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IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF [COUNTY [NAME], vs. [NAME], Plaintiff, Defendants. Case No. COMPLAINT (Personal Injury Negligence and Violations of Oregon Residential Landlord and Tenant Code) CLAIM NOT SUBJECT TO MANDATORY ARBITRATION (Prayer Amount $) ORS Fee Statute: ORS 21.160(1)(c) Plaintiff alleges as follows: 1. At all material times herein, [NAME] ( Defendants ) were the owners of real property located at [ADDRESS] ( Property ). 2. At all material times herein, [PLAINTIFF] was the lawful resident of the Property, as well as a business invitee of Defendants as the renter of the Property. 1 of 8 COMPLAINT 3.

At all material times herein, [PLAINTIFF] was a tenant of the Property, and Defendants were landlords of the Property as defined by the Oregon Residential Landlord and Tenant Code, ORS 90.100. 4. A stairway exists on the outside of the house on the Property that must be used to access the front door. One of the steps on the stairway was constructed in a manner that created a 15-inch rise for 18 inches of the length of the step and a 7-inch rise across the remaining length of the step. The stairway as constructed was and is in violation of R311.7.4.5 and R311.7.4.1 of the Oregon Residential Specialty Code regarding the maximum rise of any given step and the evenness of rise across the length of a step. 5. On or about [DATE], [PLAINTIFF] moved into and took possession of the Property. [PLAINTIFF] moved her belongings into the house through the garage entry. At no time did [PLAINTIFF] use the stairway to the front door. 6. In the evening on [DATE], [PLAINTIFF] decided to use the front door and stairway to access her car. She had not used the stairway leading outside the front door of the house earlier that day. [PLAINTIFF] had only used the stairway once before during a walkthrough of the Property. 7. A motion sensor light was affixed outside the front door to illuminate the stairway. Unbeknownst to [PLAINTIFF], the motion sensor light was not working. Additionally, a 2 of 8 COMPLAINT

large rock the size of a football had been placed on the stairway on top of the portion of the step with the 15-inch rise. 8. On the evening of [DATE], [PLAINTIFF] opened her front door to leave the house. She stepped out onto the landing in front of her door and proceeded to walk down the stairway in the darkness. After taking several steps her foot landed on the large football-sized rock and she fell down the portion of stairway with the 15-inch rise. 9. Defendants knew or should have know that the 15-inch rise of the step on the stairway, the large rock the size of a football, and the lack of lighting constituted an unreasonably dangerous condition that could not be encountered with reasonable safety by persons in Ms. Burgess s position. 10. As a direct result of the unreasonably dangerous condition described above, [PLAINTIFF] fell and sustained the following injuries, some of which are permanent and required multiple surgeries: a. [LIST OF INJURIES] b. [LIST OF INJURIES] c. [LIST OF INJURIES] d. [LIST OF INJURIES] e. [LIST OF INJURIES] 3 of 8 COMPLAINT

CLAIM FOR RELIEF (Count 1: ORS 90.380 Rental of Dwelling in Violation of Building or Housing Code) 11. As applicable, [PLAINTIFF] incorporates the above. 12. The unreasonably dangerous condition described above existed at the outset of [PLAINTIFF] tenancy of the Property. 13. The unreasonably dangerous condition described above posed an imminent threat to the health and safety of [PLAINTIFF] and her family. 14. Prior to renting the Property to [PLAINTIFF] and her family, Defendants knew or should have know that the unreasonably dangerous condition described above posed an imminent threat to the health and safety of [PLAINTIFF] and her family. 15. [PLAINTIFF] has or will incur the following economic damages: a. Reasonable and necessary medical expenses in the amount of $, an amount to be amended at the time of trial; and b. Future medical expenses in the amount of $, an amount to be amended at the time of trial. 16. 4 of 8 COMPLAINT

[PLAINTIFF] has endured and suffered permanent physical injury, physical disability, emotional distress, and inconvenience and interference with normal and usual activities. As such, [PLAINTIFF] is prays for an award of nonecomic damages in the amount of $. 17. As a result of Defendants violation of ORS 90.380(7), [PLAINTIFF] should be awarded twice the amount of her actual damages proven at trial pursuant to ORS 90.380(7). 18. As a result of Defendants violation of ORS 90.380(7), [PLAINTIFF] should be awarded her attorney fees and litigation expenses/costs against Defendants pursuant to ORS 90.255. (Count 2: ORS 90.320 Habitability) 19. As applicable, [PLAINTIFF] incorporates the above. 20. Defendants violated ORS 90.320(1) in the following particulars: a. Failing to maintain and keep the electrical lighting in good working order as required by ORS 90.320(e); and b. Failure to keep buildings, grounds, and appurtenances at the time of commencement of the rental agreement in every part safe for normal and reasonably foreseeable uses as required by ORS 90.320(f). 21. Defendants knew or had reason to know that their actions and inactions constituted a violation of ORS 90.320(1) as described above. 5 of 8 COMPLAINT

22. [PLAINTIFF] has or will incur the following economic damages: a. Reasonable and necessary medical expenses in the amount of $, an amount to be amended at the time of trial; and b. Future medical expenses in the amount of $, an amount to be amended at the time of trial. 23. [PLAINTIFF] has endured and suffered permanent physical injury, physical disability, emotional distress, and inconvenience and interference with normal and usual activities. As such, [PLAINTIFF] is prays for an award of nonecomic damages in the amount of $. 24. As a result of Defendants violation of ORS 90.320(1), [PLAINTIFF] should be awarded her attorney fees and litigation expenses/costs against Defendants pursuant to ORS 90.255. (Count 3: Negligence) 25. As applicable, [PLAINTIFF] incorporates the above. 26. Defendants were negligent in one or more of the following particulars and that negligence was the legal cause of the [PLAINTIFF] fall and her injuries as alleged above: 6 of 8 COMPLAINT

a. Renting the Property while it was in violation of the Oregon Residential Specialty Code; b. Failing to install a handrail preventing individuals from using the portion of the step with a 15-inch rise; c. Placing a large rock on top of the step with the 15-inch rise; d. Failing to verbally warn [PLAINTIFF] and her family of the unreasonably dangerous stairway leading to the front door; e. Failing to discover and/or fix the lighting fixture that is supposed to illuminate the stairway leading to the front door; and f. Failing to install warning signs and/or visually mark the step to notify individual of its safety risk. 27. [PLAINTIFF] has or will incur the following economic damages: a. Reasonable and necessary medical expenses in the amount of $, an amount to be amended at the time of trial; and b. Future medical expenses in the amount of $, an amount to be amended at the time of trial. 28. [PLAINTIFF] has endured and suffered permanent physical injury, physical disability, emotional distress, and inconvenience and interference with normal and usual activities. As such, [PLAINTIFF] prays for an award of noneconomic damages in the amount of $. 7 of 8 COMPLAINT

WHEREFORE, [PLAINTIFF] pray for judgment as follows: 1. For all three Counts, $ in economic damages, an amount to be amended at the time of trial, and $ in noneconomic damages; 2. For Counts 1 and 2, attorney fees and litigation expenses/costs against Defendants pursuant to ORS 90.255; 3. For Count 1, twice the amount of her actual damages proven at trial pursuant to ORS 90.380(7); 4. For [PLAINTIFF] cost and disbursements incurred herein; and 5. For such other relief as this court deems just and proper. DATED this day of,. Daniel A. Rayfield, OSB #06479 Of Attorneys for Plaintiff TEL: 541-928-9147 FAX: 541-928-3621 E-Mail: dan@nelsonandmacneil-law.com TRIAL ATTORNEY: Daniel A. Rayfield, OSB #06479 8 of 8 COMPLAINT