Do you find from a preponderance of the evidence:
1. That [Plaintiff] was eligible for FMLA leave?
Answer Yes or No _____________
If your answer is “No,” this ends your deliberations, and your foreperson should sign and date the last page of this verdict form.
If your answer is “Yes,” go to the next question.
2. That [Plaintiff] was entitled to FMLA leave?
Answer Yes or No _____________
If your answer is “No,” this ends your deliberations, and your foreperson should sign and date the last page of this verdict form.
If your answer is “Yes,” go to the next question.
3. That [Plaintiff] gave [Defendant] proper notice of [his] [her] need for leave?
Answer Yes or No _____________
If your answer is “No,” this ends your deliberations, and your foreperson should sign and date the last page of this verdict form.
If your answer is “Yes,” go to the next question.
4. That [Defendant] [describe interference]?
Answer Yes or No _____________
If your answer is “No,” this ends your deliberations, and your foreperson should sign and date the last page of this verdict form.
If your answer is “Yes,” go to the next question.
[5. That [Defendant] [describe interference] for reasons that were unrelated to [Plaintiff]’s [FMLA leave/attempt to take FMLA leave]?
Answer Yes or No _____________
If your answer is “Yes,” this ends your deliberations, and your foreperson should sign and date the last page of this verdict form.
If your answer is “No,” go to the next question.]
6. That [Plaintiff] should be awardeddamages?
Answer Yes or No _____________
If your answer is “Yes,” in what amount? $_____________
SO SAY WE ALL.