plaintiff’s mental or emotional condition?

If so, state:

  • (a) what the diagnosis was;
  • (b) who made it, giving the name and address;
  • (c) what was it?

27. Has the Defendant/Plaintiff ever been admitted/or confined to a mental institution or facility?

If so, state:

  • (a) that name and address of each such institution;
  • (b) when and why you were admitted and/or confined;
  • (c) the length of each admission and/or confinement;
  • (d) by whom were you admitted and/or confined?

28. Has the Defendant/Plaintiff ever been arrested?

If so, state:

  • (a) when the arrest was made;
  • (b) where did it take place;
  • (c) for what reason;
  • (d) by whom were you arrested;
  • (e) the disposition of your arrest.

29. Were criminal proceedings ever initiated against the Defendant/Plaintiff by any person other than your spouse?

If so, state:

  • (a) when it occurred;
  • (b) by whom, giving name and address;
  • (c) the reason for same;
  • (d) the name and address of the Court in which the proceedings were initiated;
  • (e) the nature of the proceedings;
  • (f) what were the results thereof?

30. Does the Defendant/Plaintiff consume alcohol?

If so, state:

  • (a) the frequency of your consumption;
  • (b) name, specifically those beverages which you consume;
  • (c) the reason why you drink.

31. Has the Defendant/Plaintiff ever been charged with driving a motor vehicle either under the influence of drugs, under the influence of alcohol or driving while impaired?

If so, state:

  • (a) when this occurred;
  • (b) where this occurred;
  • (c) by whom was the charge made;
  • (d) when was it heard;
  • (e) what was the disposition thereof?

32. Has the Defendant/Plaintiff taken any prescription drugs in the past 2 years?

If so, state:

  • (a) the purposes for which these drugs were prescribed;
  • (b) by whom were these drugs prescribed.

33. What is the present state of the Defendant’s/Plaintiff’s health?

34. When was the Defendant’s/Plaintiff’s last physical examination?

35. State the date of the physical examination, the physician who examined you.

36. Was a report made thereof?

If so, attach a copy thereof hereto.

37. State the name and address of the Defendant’s/Plaintiff’s current physician.

38. Has the Defendant/Plaintiff consulted with any other physician or practitioners of the healing arts in the past 36 months?

If so, state:

  • (a) the name and address of each physician or practitioner;
  • (b) when consulted;
  • (c) the reason for the consultation;
  • (d) if treatment was necessary;
  • (e) the nature of the treatment and the duration thereof.

39. Does the Defendant/Plaintiff have a religious preference?

If so, state:

  • (a) the name and address of the religious institution with which you are affiliated;
  • (b) the frequency with which you attend religious services;
  • (c) the name of the presiding clergyman.

40. Do you intend to provide religious training for the child/children;

If so, state:

  • (a) what type of religious training;

41. Does the Defendant/Plaintiff feel that religious training has any importance in the up-bringing of the child/children and, if so, why. If not, why not?

42. Does the Defendant/Plaintiff intend to reside permanently in the State of New Jersey?

If not, state:

  • (a) why not;
  • (b) what plans do you have to remove the child from the State of New Jersey;
  • (c) describe what you have done to carry out said plans.

43. Have you ever told the child/children that you intend to move from the State of New Jersey?

If so, state:

  • (a) when did you tell them;
  • (b) when did you tell them;
  • (c) what are the circumstances;
  • (d) did you tell the child/children where you were going to move?
  • (e) did you tell the child/children that you were going to the child/children with you and, if so, why?
  • (f) what was the child/children’s response?

44. Does the Defendant/Plaintiff feel that the custody of the child/children would be enhanced in her custody?

If so, state:

  • (a) why, giving specific reasons. (It is intended to limit you at the time of the trial to the response given.)

45. Can you perceive any disadvantages to the child/children if custody were given to you? If so, what are they?

46. Does the Defendant/Plaintiff feel that custody of the child/children with the Plaintiff would be inimical to the child’s/children’s health, welfare and general well-being?

If so, state:

  • (a) why, giving specific reasons. (It is intended to limit you at the time of the trial to the response given.)

47. Are you aware of any defect or deficit in the Plaintiff’s character and personality?

If so, state:

  • (a) what the defect or deficit is;
  • (b) when you perceive it;
  • (c) did you ever discuss it with her/him and when;
  • (d) what was said during this discussion.

48. What are the Defendant’s/Plaintiff’s ties to the State of New Jersey (be specific).

49. Does the Defendant/Plaintiff have ties to any other state or country?

If so, as to each, state:

  • (a) which state or country?
  • (b) describe in detail the ties.

50. Has the Defendant/Plaintiff suffered from any serious illness, sickness or disease within the past 10 years?

If so, state:

  • (a) what illness, sickness or disease;
  • (b) when;
  • (c) where were you treated and by whom, giving names and addresses;
  • (d) have you fully recovered therefrom;
  • (e) if not, state in detail to what extent you have not recovered.

51. Has the child/children ever been exposed to or witnessed any upsetting or disquieting incidents between you and the Plaintiff?

If so, as to each incident, describe:

  • (a) when;
  • (b) where;
  • (c) describe the incident;
  • (d) what effect, if any, did it have upon the child/children?

52. Did you discuss any such incidents with the child/children?

If so, state:

  • (a) when;
  • (b) where;
  • (c) who was present;
  • (d) what did you say;
  • (e) the reason or basis for your statement;
  • (f) was it true when you stated it;
  • (g) did you know if it was true when you stated it.

53. Have you ever discussed your relationship with the Plaintiff with the child/children?

If so, state:

  • (a) the date;
  • (b) who was present;
  • (c)what was said;
  • (d) you reason for the discussion.

54. Set forth in detail the reasons for which you allege that visitation should be awarded to the Defendant/Plaintiff without a best interests evaluation being performed.

55. In the past, did the child/children display or reveal any unusual habits, abnormal tendencies or erratic behavior?

If so, state:

  • (a) the nature and description thereof;
  • (b) dates of same;
  • (c) the name and address of the doctors treating the child/children, if any.

56. Are you going to rely on expert testimony at the trial?

If so, state:

  • (a) name and address of each expert;
  • (b) field of expertise of each expert;
  • (c) full and detailed qualifications training, professional and practical experience, education and degree(s).
  • (d) name and address of each institution attended;
  • (e) dates and/or years of education, training, and experience.

57. Has the Defendant/Plaintiff observed any behavioral and/or emotional and/or psychological problems in the child/children?

If so, state:

  • (a) what you observed;
  • (b) when;
  • (c) what, if anything, did you do about it.

58. Does the child/children take any medicine or drug?

If so, state:

  • (a) what it is;
  • (b) when does the child/children take it;
  • (c) what dosage;
  • (d) the reason therefore;
  • (e) by whom was it prescribed.

59. What are the 5 most important considerations in the child’s/children’s life, according to the child/children? List in ascending order.

60. Does the Defendant/Plaintiff have any plans to marry?

If so, state:

  • (a) name and address of the party whom you plan to marry;
  • (b) number and age of children, if any, of the party.

61. Does the Defendant/Plaintiff suffer from any handicaps, disabilities and chronic illnesses?

If so, state:

  • (a) treatment you receive, if any, specify;
  • (b) from whom;
  • (c) nature of treatment;
  • (d) the frequency thereof.

62. Would the child/children better relate to:

  • (a) a strict disciplinarian;
  • (b) a very lenient disciplinarian;
  • (c) a moderate disciplinarian;

63. Have you ever struck the Plaintiff?

If so, state:

  • (a) when;
  • (b) under what circumstances;
  • (c) the nature and extent of the striking;
  • (d) if the Plaintiff was injured and, if so, to what extent;
  • (e) if the Plaintiff received medical treatment and if so, from whom, giving name and address;
  • (f) nature of treatment rendered;
  • (g) who was present at each striking, giving names and addresses.
  • (h) the criminal and/or civil charges related to same;
    • (i) docket number(s);
    • (ii) municipalities;
    • (iii) charges;
    • (iv) judicial decision, finding or resolution reached;
    • (v) punishment received.

64. Did you ever attempt to strike the father of the child/children?

If so, state:

  • (a) when;
  • (b) where;
  • (c) who was present at each attempt, giving names and addresses;
  • (d) what were the circumstances.

65. Did you ever physically cause any harm to the father of the children by pushing, shoving, tripping, spitting on or in any related way?

If so, state:

  • (a) when;
  • (b) where;
  • (c) give names and addresses of persons present;
  • (d) the circumstances surrounding each incident.

66. Has the Defendant/Plaintiff ever struck the child/children within the past 24 months?

If so, state:

  • (a) when;
  • (b) under what circumstances;
  • (c) the nature and extent of the striking;
  • (d) if the child/children was injured and, if so, to what extent;
  • (e) if the child/children received medical treatment and, if so, from whom, giving name and address;
  • (f) nature of treatment rendered;
  • (g) who was present at each striking, giving names and addresses;

67. Did the Defendant/Plaintiff ever attempt to strike the child/children?

If so, state:

  • (a) when;
  • (b) where;
  • (c) who was present at each attempt, giving names and addresses;
  • (d) what were the circumstances.

68. Did the Defendant/Plaintiff ever physically cause any harm to the child/children by pushing, shoving, tripping, spitting on or in any related way?

If so, state:

  • (a) when;
  • (b) where;
  • (c) give names and addresses of persons present;
  • (d) the circumstances surrounding each incident.

69. Does the Defendant/Plaintiff have any traits or tendencies which you would not like the child/children to emulate?

If so, state:

  • (a) what are the traits or tendencies;
  • (b) why would you not want the child/children to emulate same?

70. As between the Plaintiff and yourself, who is in better position to influence the child/children? State why?

71. Is the Defendant/Plaintiff a sensitive person?

If so, state:

  • (a) on what do you base this statement?

72. Does the child/children have many friends?

If so, state:

  • (a) set forth the names and addresses of the child/children’s closet friends?

73. Do you now or did you ever spend any time in the company of the child/children’s friends?

If so, state:

  • (a) on an average week, how much time;
  • (b) what you generally do/did during such time.

74. What school is the child/children attending?

75. Who is the child/children’s teacher(s)?

76. How does the child/children get along with the teacher(s)?

77. Has the child/children been a disciplinary problem at any school?

If so, state:

  • (a) when;
  • (b) the nature of the problem;
  • (c) was it corrected and, if so, how;
  • (d) by whom, giving name and address;

78. When the child/children needed school held in the first instance whose assistance was sought?

79. Whose company does the child/children most frequently seek, yours or Plaintiff’s?

80. In the past, if you request the child/children to run an errand, will the child/children readily perform it?

81. Does the Defendant/Plaintiff currently work? If so, state as to each position (a) the name, address and telephone number of your employer; (b) is it part-time or full-time (c) the position or title held; (d) how long you have worked at the position; (e) number of days and hours worked and (f) current salary.

82. If the Defendant/Plaintiff is not currently working, state as to all positions held for the last 5 years:

  • (a) the name, address and telephone number of your employer;
  • (b) whether the position was part-time or full-time;
  • (c) the position or title held;
  • (d) how long you held the position;
  • (e) number of days and hours worked and;
  • (f) date on which you ceased employment.
  • 83. Please list any and all jobs the Defendant/Plaintiff has held in the last ten years, specifying for each;
  • (a) the name, address and telephone number of your employer;
  • (b) was it part-time or full-time
  • (c) the position or title held;
  • (d) how long you worked at that employer;
  • (e) number of days and hours worked;
  • (f) your salary when employed there;
  • (g) date you commenced employment and the date your employment was terminated; and
  • (h) state with specificity the reason(s) you were terminate from and/or quit such job giving the factual basis for same.

84. Does the Defendant/Plaintiff, or any other member of your household currently smoke or smoked in the last five (5) years?

85. Does the Defendant/Plaintiff maintain, or have you in the last five (5) years maintained, a restraining order against any party to this action.

If so, state as to each:

  • (a) the date that the restraining order was entered by the court;
  • (b) the county in which the restraining order was entered;
  • (c) the party restrained by the order;
  • (d) the detailed circumstances leading to your request for the restraining order and;
  • (e) a copy of the restraining order.

86. In the past five (5) years, has anyone maintained a restraining order against you?

If so, state as to each:

  • (a) the date the restraining order was entered by the court;
  • (b) the county in which the restraining order was entered;
  • (c) from whom you were restrained;
  • (d) the details that led up to the issuance of the restraining order;
  • (e) attach a copy of the restraining order(s);
  • (f) any related criminal charges and the disposition as to each.

87. Has the Defendant/Plaintiff in the last five (5) years ever reported acts of alleged domestic violence or injuries observed as to child/children to any law enforcement or medical authority?

If so, state as to each:

  • (a) the date of your report;
  • (b) the law enforcement or medical authority reported to;
  • (c) the name, address and telephone number of the individual(s) who took your statement and;
  • (d) a detailed account of the statement you provided.

88. Has the Defendant/Plaintiff ever personally observed or witnessed in the last five years any acts of domestic violence as to child/children.

If so, state as to each:

  • (a) the date on which you observed the incident;
  • (b) the law enforcement authority that you reported the incident to;
  • (c) any evidence (i.e. photographs, tape recordings, etc.) in your possession as to the incident; and
  • (d) describe in detail the incident you witnessed.

89. With whom do you currently live/reside?

90. Describe in detail the floor plan of the Defendant’s/Plaintiff’s residence, its condition, its furnishings, the structure in which it exists, and the surrounding neighborhood.

91. Describe in detail the prior arrangement existed with regard to custody and parenting time. Please include the following:

  • (a) custodial parent
  • (b) non-custodial parent
  • (c) visitation plan
  • (d) driving arrangements
  • (e) any problems that occurred during visitation periods.

CERTIFICATION

I hereby certify that the copies of the written reports or complete summaries of any oral reports of treating physicians or expert witnesses, annexed hereto, are exact copies of the entire written report or reports or complete summaries of any oral report or reports rendered by them; that the existence of other reports or treating physicians or expert witnesses, either written or oral, are unknown to me; and that if such reports become later known or available, I shall serve them promptly upon the propounding party, but in no case later than the time prescribed by the Court Rules.

I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing statements made by me are willfully false, I am subject to punishment.

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CLIENT Dated: