Opinion
20-CV-10939 (LLS)
02-10-2021
JOSHUA KELLIER, Plaintiff, v. MMS, et al., Defendants.
ORDER TO AMEND :
Plaintiff, appearing pro se, brings this action under 42 U.S.C. § 1983, alleging that Defendants violated his constitutional rights. He also alleges that Defendants conspired to harm him, in violation of federal criminal statutes 18 U.S.C. § 241 and § 242.
By order dated January 28, 2021, the Court granted Plaintiff's request to proceed without prepayment of fees, that is, in forma pauperis (IFP). For the reasons set forth below, the Court grants Plaintiff leave to file an amended complaint within sixty days of the date of this order. The Court also denies Plaintiff's request for preliminary injunctive relief and for the appointment of pro bono counsel.
STANDARD OF REVIEW
The Court must dismiss an IFP complaint, or any portion of the complaint, that is frivolous or malicious, fails to state a claim on which relief may be granted, or seeks monetary relief from a defendant who is immune from such relief. 28 U.S.C. § 1915(e)(2)(B); see Livingston v. Adirondack Beverage Co., 141 F.3d 434, 437 (2d Cir. 1998). The Court must also dismiss a complaint when the Court lacks subject matter jurisdiction. See Fed. R. Civ. P. 12(h)(3).
While the law mandates dismissal on any of these grounds, the Court is obliged to construe pro se pleadings liberally, Harris v. Mills, 572 F.3d 66, 72 (2d Cir. 2009), and interpret them to raise the "strongest [claims] that they suggest," Triestman v. Fed. Bureau of Prisons, 470 F.3d 471, 474 (2d Cir. 2006) (internal quotation marks and citations omitted) (emphasis in original). But the "special solicitude" in pro se cases, id. at 475 (citation omitted), has its limits - to state a claim, pro se pleadings still must comply with Rule 8 of the Federal Rules of Civil Procedure, which requires a complaint to make a short and plain statement showing that the pleader is entitled to relief.
The Supreme Court has held that under Rule 8, a complaint must include enough facts to state a claim for relief "that is plausible on its face." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007). A claim is facially plausible if the plaintiff pleads enough factual detail to allow the Court to draw the inference that the defendant is liable for the alleged misconduct. In reviewing the complaint, the Court must accept all well-pleaded factual allegations as true. Ashcroft v. Iqbal, 556 U.S. 662, 678-79 (2009). But it does not have to accept as true "[t]hreadbare recitals of the elements of a cause of action," which are essentially just legal conclusions. Twombly, 550 U.S. at 555. After separating legal conclusions from well-pleaded factual allegations, the Court must determine whether those facts make it plausible - not merely possible - that the pleader is entitled to relief. Id.
BACKGROUND
This action arises out of a lien placed on Plaintiff's storage unit at Manhattan Mini Storage (MMS), as a result of his alleged failure to pay the balance of his account. Plaintiff names three sets of defendants, all of whom appear to be involved in his storage unit tenancy. The first set includes the following MMS employees: Assistant Manager Jamelia; Manager Taylor; General Manager Delroy; Manager Kurwin Kurtwood; Assistant Manager Kevin CC; and Assistant to the General Manager, Kenny. The second set of defendants includes individuals associated with a judicial proceeding held by the Office of Temporary and Disability Assistance (OTDA), namely: Administrative Law Judge Marshall and a Human Resource Administration (HRA) representative, Gabriel. The third set of defendants includes HRA employees from a Bronx job center: Marky, Garcia, Salocumb, and Smalls; and a John Doe police officer who may have been stationed at the job center. Plaintiff seeks $25,000,000 in money damages.
The following facts are taken from the complaint: On an unspecified date in 2020, MMS (1) changed the locks on Plaintiff's storage unit while he was away, (2) deactivated his access to the unit, and (3) performed unnecessary inspections for the purpose of harassing Plaintiff. Around this same time, MMS provided Plaintiff with notice that it would evict him; Plaintiff alleges that this eviction was "based on false charges." (ECF 2, at 10.)
Plaintiff also alleges that an OTDA administrative law judge, HRA employees, and a John Doe police officer violated his rights with respect to his MMS storage unit. Plaintiff states that he "commenced [a] hearing with the office of [OTDA] for breach of contract with the HRA Department [which] made the payment and breach of duty and have not received a response." (ECF 2, at 13.) He also states that "[o]n February 28, 2020, HRA imposed a new contract on the plaintiff to reduce storage size and to pay him less money $156 maximum amount when the plaintiff's invoice amount to 176.00 every month." (Id.) Plaintiff "kept [MMS] informed"; he also asked Defendant Delroy, General Manager at MMS, for an extension of time until the pandemic was "over or until the hearing [was] done before putting on additional fees." (Id.) But in May 2020, Delroy informed Plaintiff that he needed to "come in and get your stuff and go." (Id.) Plaintiff also learned, however, from Assistant Manager Kevin "that it was safe to leave" his property at MMS during the pandemic, "[b]eing that [Plaintiff] was locked out from going back . . . ." (Id.)
At some later point, Plaintiff "filed his notice of tort claims against the HRA and they have failed to adjudicate the matter during COVID . . . ." (Id. at 14.) Defendant Marshall told the plaintiff that the matter would be adjourned and the matter would be dealt with at a later date," possibly in December 2020. (Id.) Then, on December 20, 2020, a lien was issued. (Id.) MMS has refused to provide Plaintiff with a copy of the eviction notice, which Plaintiff asserts "was used to usurp the power from the governors executive law." (Id.) Plaintiff alleges that HRA has denied him due process by failing to set a date for his hearing.
Plaintiff claims that HRA and MMS are conspiring to evict him from his storage unit. He alleges that the "relationship between [MMS] and HRA is HRA pays the plaintiff to cover his invoice of $176. In the other hand [MMS] received the check from HRA." (Id. at 15.) He also claims that a new contract between MMS and Plaintiff "violates the initial agreement Plaintiff had with HRA." (Id.)
Plaintiff brings a breach of contract claim against Defendants, claiming that HRA "has from the moment they issued that contract . . . knew with substantial certainty that . . . such contract would injure the Plaintiff." (Id. at 31.) He also claims that the Bronx HRA office has required him "to make a statement" before he receives a check. (Id.)
Attached to the complaint are two documents (1) a November 25, 2020 letter from MMS to Plaintiff, notifying him of its intention to sell his property because of alleged nonpayment (id. at 47); and (2) a notice of claim filed by Plaintiff in the New York Supreme Court, Kings County, concerning the events giving rise to his claim here.
DISCUSSION
Because Plaintiff alleges that his constitutional rights have been violated, the Court construes his claims as arising under 42 U.S.C. § 1983. To state a claim under 42 U.S.C. § 1983, a plaintiff must allege both that: (1) a right secured by the Constitution or laws of the United States was violated, and (2) the right was violated by a person acting under the color of state law, or a "state actor." West v. Atkins, 487 U.S. 42, 48-49 (1988).
A. MSS Defendants
The complaint fails to show that the MSS Defendants qualify as state actors who may be held liable under § 1983. "Because the United States Constitution regulates only the Government, not private parties, a litigant claiming that his constitutional rights have been violated must first establish that the challenged conduct constitutes state action." Flagg v. Yonkers Sav. & Loan Ass'n, 396 F.3d 178, 186 (2d Cir. 2005) (internal quotation marks omitted); see also Tancredi v. Metro. Life Ins. Co., 316 F.3d 308, 312 (2d Cir. 2003) ("A plaintiff pressing a claim of violation of his constitutional rights under § 1983 is thus required to show state action.").
The activity of a private entity can be attributed to the state in three situations: (1) the entity acts using the coercive power of the state or is controlled by the state; (2) the entity willfully participates in joint activity with state or its functions are entwined with state policies; or (3) the state has delegated a public function to the entity. See Fabrikant v. French, 691 F.3d 193, 207 (2d Cir. 2012). The fundamental question under each test is whether the private entity's challenged actions are "fairly attributable" to the state. Id. (citing Rendell-Baker v. Kohn, 457 U.S. 830, 838 (1982)).
Private activity does not qualify as state action based "solely on the private entity's creation, funding, licensing, or regulation by the government." Cranley v. Nat'l Life Ins. Co. of Vermont, 318 F.3d 105, 112 (2d Cir. 2003). Moreover, private "conduct [that] is not compelled by the state but . . . merely permitted by state law" also does not qualify as state action. Id. Thus, a private storage company authorized under state law to sell a tenant's property to cover unpaid fees does not qualify as state action. See, e.g., Flagg Brothers, 436 U.S. at 164-66.
Here, Plaintiff does not assert facts suggesting that the actions of the MSS Defendants are attributable to any government agency. While Plaintiff alleges that MMS and HRA conspired to violate his rights, he does not state any facts suggesting that these two entities jointly managed his storage unit. Rather, it appears that HRA assisted Plaintiff financially, possibly with rental assistance, and that Plaintiff then contracted with MMS to store his property. These allegations suggest only that HRA provided Plaintiff with the financial means to pay for a storage unit with MMS, not that MMS participated in any state action with HRA. Thus, the Court finds that MMS's private conduct does not qualify as state action.
Plaintiff proceeds in this matter without the benefit of a lawyer. While the Court is inclined to dismiss the claims brought against the MMS Defendants, in an abundance of caution, the Court grants Plaintiff leave to file an amended complaint to detail his claims against these defendants. If Plaintiff chooses to amend, he should provide the following details: (1) the location of his storage unit; (2) the details of his agreement with HRA to open an account with MMS; and (3) the specific relationship between HRA and MMS. As to the third detail, the Court directs Plaintiff to state facts suggesting an actual relationship between these two entities, not his speculation that they conspired against him.
B. HRA Defendants
The Court construes Plaintiff's claims against the HRA defendants as asserting a procedural due process claim under the Fourteenth Amendment to the United States Constitution. To state a § 1983 due process claim, a plaintiff must "demonstrate that he possessed a protected liberty or property interest, and that he was deprived of that interest without due process of law." Hynes v. Squillance, 143 F.3d 653, 658 (2d Cir. 1998); see Nnebe v. Daus, 644 F.3d 147, 158 (2d Cir. 2011). "The fundamental requisite of due process of law is the opportunity to be heard . . . at a meaningful time and in a meaningful manner." Goldberg v. Kelly, 397 U.S. 254, 267 (1970) (citations omitted). Generally, due process requires some kind of hearing prior to a final deprivation of an individual's liberty or property interest. See Hodel v. Va. Surface Mining & Reclamation Ass'n, Inc., 452 U.S. 264, 299 (1981); DiBlasio v. Novello, 344 F.3d 292, 302 (2d Cir. 2003). "[W]here a plaintiff alleges a deprivation of property in violation of the due process clause, the federal court's initial inquiry must be whether the state has provided adequate remedies to redress such unlawful acts. If so, there will be no claim before the federal court, whether or not plaintiff took advantage of the state procedure." Vialez v. New York City Hous. Auth., 783 F. Supp. 109, 114 (S.D.N.Y. 1991).
Public assistance benefits "have long been afforded constitutional protection as a species of property protected by the federal Due Process Clause." Kapps v. Wing, 404 F.3d 105, 112 (2d Cir. 2005). In the context of public assistance benefits, due process typically requires predeprivation notice and an opportunity to be heard. Goldberg, 397 U.S. at 260-61.
New York State law provides a remedy to challenge the deprivation of property. For example, under New York law, an individual may challenge the deprivation of benefits in a fair hearing pursuant to N.Y. Soc. Serv. Law § 22 and 18 N.Y.C.R.R. § 358, or in the state courts in an Article 78 proceeding. Federal courts have found these remedies to be constitutionally adequate procedures to challenge adverse determinations in connection with government entitlement programs. See, e.g., Marvin v. Peldunas, No. 16-CV-1456, 2020 WL 5548823, at *4 (S.D.N.Y. Sept. 16, 2020) ("Plaintiff does not assert that he was denied access to the fair hearing process. Plaintiff chose not to avail himself of an Article 78 proceeding to challenge the determination of [the administrative law judge]".).
Public benefits recipients ultimately must utilize the state courts to challenge any dispute with a benefit determination and may not resort to federal courts to litigate such determinations. See, e.g., McCluskey v. Imhof, No. 17-CV-5873, 2018 WL 5077169, at *8 (E.D.N.Y. Aug. 27, 2018) (The plaintiff's "procedural due process claim is an attempt to end run the protections and review process afforded to him under state law and impermissibly turn what should be an ordinary [A]rticle 78 proceeding into a federal action [citation omitted]. Although Article 78 would be an inappropriate remedy for violations of due process, where, as here, the plaintiff's claim is actually a dispute [over] the amount of food stamp benefits, Article 78 would be the appropriate venue to challenge the adverse food stamp determination.") (internal quotation marks and citations omitted), report and recommendation adopted, 2018 WL 4521207 (E.D.N.Y. Sept. 21, 2018).
Here, Plaintiff fails to state a due process claim against the HRA Defendants for three reasons. First, the complaint does not suggest that HRA denied Plaintiff any benefits. Second, even if HRA did deny Plaintiff benefits, he does not allege that he took advantage of the state procedures to challenge such a denial. Rather, it appears he seeks federal court review of an ongoing state court proceeding regarding his benefits. Third, to the extent Plaintiff is alleging that his proceedings have been delayed because of the global pandemic, he does not allege any facts suggesting that the state courts are unavailable to challenge any deprivation of his benefits.
Although the Court is inclined to dismiss the claims against the HRA defendants because he has failed to state a claim against any of these defendants, in an abundance of caution, the Court grants Plaintiff leave to amend these claims by providing specific details as to (1) the denial of any benefits on the part of HRA and (2) the unavailability of the state courts to challenge this denial. The Court also directs Plaintiff to state facts in support of his claims against the HRA representative, Gabriel, and the John Doe Police Officer who worked at the HRA office in the Bronx, along with identifying information describing this John Doe defendant.
C. Judicial Immunity
Judges are absolutely immune from suit for damages for any actions taken within the scope of their judicial responsibilities. Mireles v. Waco, 502 U.S. 9, 11 (1991). Generally, "acts arising out of, or related to, individual cases before the judge are considered judicial in nature." Bliven v. Hunt, 579 F.3d 204, 210 (2d Cir. 2009). "Even allegations of bad faith or malice cannot overcome judicial immunity." Id. (citations omitted). This is because "[w]ithout insulation from liability, judges would be subject to harassment and intimidation . . . ." Young v. Selsky, 41 F.3d 47, 51 (2d Cir. 1994). In addition, as amended in 1996, § 1983 provides that "in any action brought against a judicial officer for an act or omission taken in such officer's judicial capacity, injunctive relief shall not be granted unless a declaratory decree was violated or declaratory relief was unavailable." 42 U.S.C. § 1983. This immunity doctrine has been extended to administrative law judges for their actions in their adjudicatory roles. See, e.g., Cleavinger v. Saxner, 474 U.S. 193, 200 (1985); Rivera v. Mattingly, 604 F. Supp. 2d 634, 638 (S.D.N.Y. 2009) (noting that judicial immunity protects OCFS administrative law judges from suit under § 1983).
Judicial immunity does not apply when the judge takes action "outside" his judicial capacity, or when the judge takes action that, although judicial in nature, is taken "in absence of jurisdiction." Mireles, 502 U.S. at 9-10; see also Bliven, 579 F.3d at 209-10 (describing actions that are judicial in nature). But "the scope of [a] judge's jurisdiction must be construed broadly where the issue is the immunity of the judge." Stump v. Sparkman, 435 U.S. 349, 356 (1978).
As Plaintiff sues Defendant Marshall, an OTDA Administrative Judge, based on her judicial conduct, the Court dismisses all claims brought against her under the doctrine of judicial immunity, and as frivolous. See 28 U.S.C. § 1915(e)(2)(B)(i), (iii); Mills v. Fischer, 645 F.3d 176, 177 (2d Cir. 2011) ("Any claim dismissed on the ground of absolute judicial immunity is 'frivolous' for purposes of [the in forma pauperis statute].").
D. Criminal Prosecution
Plaintiff alleges that Defendants violated federal criminal statues, but a private party cannot prosecute a criminal action in federal court. See Leek v. Timmerman, 454 U.S. 83, 86-87 (1981) (plaintiffs lack standing to seek the issuance of an arrest warrant); Linda R.S. v. Richard D., 410 U.S. 614, 619 (1973) ("[A] private citizen lacks a judicially cognizable interest in the prosecution or nonprosecution of another."). And because federal prosecutors possess discretionary authority to bring criminal actions, they are "immune from control or interference by citizen or court." Conn. Action Now, Inc. v. Roberts Plating Co., 457 F.2d 81, 87 (2d Cir. 1972). Accordingly, the Court dismisses Plaintiff's claims in which he seeks the criminal prosecution of Defendants, for failure to state a claim on which relief may be granted. See 28 U.S.C. § 1915(e)(2)(B)(ii).
E. Request for an order to show cause
Plaintiff has filed a motion requesting preliminary injunctive relief. To obtain such relief, Plaintiff must show: (1) that he is likely to suffer irreparable harm and (2) either (a) a likelihood of success on the merits of his case or (b) sufficiently serious questions going to the merits to make them a fair ground for litigation and a balance of hardships tipping decidedly in his favor. See UBS Fin. Servs., Inc. v. W.V. Univ. Hosps., Inc., 660 F. 3d 643, 648 (2d Cir. 2011) (citation and internal quotation marks omitted); Wright v. Giuliani, 230 F.3d 543, 547 (2000). Preliminary injunctive relief "is an extraordinary and drastic remedy, one that should not be granted unless the movant, by a clear showing, carries the burden of persuasion." Moore v. Consol. Edison Co. of N.Y., Inc., 409 F.3d 506, 510 (2d Cir. 2005) (internal quotation marks and citation omitted).
Because Plaintiff has failed to state a claim against any of the defendants, the Court finds that Plaintiff has failed to show (1) a likelihood of success on the merits, or (2) sufficiently serious questions going to the merits to make them a fair ground for litigation and a balance of hardships tipping decidedly in his favor. Accordingly, Plaintiff's request for an order to show cause is denied. F. Request for pro bono counsel
The factors to be considered in ruling on an indigent litigant's request for counsel include the merits of the case, Plaintiff's efforts to obtain a lawyer, and Plaintiff's ability to gather the facts and present the case if unassisted by counsel. See Cooper v. A. Sargenti Co., 877 F.2d 170, 172 (2d Cir. 1989); Hodge v. Police Officers, 802 F.2d 58, 60-62 (2d Cir. 1986). Of these, the merits are "[t]he factor which command[s] the most attention." Cooper, 877 F.2d at 172. Because it is too early in the proceedings for the Court to assess the merits of the action, Plaintiff's motion for counsel is denied without prejudice to renewal at a later date.
LEAVE TO AMEND
Plaintiff is granted leave to amend his complaint to detail his claims. First, Plaintiff must name as the defendant(s) in the caption and in the statement of claim those individuals who were allegedly involved in the deprivation of his federal rights. If Plaintiff does not know the name of a defendant, he may refer to that individual as "John Doe" or "Jane Doe" in both the caption and the body of the amended complaint. The naming of John Doe defendants, however, does not toll the three-year statute of limitations period governing this action and Plaintiff shall be responsible for ascertaining the true identity of any "John Doe" defendants and amending his complaint to include the identity of any "John Doe" defendants before the statute of limitations period expires. Should Plaintiff seek to add a new claim or party after the statute of limitations period has expired, he must meet the requirements of Rule 15(c) of the Federal Rules of Civil Procedure. In the statement of claim, Plaintiff must provide a short and plain statement of the relevant facts supporting each claim against each defendant named in the amended complaint. Plaintiff is also directed to provide the addresses for any named defendants. To the greatest extent possible, Plaintiff's amended complaint must:
The caption is located on the front page of the complaint. Each individual defendant must be named in the caption. Plaintiff may attach additional pages if there is not enough space to list all of the defendants in the caption. If Plaintiff needs to attach an additional page to list all defendants, he should write "see attached list" on the first page of the Amended Complaint. Any defendants named in the caption must also be discussed in Plaintiff's statement of claim.
For example, a defendant may be identified as: "John Doe #1 on duty August 31, 2020, at HRA office, during the 7-3 p.m. shift."
a) give the names and titles of all relevant persons;
b) describe all relevant events, stating the facts that support Plaintiff's case including what each defendant did or failed to do;
c) give the dates and times of each relevant event or, if not known, the approximate date and time of each relevant event;
d) give the location where each relevant event occurred;
e) describe how each defendant's acts or omissions violated Plaintiff's rights and describe the injuries Plaintiff suffered; and
f) state what relief Plaintiff seeks from the Court, such as money damages, injunctive relief, or declaratory relief.
Essentially, the body of Plaintiff's amended complaint must tell the Court: who violated his federally protected rights; what facts show that his federally protected rights were violated; when such violation occurred; where such violation occurred; and why Plaintiff is entitled to relief. Because Plaintiff's amended complaint will completely replace, not supplement, the original complaint, any facts or claims that Plaintiff wishes to maintain must be included in the amended complaint.
Finally, the Court directs Plaintiff to limit his amended complaint to 20 pages, including any attachments. Plaintiff is advised that he need only allege enough facts to suggest that each defendant has violated his rights; at this stage, he is not required to recite each and every interaction.
CONCLUSION
The Clerk of Court is directed to mail a copy of this order to Plaintiff and note service on the docket. Plaintiff is granted leave to file an amended complaint that complies with the standards set forth above. Plaintiff must submit the amended complaint to this Court's Pro Se Intake Unit within sixty days of the date of this order, caption the document as an "Amended Complaint," and label the document with docket number 20-CV-10939 (LLS). An Amended Complaint form is attached to this order. No summons will issue at this time. If Plaintiff fails to comply within the time allowed, and he cannot show good cause to excuse such failure, the complaint will be dismissed for failure to state a claim upon which relief may be granted.
The Court dismisses all claims brought against Defendant Marshall under the doctrine of judicial immunity, and as frivolous. See 28 U.S.C. § 1915(e)(2)(B)(i), (iii).
The Court denied Plaintiff request for preliminary injunctive relief (ECF 8) and his motions for the appointment of pro bono counsel (ECF 5, 10). SO ORDERED. Dated: February 10, 2021
New York, New York
/s/_________
Louis L. Stanton
U.S.D.J. __________ Write the full name of each plaintiff. -against- __________ Write the full name of each defendant. If you need more space, please write "see attached" in the space above and attach an additional sheet of paper with the full list of names. The names listed above must be identical to those contained in Section II. ___CV__________
(Include case number if one has been assigned)
AMENDED COMPLAINT
Do you want a jury trial?
[ ] Yes [ ] No
NOTICE
The public can access electronic court files. For privacy and security reasons, papers filed with the court should therefore not contain: an individual's full social security number or full birth date; the full name of a person known to be a minor; or a complete financial account number. A filing may include only: the last four digits of a social security number; the year of an individual's birth; a minor's initials; and the last four digits of a financial account number. See Federal Rule of Civil Procedure 5.2.
I. BASIS FOR JURISDICTION
Federal courts are courts of limited jurisdiction (limited power). Generally, only two types of cases can be heard in federal court: cases involving a federal question and cases involving diversity of citizenship of the parties. Under 28 U.S.C. § 1331, a case arising under the United States Constitution or federal laws or treaties is a federal question case. Under 28 U.S.C. § 1332, a case in which a citizen of one State sues a citizen of another State or nation, and the amount in controversy is more than $75,000, is a diversity case. In a diversity case, no defendant may be a citizen of the same State as any plaintiff. What is the basis for federal-court jurisdiction in your case?
[ ] Federal Question
[ ] Diversity of Citizenship
A. If you checked Federal Question
Which of your federal constitutional or federal statutory rights have been violated? __________
B. If you checked Diversity of Citizenship
1. Citizenship of the parties Of what State is each party a citizen? The plaintiff , __________ (Plaintiff's name), is a citizen of the State of __________ (State in which the person resides and intends to remain.) or, if not lawfully admitted for permanent residence in the United States, a citizen or subject of the foreign state of __________. If more than one plaintiff is named in the complaint, attach additional pages providing information for each additional plaintiff. If the defendant is an individual: The defendant, __________ (Defendant's name), is a citizen of the State of __________ or, if not lawfully admitted for permanent residence in the United States, a citizen or subject of the foreign state of __________. If the defendant is a corporation: The defendant, __________, is incorporated under the laws of the State of __________ and has its principal place of business in the State of __________ or is incorporated under the laws of (foreign state) __________ and has its principal place of business in __________. If more than one defendant is named in the complaint, attach additional pages providing information for each additional defendant.
II. PARTIES
A. Plaintiff Information
Provide the following information for each plaintiff named in the complaint. Attach additional pages if needed. __________
First Name __________
Middle Initial __________
Last Name __________
Street Address __________
County, City __________
State __________
Zip Code __________
Telephone Number
__________
Email Address (if available)
B. Defendant Information
To the best of your ability, provide addresses where each defendant may be served. If the correct information is not provided, it could delay or prevent service of the complaint on the defendant. Make sure that the defendants listed below are the same as those listed in the caption. Attach additional pages if needed. Defendant 1:
__________
First Name
__________
Last Name
__________
Current Job Title (or other identifying information)
__________
Current Work Address (or other address where defendant may be served)
__________
County, City
__________
State
__________
Zip Code Defendant 2:
__________
First Name
__________
Last Name
__________
Current Job Title (or other identifying information)
__________
Current Work Address (or other address where defendant may be served)
__________
County, City
__________
State
__________
Zip Code Defendant 3:
__________
First Name
__________
Last Name
__________
Current Job Title (or other identifying information)
__________
Current Work Address (or other address where defendant may be served)
__________
County, City
__________
State
__________
Zip Code Defendant 4:
__________
First Name
__________
Last Name
__________
Current Job Title (or other identifying information)
__________
Current Work Address (or other address where defendant may be served)
__________
County, City
__________
State
__________
Zip Code
III. STATEMENT OF CLAIM
Place(s) of occurrence: __________ Date(s) of occurrence: __________
FACTS:
State here briefly the FACTS that support your case. Describe what happened, how you were harmed, and what each defendant personally did or failed to do that harmed you. Attach additional pages if needed. __________
INJURIES:
If you were injured as a result of these actions, describe your injuries and what medical treatment, if any, you required and received. __________
IV. RELIEF
State briefly what money damages or other relief you want the court to order. __________
V. PLAINTIFF'S CERTIFICATION AND WARNINGS
By signing below, I certify to the best of my knowledge, information, and belief that: (1) the complaint is not being presented for an improper purpose (such as to harass, cause unnecessary delay, or needlessly increase the cost of litigation); (2) the claims are supported by existing law or by a nonfrivolous argument to change existing law; (3) the factual contentions have evidentiary support or, if specifically so identified, will likely have evidentiary support after a reasonable opportunity for further investigation or discovery; and (4) the complaint otherwise complies with the requirements of Federal Rule of Civil Procedure 11. I agree to notify the Clerk's Office in writing of any changes to my mailing address. I understand that my failure to keep a current address on file with the Clerk's Office may result in the dismissal of my case. Each Plaintiff must sign and date the complaint. Attach additional pages if necessary. If seeking to proceed without prepayment of fees, each plaintiff must also submit an IFP application. __________
Dated
__________
Plaintiff's Signature __________
First Name __________
Middle Initial __________
Last Name __________
Street Address __________
County, City __________
State __________
Zip Code __________
Telephone Number
__________
Email Address (if available) I have read the Pro Se (Nonprisoner) Consent to Receive Documents Electronically:
[ ] Yes [ ] No If you do consent to receive documents electronically, submit the completed form with your complaint. If you do not consent, please do not attach the form.