Trespass Evidence Gathering Questionnaire

This questionnaire is used to gather detailed information and evidence for your litigation. Before you begin, please ensure that your evidence is ready to be uploaded.

The questionnaire is divided into the following sections:

P - Parties *
TPN - Trespass Person
TPY - Trespass Property
TPC - Trespass Chattels
TPE - Trespass Privilege
E - Event Timeline *
D - Damages Itemised *
R - Remedy Proposed *

Note: All fields marked with a red asterisk (*) are required.

People's Registry de Jure Member No

PRDJ

Which type(s) of trespass do you claim? Select all that apply:

Parties - Plaintiff Details

You are the plaintiff.

P1. Full (straw/legal) name of the Plaintiff

P2. Name on Royal Registry Certificate

P3. Occupation

P4. Profession (Do you earn an income from a particular activity?

No

Yes

P5. Is your current address is different to your address when the events occurred, please provide both.

Yes

No

Current Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Address at the time of the event

Address Line 1

Address Line 2

City

State

Zip Code

Country

P6. Phone

P7. Email

Parties - Defendants/Trespassers Information

TPN - Trespass Person

Did the incident involve any unwanted physical contact?

Yes

No

If yes, what unwanted physical contact occurred?

Did you suffer any injuries?

Yes

No

If yes, describe the injuries.

Have you sought medical attention?

Yes

No

If yes, provide details of medical interactions (tick + to add more lines):

Date of Medical Interaction	Medical Practitioner Name	Details of Medical Interaction

Upload all Medical Evidence

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