Wrongful Death Complaint

WRONGFUL DEATH COMPLAINT

(Arizona – A.R.S. §§ 12-611 to 12-613; A.R.S. § 14-3110)

I. DOCUMENT HEADER

IN THE SUPERIOR COURT OF THE STATE OF ARIZONA
IN AND FOR THE COUNTY OF [COUNTY]

[PLAINTIFF FULL NAME], individually and as the duly–appointed Personal Representative of the ESTATE OF [DECEDENT FULL NAME], and on behalf of all Statutory Beneficiaries defined under A.R.S. § 12-612(B),
  Plaintiff,

v.

[DEFENDANT LEGAL NAME], a [STATE] [corporation/limited liability company/individual/etc.],
  Defendant.

Case No. __________

COMPLAINT FOR WRONGFUL DEATH
(Jury Trial Demanded)

*Filed: [MM/DD/YYYY]*  

*Governing Law: Arizona Wrongful Death Act (A.R.S. §§ 12-611 – 12-613)*  
*Forum: Arizona state court (mandatory)*  

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### TABLE OF CONTENTS
1. Definitions…………………………………………………………………………………. 2  
2. Jurisdiction, Venue & Parties………………………………………………….. 3  
3. General Allegations (Factual Background)……………………………… 4  
4. Operative Provisions (Causes of Action)………………………………… 6  
   4.1 Count I – Negligence Resulting in Wrongful Death  
   4.2 Count II – Survival Action (Optional)  
5. Representations & Warranties (Statutory Compliance)…………… 9  
6. Covenants & Restrictions (Litigation Holds, Etc.)…………………… 10  
7. Default & Remedies (Damages Sought)………………………………… 11  
8. Risk Allocation (Statutory Damage Parameters)……………………… 12  
9. Dispute Resolution…………………………………………………………………… 13  
10. General Provisions…………………………………………………………………… 14  
11. Execution, Attorney Signature & Verification………………………… 16  

*Page numbers will auto-adjust when finalized.*

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### II. DEFINITIONS
For purposes of this Complaint, the following capitalized terms shall have the meanings set forth below.  Undefined capitalized terms shall have their ordinary legal meaning under Arizona law.

“Decedent” – [DECEDENT FULL NAME], who died on [DATE OF DEATH] as a direct and proximate result of Defendant’s conduct alleged herein.

“Statutory Beneficiaries” – The persons authorized to recover under A.R.S. § 12-612(B), specifically the Decedent’s [SPOUSE/CHILD(REN)/PARENT(S)/GUARDIAN].

“Estate” – The probate estate of the Decedent, administered under Arizona law by the Personal Representative duly appointed by the [NAME OF PROBATE COURT], Case No. ☐.

“Subject Incident” – The event(s) on [DATE] at/on [LOCATION] that caused the injuries resulting in Decedent’s death.

“Complaint” – This civil pleading, inclusive of all exhibits, attachments, and any amendments permitted by law.

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### III. JURISDICTION, VENUE & PARTIES  

3.1 Jurisdiction.  This Court has subject-matter jurisdiction pursuant to A.R.S. § 12-123 and because the amount in controversy exceeds the jurisdictional minimum of the Superior Court.  

3.2 Venue.  Venue is proper in [COUNTY] County under A.R.S. § 12-401(10) because the Subject Incident occurred in this county and/or Defendant resides or conducts business here.  

3.3 Plaintiff.  Plaintiff [PLAINTIFF NAME] is an adult resident of [COUNTY], Arizona, and is the duly appointed Personal Representative of the Estate.  Plaintiff also sues in their individual capacity as a Statutory Beneficiary.  

3.4 Defendant.  Defendant [DEFENDANT NAME] is a [describe entity/individual], with its principal address at [ADDRESS].  Defendant may be served with process via [STATUTORY AGENT/ADDRESS] pursuant to Ariz. R. Civ. P. 4.  

3.5 Additional Parties.  At all relevant times, each fictitiously named Defendant was an agent, servant, employee, partner, joint venturer, or co-conspirator of every other Defendant and acted within the course and scope of said relationship.  

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### IV. GENERAL ALLEGATIONS (FACTUAL BACKGROUND)

4.1 On [DATE], Decedent was lawfully present at [LOCATION] when the Subject Incident occurred.  

4.2 Defendant owed Decedent a duty of care to [describe duty– e.g., safely operate a motor vehicle / design, manufacture, and market a product free of unreasonable dangers / maintain premises].  

4.3 Defendant breached that duty by [specific acts or omissions].  

4.4 As a direct and proximate result of Defendant’s breach, Decedent sustained severe bodily injuries leading to death on [DATE OF DEATH].  

4.5 Decedent is survived by the Statutory Beneficiaries identified in § II above.  

4.6 All conditions precedent to bringing this action, including any required probate appointments and, if applicable, the statutory Notice of Claim under A.R.S. § 12-821.01 (public-entity defendants only), have been satisfied, waived, or otherwise fulfilled.  

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### V. OPERATIVE PROVISIONS (CAUSES OF ACTION)

#### 5.1 Count I – Wrongful Death (Negligence)  
a. Plaintiff realleges §§ 2–4 as though fully set forth herein.  
b. Pursuant to A.R.S. § 12-611, Plaintiff, on behalf of the Statutory Beneficiaries, may maintain an action when a person’s death is caused by the wrongful act, neglect, or default of another.  
c. Defendant’s conduct constituted negligence in that Defendant [list negligent acts/omissions].  
d. Defendant’s negligence directly and proximately caused Decedent’s death and the damages to Statutory Beneficiaries described in § 7 below.  

#### 5.2 Count II – Survival Action (A.R.S. § 14-3110) [OPTIONAL]  
a. Plaintiff realleges §§ 2–4 as though fully set forth herein.  
b. Under A.R.S. § 14-3110, claims for personal injuries survive the injured party’s death and may be asserted by the Personal Representative.  
c. Decedent sustained conscious pain, suffering, medical expenses, and other losses between injury and death, for which the Estate is entitled to recovery.  

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### VI. REPRESENTATIONS & WARRANTIES (STATUTORY COMPLIANCE)

6.1 Plaintiff represents that (i) Plaintiff has been duly appointed and is acting in the capacity stated; (ii) no other action concerning the Subject Incident has been adjudicated or is currently pending in any other jurisdiction; and (iii) all known Statutory Beneficiaries have been joined or their interests adequately represented herein.  

6.2 Plaintiff warrants that this pleading is submitted in good faith, is well-grounded in fact, and is warranted by existing law or a non-frivolous argument for the extension, modification, or reversal of existing law, consistent with Ariz. R. Civ. P. 11.  

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### VII. COVENANTS & RESTRICTIONS

7.1 Evidence Preservation.  Plaintiff hereby demands that Defendant preserve all documents, electronically stored information (“ESI”), tangible things, and data relating to the Subject Incident.  

7.2 Notice of Insurance.  Pursuant to Ariz. R. Civ. P. 26.1(a)(6), Defendant is obligated to disclose all insurance agreements that may satisfy part or all of any judgment that may be entered in this action.  

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### VIII. DEFAULT & REMEDIES (DAMAGES SOUGHT)

8.1 Pecuniary Damages.  Pursuant to A.R.S. § 12-613, Plaintiff seeks the full measure of pecuniary damages suffered by the Statutory Beneficiaries, including but not limited to:  
 a. Loss of support, services, and maintenance;  
 b. Loss of love, affection, companionship, care, protection, and guidance;  
 c. Reasonable funeral and burial expenses already incurred or to be incurred.  

8.2 Survival Damages (if Count II asserted).  Pre-death medical expenses, lost earnings, pain and suffering, and property damage incurred by Decedent.  

8.3 Punitive Damages.  Plaintiff seeks punitive and exemplary damages to punish and deter Defendant’s willful, wanton, or reckless conduct.  Arizona law imposes no legislative cap on punitive damages in wrongful-death actions.  

8.4 Pre- and Post-Judgment Interest, costs taxable under A.R.S. § 12-332, and any attorneys’ fees recoverable under applicable law.  

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### IX. RISK ALLOCATION

9.1 Statutory Damage Parameters.  Plaintiff acknowledges that damages in wrongful-death actions are distributed to Statutory Beneficiaries in proportion to their losses as determined by the trier of fact pursuant to A.R.S. § 12-612(C).  

9.2 Indemnification.  No contractual indemnity claims are asserted herein.  

9.3 Force Majeure / Impossibility.  Not applicable to the pleaded causes of action.  

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### X. DISPUTE RESOLUTION

10.1 Governing Law.  This action is governed exclusively by the substantive laws of the State of Arizona.  

10.2 Forum Selection.  All claims shall be heard in the Superior Court of Arizona, [COUNTY] County.  Removal or transfer is expressly opposed.  

10.3 Arbitration.  The parties may agree to binding arbitration under A.R.S. § 12-1501 *only by subsequent written stipulation approved by the Court.*  

10.4 Jury Demand.  Plaintiff demands trial by jury on all issues so triable as a matter of right under the Arizona Constitution, art. 2 § 23.  Any contractual jury waiver asserted by Defendant is void as against public policy.  

10.5 Injunctive Relief.  Plaintiff reserves the right to seek limited equitable relief (e.g., evidence preservation orders) consistent with Rule 65, Ariz. R. Civ. P.  

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### XI. GENERAL PROVISIONS

11.1 Reservation of Rights.  Plaintiff reserves the right to amend this Complaint to assert additional claims and parties as discovery proceeds, pursuant to Ariz. R. Civ. P. 15.  

11.2 Severability.  Should any provision of this Complaint be deemed legally deficient, such deficiency shall not affect the remaining allegations or claims.  

11.3 Integration.  This pleading constitutes the entire statement of claims known to Plaintiff at this time.  

11.4 Electronic Signatures.  Consistent with Rule 5(e), Ariz. R. Civ. P., this Complaint may be executed and filed electronically.  

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### XII. PRAYER FOR RELIEF

WHEREFORE, Plaintiff respectfully requests that the Court enter judgment in favor of Plaintiff and against Defendant as follows:  

A. For all compensatory damages permitted by A.R.S. § 12-613 in an amount to be proven at trial;  
B. For all Estate damages permitted by A.R.S. § 14-3110 (if applicable);  
C. For punitive and exemplary damages in an amount sufficient to punish and deter Defendant;  
D. For pre-judgment and post-judgment interest as allowed by law;  
E. For taxable costs and such attorneys’ fees as may be recoverable; and  
F. For such other and further relief as the Court deems just and proper.  

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### XIII. EXECUTION BLOCK

Respectfully submitted this ___ day of __________, 20__.  

```text
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_  
[ATTORNEY NAME], Esq.  
[State Bar No. \_\_\_\_\_]  
[LAW FIRM NAME]  
[ADDRESS]  
[PHONE] | [EMAIL]  
Counsel for Plaintiff  

XIV. VERIFICATION

STATE OF ARIZONA          )  
  ) ss.  
County of [COUNTY]   )  

I, [PLAINTIFF NAME], being duly sworn, depose and state that I have read the foregoing Complaint and know the contents thereof; that the same is true of my own knowledge except as to those matters stated upon information and belief, and as to those matters I believe them to be true.  

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_  
[PLAINTIFF NAME]  

Subscribed and sworn to before me this ___ day of ____, 20__.

Notary Public
My Commission Expires: ____

```