Datasets:
File size: 43,007 Bytes
f039255 | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 536 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570 571 572 573 574 575 576 577 578 579 580 581 582 583 584 585 586 587 588 589 590 591 592 593 594 595 596 597 598 599 600 601 602 603 604 605 606 607 608 609 610 611 612 613 614 615 616 617 618 619 620 621 622 623 624 625 626 627 628 629 630 631 632 633 634 635 636 637 638 639 640 641 642 643 644 645 646 647 648 649 650 651 652 653 654 655 656 657 658 659 660 661 662 663 664 665 666 667 668 669 670 671 672 673 674 675 676 677 678 679 680 681 682 683 684 685 686 687 688 689 690 691 692 693 694 695 696 697 698 699 700 701 702 703 704 705 706 707 708 709 710 711 712 713 714 715 716 717 718 719 720 721 722 723 724 725 726 727 728 729 730 731 732 733 734 735 736 737 738 739 740 741 742 743 744 745 746 747 748 749 750 751 752 753 754 755 756 757 758 759 760 761 762 763 764 765 766 767 768 769 770 771 772 773 774 775 776 777 778 779 780 781 782 783 784 785 786 787 788 789 790 791 792 793 794 795 796 797 798 799 800 801 802 803 804 805 806 807 808 809 810 811 812 813 814 815 816 817 818 819 820 821 822 823 824 825 826 827 828 829 830 831 832 833 834 835 836 837 838 839 840 841 842 843 844 845 846 847 848 849 850 851 852 853 854 855 856 857 858 859 860 861 862 863 864 865 866 867 868 869 870 871 872 873 874 875 876 877 878 879 880 881 882 883 884 885 886 887 888 889 890 891 892 893 894 895 896 897 898 899 900 901 902 903 904 905 906 907 908 909 910 911 912 913 914 915 916 917 918 919 920 921 922 923 924 925 926 927 928 929 930 931 932 933 934 935 936 937 938 939 940 941 942 943 944 945 946 947 948 949 950 951 952 953 954 955 956 957 958 959 960 961 962 963 964 965 966 967 968 969 970 971 972 973 974 975 976 977 978 979 980 981 982 983 984 985 986 987 988 989 990 991 992 993 994 995 996 997 998 999 1000 1001 1002 1003 1004 1005 1006 1007 1008 1009 1010 1011 1012 1013 1014 1015 1016 1017 1018 1019 1020 1021 1022 1023 1024 1025 1026 1027 1028 1029 1030 1031 1032 1033 1034 1035 1036 1037 1038 1039 1040 1041 1042 1043 1044 1045 1046 1047 1048 1049 1050 1051 1052 1053 1054 1055 1056 1057 1058 1059 1060 1061 1062 1063 1064 1065 1066 1067 1068 1069 1070 1071 1072 1073 1074 1075 1076 1077 1078 1079 1080 1081 1082 1083 1084 1085 1086 1087 1088 1089 1090 1091 1092 1093 1094 1095 1096 1097 1098 1099 1100 1101 1102 1103 1104 1105 1106 1107 1108 1109 1110 1111 1112 1113 1114 1115 1116 1117 1118 1119 1120 1121 1122 1123 1124 1125 1126 1127 1128 1129 1130 1131 1132 1133 1134 1135 1136 1137 1138 1139 1140 1141 1142 1143 1144 1145 1146 1147 1148 1149 1150 1151 1152 1153 1154 1155 1156 1157 1158 1159 1160 1161 1162 1163 1164 1165 1166 1167 1168 1169 1170 1171 1172 1173 1174 1175 1176 1177 1178 1179 1180 1181 1182 1183 1184 1185 1186 1187 1188 1189 1190 1191 1192 1193 1194 1195 1196 1197 1198 1199 1200 1201 1202 1203 1204 1205 1206 1207 1208 1209 1210 1211 1212 1213 1214 1215 1216 1217 1218 1219 1220 1221 1222 1223 1224 1225 1226 1227 1228 1229 1230 1231 1232 1233 1234 1235 1236 1237 1238 1239 1240 1241 1242 1243 1244 1245 1246 1247 1248 1249 1250 1251 1252 1253 1254 1255 1256 1257 1258 1259 1260 1261 1262 1263 1264 1265 1266 1267 1268 1269 1270 1271 1272 1273 1274 1275 1276 1277 1278 1279 1280 1281 1282 1283 1284 1285 1286 1287 1288 1289 1290 1291 1292 1293 1294 1295 1296 1297 1298 1299 1300 1301 1302 1303 1304 1305 1306 1307 1308 1309 1310 1311 1312 1313 1314 1315 1316 1317 1318 1319 1320 1321 1322 1323 1324 1325 1326 1327 1328 1329 1330 1331 1332 1333 1334 1335 1336 1337 1338 1339 1340 1341 1342 1343 1344 1345 1346 1347 1348 1349 1350 1351 1352 1353 1354 1355 1356 1357 1358 1359 1360 1361 1362 1363 1364 1365 1366 1367 1368 1369 1370 1371 1372 1373 1374 1375 1376 1377 1378 1379 1380 1381 1382 1383 1384 1385 1386 1387 1388 1389 1390 1391 1392 1393 1394 1395 1396 1397 1398 1399 1400 1401 1402 1403 1404 1405 1406 1407 1408 1409 1410 1411 1412 1413 1414 1415 1416 1417 1418 1419 1420 1421 1422 1423 1424 1425 1426 1427 1428 1429 1430 1431 1432 1433 1434 1435 1436 1437 1438 1439 1440 1441 1442 1443 1444 1445 1446 1447 1448 1449 1450 1451 1452 1453 1454 1455 1456 1457 1458 1459 1460 1461 1462 1463 1464 1465 1466 1467 1468 1469 1470 1471 1472 1473 1474 1475 1476 1477 1478 1479 1480 1481 1482 1483 1484 1485 1486 1487 1488 1489 1490 1491 1492 1493 1494 1495 1496 1497 1498 1499 1500 1501 1502 1503 1504 1505 1506 1507 1508 1509 1510 1511 1512 1513 1514 1515 1516 1517 1518 1519 1520 1521 1522 1523 1524 1525 1526 1527 1528 1529 1530 1531 1532 1533 1534 1535 1536 1537 1538 1539 1540 1541 1542 1543 1544 1545 1546 1547 1548 1549 1550 1551 1552 1553 1554 1555 1556 1557 1558 1559 1560 1561 1562 1563 1564 1565 1566 1567 1568 1569 1570 1571 1572 1573 1574 1575 1576 1577 1578 1579 1580 1581 1582 1583 1584 1585 1586 1587 1588 1589 1590 1591 1592 1593 1594 1595 1596 1597 1598 1599 1600 1601 1602 1603 1604 1605 1606 1607 1608 1609 1610 1611 1612 1613 1614 1615 1616 1617 1618 1619 1620 1621 1622 1623 1624 1625 1626 1627 1628 1629 1630 1631 1632 1633 1634 1635 1636 1637 1638 1639 1640 1641 1642 1643 1644 1645 1646 1647 1648 1649 1650 1651 1652 1653 1654 1655 1656 1657 1658 1659 1660 1661 1662 1663 1664 1665 1666 1667 1668 1669 1670 1671 1672 1673 1674 1675 1676 1677 1678 1679 1680 1681 1682 1683 1684 1685 1686 1687 1688 1689 1690 1691 1692 1693 1694 1695 1696 1697 1698 1699 1700 1701 1702 1703 1704 1705 1706 1707 1708 1709 1710 1711 1712 1713 1714 1715 1716 1717 1718 1719 1720 1721 1722 1723 1724 1725 1726 1727 1728 1729 1730 1731 1732 1733 1734 1735 1736 1737 | 1.
2.
3.
4.
5.
6.
7.
About These Forms
In General. This and the other pleading forms available from the www.uscourts.gov
website illustrate some types of information that are useful to have in complaints and
some other pleadings. The forms do not try to cover every type of case. They are limited
to types of cases often filed in federal courts by those who represent themselves or who
may not have much experience in federal courts.
Not Legal Advice. No form provides legal advice. No form substitutes for having or
consulting a lawyer. If you are not a lawyer and are suing or have been sued, it is best to
have or consult a lawyer if possible.
No Guarantee. Following a form does not guarantee that any pleading is legally or
factually correct or sufficient.
Variations Possible. A form may call for more or less information than a particular
court requires. The fact that a form asks for certain information does not mean that every
court or a particular court requires it. And if the form does not ask for certain
information, a particular court might still require it. Consult the rules and caselaw that
govern in the court where you are filing the pleading.
Examples Only. The forms do not try to address or cover all the different types of
claims or defenses, or how specific facts might affect a particular claim or defense. Some
of the forms, such as the form for a generic complaint, apply to different types of cases.
Others apply only to specific types of cases. Be careful to use the form that fits your case
and the type of pleading you want to file. Be careful to change the information the form
asks for to fit the facts and circumstances of your case.
No Guidance on Timing or Parties. The forms do not give any guidance on when
certain kinds of pleadings or claims or defenses have to be raised, or who has to be sued.
Some pleadings, claims, or defenses have to be raised at a certain point in the case or
within a certain period of time. And there are limits on who can be named as a party in a
case and when they have to be added. Lawyers and people representing themselves must
know the Federal Rules of Civil Procedure and the caselaw setting out these and other
requirements. The current Federal Rules of Civil Procedure are available, for free, at
www.uscourts.gov.
Privacy Requirements. Federal Rule of Civil Procedure 5.2 addresses the privacy and
security concerns over public access to electronic court files. Under this rule, papers filed
with the court should not contain anyone’s full social-security number or full birth date;
the 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 and taxpayer
identification number; the year of someone’s birth; a minor’s initials; and the last four
digits of a financial-account number.
MIED ProSe 1 (Rev 5/16) Complaint for a Civil Case
IN THE UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF MICHIGAN
Case No.
________________________________
(to be filled in by the Clerk’s Office)
(Write the full name of each plaintiff who is filing this complaint.
If the names of all the plaintiffs cannot fit in the space above,
please write “see attached” in the space and attach an additional
page with the full list of names.)
Jury Trial: ☐ Yes ☐ No
(check one)
v.
(Write the full name of each defendant who is being sued. If the
names of all the defendants cannot fit in the space above, please
write “see attached” in the space and attach an additional page
with the full list of names.)
Complaint for a Civil Case
MIED ProSe 1 (Rev 5/16) Complaint for a Civil Case
I.
The Parties to This Complaint
A.
The Plaintiff(s)
Provide the information below for each plaintiff named in the complaint. Attach
additional pages if needed.
Name
__________________________________________
Street Address
__________________________________________
City and County
__________________________________________
State and Zip Code
__________________________________________
Telephone Number
__________________________________________
E-mail Address
__________________________________________
B.
The Defendant(s)
Provide the information below for each defendant named in the complaint, whether the
defendant is an individual, a government agency, an organization, or a corporation.
For an individual defendant, include the person’s job or title (if known). Attach
additional pages if needed.
Defendant No. 1
Name
Job or Title
(if known)
__________________________________________
__________________________________________
Street Address
__________________________________________
City and County
__________________________________________
State and Zip Code
__________________________________________
Telephone Number
__________________________________________
E-mail Address
(if known)
Defendant No. 2
Name
Job or Title
(if known)
__________________________________________
__________________________________________
__________________________________________
Street Address
__________________________________________
City and County
__________________________________________
State and Zip Code
__________________________________________
Telephone Number
__________________________________________
E-mail Address
(if known)
__________________________________________
2
MIED ProSe 1 (Rev 5/16) Complaint for a Civil Case
Defendant No. 3
Name
Job or Title
(if known)
__________________________________________
__________________________________________
Street Address
__________________________________________
City and County
__________________________________________
State and Zip Code
__________________________________________
Telephone Number
__________________________________________
E-mail Address
(if known)
__________________________________________
Defendant No. 4
Name
Job or Title
(if known)
__________________________________________
__________________________________________
Street Address
__________________________________________
City and County
__________________________________________
State and Zip Code
__________________________________________
Telephone Number
__________________________________________
E-mail Address
(if known)
__________________________________________
II.
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 at stake is more than $75,000 is a diversity of citizenship case. In a diversity of
citizenship case, no defendant may be a citizen of the same State as any plaintiff.
What is the basis for federal court jurisdiction? (check all that apply)
☐ Federal question
☐ Diversity of citizenship
Fill out the paragraphs in this section that apply to this case.
3
MIED ProSe 1 (Rev 5/16) Complaint for a Civil Case
A.
If the Basis for Jurisdiction Is a Federal Question
List the specific federal statutes, federal treaties, and/or provisions of the United States
Constitution that are at issue in this case.
B.
If the Basis for Jurisdiction Is Diversity of Citizenship
1.
The Plaintiff(s)
a.
b.
If the plaintiff is an individual
The plaintiff, (name) _________________________________________,
is a citizen of the State of (name) _______________________.
If the plaintiff is a corporation
The plaintiff, (name) ________________________________________,
is incorporated under the laws of the State of (name)
______________________, and has its principal place of business in the
State of (name) _______________________.
(If more than one plaintiff is named in the complaint, attach an additional page
providing the same information for each additional plaintiff.)
2.
The Defendant(s)
a.
b.
If the defendant is an individual
The defendant, (name) ______________________, is a citizen of the
State of (name) _______________________. Or is a citizen of (foreign
nation) _______________________.
If the defendant is a corporation
The defendant, (name) _______________________, is incorporated
under the laws of the State of (name) _______________________, and
has its principal place of business in the State of (name)
_______________________. Or is incorporated under the laws of
(foreign nation) _______________________, and has its principal place
of business in (name) _______________________.
(If more than one defendant is named in the complaint, attach an additional
page providing the same information for each additional defendant.)
4
MIED ProSe 1 (Rev 5/16) Complaint for a Civil Case
3.
The Amount in Controversy
The amount in controversy—the amount the plaintiff claims the defendant owes
or the amount at stake—is more than $75,000, not counting interest and costs of
court, because (explain):
III.
Statement of Claim
Write a short and plain statement of the claim. Do not make legal arguments. State as briefly
as possible the facts showing that each plaintiff is entitled to the damages or other relief sought.
State how each defendant was involved and what each defendant did that caused the plaintiff
harm or violated the plaintiff’s rights, including the dates and places of that involvement or
conduct. If more than one claim is asserted, number each claim and write a short and plain
statement of each claim in a separate paragraph. Attach additional pages if needed.
5
MIED ProSe 1 (Rev 5/16) Complaint for a Civil Case
IV. Relief
State briefly and precisely what damages or other relief the plaintiff asks the court to order. Do
not make legal arguments. Include any basis for claiming that the wrongs alleged are
continuing at the present time. Include the amounts of any actual damages claimed for the acts
alleged and the basis for these amounts. Include any punitive or exemplary damages claimed,
the amounts, and the reasons you claim you are entitled to actual or punitive money damages.
V.
Certification and Closing
Under Federal Rule of Civil Procedure 11, by signing below, I certify to the best of my
knowledge, information, and belief that this complaint: (1) is not being presented for an
improper purpose, such as to harass, cause unnecessary delay, or needlessly increase the cost of
litigation; (2) is supported by existing law or by a nonfrivolous argument for extending,
modifying, or reversing 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 Rule 11.
A.
For Parties Without an Attorney
I agree to provide the Clerk’s Office with any changes to my address where case-
related papers may be served. 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.
Date of signing: _____________________, 20_____.
Signature of Plaintiff
___________________________________________
Printed Name of Plaintiff ___________________________________________
6
MIED ProSe 1 (Rev 5/16) Complaint for a Civil Case
Additional Information:
7
JS 44 (Rev. 10/20)
CIVIL COVER SHEET
The JS 44 civil cover sheet and the information contained herein neither replace nor supplement the filing and service of pleadings or other papers as required by law, except as
provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is required for the use of the Clerk of Court for the
purpose of initiating the civil docket sheet. (SEE INSTRUCTIONS ON NEXT PAGE OF THIS FORM.)
I. (a) PLAINTIFFS
County in which action arose: _______________
DEFENDANTS
(b) County of Residence of First Listed Plaintiff
(EXCEPT IN U.S. PLAINTIFF CASES)
County of Residence of First Listed Defendant
NOTE:
(IN U.S. PLAINTIFF CASES ONLY)
IN LAND CONDEMNATION CASES, USE THE LOCATION OF
THE TRACT OF LAND INVOLVED.
(c) Attorneys (Firm Name, Address, and Telephone Number)
Attorneys (If Known)
II. BASIS OF JURISDICTION (Place an “X” in One Box Only)
III. CITIZENSHIP OF PRINCIPAL PARTIES (Place an “X” in One Box for Plaintiff
1 U.S. Government
Plaintiff
3 Federal Question
(U.S. Government Not a Party)
Citizen of This State
PTF
1
DEF
1
(For Diversity Cases Only)
and One Box for Defendant)
PTF
Incorporated or Principal Place
of Business In This State
2 U.S. Government
Defendant
4 Diversity
Citizen of Another State
(Indicate Citizenship of Parties in Item III)
DEF
4
5
6
4
5
6
2
3
2
Incorporated and Principal Place
of Business In Another State
3
Foreign Nation
Click here for: Nature of Suit Code Descriptions.
OTHER STATUTES
BANKRUPTCY
IV. NATURE OF SUIT (Place an “X” in One Box Only)
TORTS
CONTRACT
110 Insurance
120 Marine
130 Miller Act
140 Negotiable Instrument
150 Recovery of Overpayment
PERSONAL INJURY
310 Airplane
315 Airplane Product
Liability
320 Assault, Libel &
& Enforcement of Judgment
Slander
151 Medicare Act
152 Recovery of Defaulted
Student Loans
(Excludes Veterans)
153 Recovery of Overpayment
of Veteran’s Benefits
160 Stockholders’ Suits
190 Other Contract
195 Contract Product Liability
196 Franchise
REAL PROPERTY
210 Land Condemnation
220 Foreclosure
230 Rent Lease & Ejectment
240 Torts to Land
245 Tort Product Liability
290 All Other Real Property
330 Federal Employers’
Liability
340 Marine
345 Marine Product
Liability
350 Motor Vehicle
355 Motor Vehicle
Product Liability
360 Other Personal
Injury
362 Personal Injury -
Medical Malpractice
CIVIL RIGHTS
440 Other Civil Rights
441 Voting
442 Employment
443 Housing/
Accommodations
445 Amer. w/Disabilities -
Employment
446 Amer. w/Disabilities -
Other
448 Education
Citizen or Subject of a
Foreign Country
FORFEITURE/PENALTY
625 Drug Related Seizure
of Property 21 USC 881
690 Other
PERSONAL INJURY
365 Personal Injury -
Product Liability
367 Health Care/
Pharmaceutical
Personal Injury
Product Liability
368 Asbestos Personal
Injury Product
Liability
422 Appeal 28 USC 158
423 Withdrawal
28 USC 157
PROPERTY RIGHTS
820 Copyrights
830 Patent
835 Patent - Abbreviated
New Drug Application
840 Trademark
880 Defend Trade Secrets
PERSONAL PROPERTY
LABOR
710 Fair Labor Standards
Act of 2016
Act
720 Labor/Management
Relations
740 Railway Labor Act
751 Family and Medical
Leave Act
790 Other Labor Litigation
791 Employee Retirement
Income Security Act
IMMIGRATION
462 Naturalization Application
465 Other Immigration
Actions
SOCIAL SECURITY
861 HIA (1395ff)
862 Black Lung (923)
863 DIWC/DIWW (405(g))
864 SSID Title XVI
865 RSI (405(g))
FEDERAL TAX SUITS
870 Taxes (U.S. Plaintiff
or Defendant)
871 IRS—Third Party
26 USC 7609
370 Other Fraud
371 Truth in Lending
380 Other Personal
Property Damage
385 Property Damage
Product Liability
PRISONER PETITIONS
Habeas Corpus:
463 Alien Detainee
510 Motions to Vacate
Sentence
530 General
535 Death Penalty
Other:
540 Mandamus & Other
550 Civil Rights
555 Prison Condition
560 Civil Detainee -
Conditions of
Confinement
375 False Claims Act
376 Qui Tam (31 USC
3729(a))
400 State Reapportionment
410 Antitrust
430 Banks and Banking
450 Commerce
460 Deportation
470 Racketeer Influenced and
Corrupt Organizations
480 Consumer Credit
(15 USC 1681 or 1692)
485 Telephone Consumer
Protection Act
490 Cable/Sat TV
850 Securities/Commodities/
Exchange
890 Other Statutory Actions
891 Agricultural Acts
893 Environmental Matters
895 Freedom of Information
Act
896 Arbitration
899 Administrative Procedure
Act/Review or Appeal of
Agency Decision
950 Constitutionality of
State Statutes
V. ORIGIN (Place an “X” in One Box Only)
1 Original
Proceeding
2 Removed from
State Court
3 Remanded from
Appellate Court
4 Reinstated or
Reopened
5 Transferred from
Another District
(specify)
6 Multidistrict
Litigation -
Transfer
8 Multidistrict
Litigation -
Direct File
Cite the U.S. Civil Statute under which you are filing (Do not cite jurisdictional statutes unless diversity):
VI. CAUSE OF ACTION
Brief description of cause:
VII. REQUESTED IN
COMPLAINT:
VIII. RELATED CASE(S)
IF ANY
CHECK IF THIS IS A CLASS ACTION
UNDER RULE 23, F.R.Cv.P.
DEMAND $
CHECK YES only if demanded in complaint:
JURY DEMAND:
Yes
No
(See instructions):
JUDGE
DOCKET NUMBER
DATE
SIGNATURE OF ATTORNEY OF RECORD
FOR OFFICE USE ONLY
RECEIPT #
AMOUNT
APPLYING IFP
JUDGE
MAG. JUDGE
PURSUANT TO LOCAL RULE 83.11
1.
Is this a case that has been previously dismissed?
If yes, give the following information:
Court:
Case No.:
Judge:
2.
Other than stated above, are there any pending or previously
discontinued or dismissed companion cases in this or any other
court, including state court? (Companion cases are matters in which
it appears substantially similar evidence will be offered or the same
or related parties are present and the cases arise out of the same
transaction or occurrence.)
Yes
No
Yes
No
If yes, give the following information:
Court:
Case No.:
Judge:
Notes :
JS 44 Reverse (Rev. 10/20)
INSTRUCTIONS FOR ATTORNEYS COMPLETING CIVIL COVER SHEET FORM JS 44
Authority For Civil Cover Sheet
The JS 44 civil cover sheet and the information contained herein neither replaces nor supplements the filings and service of pleading or other papers as
required by law, except as provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is
required for the use of the Clerk of Court for the purpose of initiating the civil docket sheet. Consequently, a civil cover sheet is submitted to the Clerk of
Court for each civil complaint filed. The attorney filing a case should complete the form as follows:
I.(a) Plaintiffs-Defendants. Enter names (last, first, middle initial) of plaintiff and defendant. If the plaintiff or defendant is a government agency, use
only the full name or standard abbreviations. If the plaintiff or defendant is an official within a government agency, identify first the agency and then
the official, giving both name and title.
(b) County of Residence. For each civil case filed, except U.S. plaintiff cases, enter the name of the county where the first listed plaintiff resides at the
time of filing. In U.S. plaintiff cases, enter the name of the county in which the first listed defendant resides at the time of filing. (NOTE: In land
condemnation cases, the county of residence of the "defendant" is the location of the tract of land involved.)
(c) Attorneys. Enter the firm name, address, telephone number, and attorney of record. If there are several attorneys, list them on an attachment, noting
in this section "(see attachment)".
II.
III.
IV.
V.
Jurisdiction. The basis of jurisdiction is set forth under Rule 8(a), F.R.Cv.P., which requires that jurisdictions be shown in pleadings. Place an "X"
in one of the boxes. If there is more than one basis of jurisdiction, precedence is given in the order shown below.
United States plaintiff. (1) Jurisdiction based on 28 U.S.C. 1345 and 1348. Suits by agencies and officers of the United States are included here.
United States defendant. (2) When the plaintiff is suing the United States, its officers or agencies, place an "X" in this box.
Federal question. (3) This refers to suits under 28 U.S.C. 1331, where jurisdiction arises under the Constitution of the United States, an amendment
to the Constitution, an act of Congress or a treaty of the United States. In cases where the U.S. is a party, the U.S. plaintiff or defendant code takes
precedence, and box 1 or 2 should be marked.
Diversity of citizenship. (4) This refers to suits under 28 U.S.C. 1332, where parties are citizens of different states. When Box 4 is checked, the
citizenship of the different parties must be checked. (See Section III below; NOTE: federal question actions take precedence over diversity
cases.)
Residence (citizenship) of Principal Parties. This section of the JS 44 is to be completed if diversity of citizenship was indicated above. Mark this
section for each principal party.
Nature of Suit. Place an "X" in the appropriate box. If there are multiple nature of suit codes associated with the case, pick the nature of suit code
that is most applicable. Click here for: Nature of Suit Code Descriptions.
Origin. Place an "X" in one of the seven boxes.
Original Proceedings. (1) Cases which originate in the United States district courts.
Removed from State Court. (2) Proceedings initiated in state courts may be removed to the district courts under Title 28 U.S.C., Section 1441.
Remanded from Appellate Court. (3) Check this box for cases remanded to the district court for further action. Use the date of remand as the filing
date.
Reinstated or Reopened. (4) Check this box for cases reinstated or reopened in the district court. Use the reopening date as the filing date.
Transferred from Another District. (5) For cases transferred under Title 28 U.S.C. Section 1404(a). Do not use this for within district transfers or
multidistrict litigation transfers.
Multidistrict Litigation – Transfer. (6) Check this box when a multidistrict case is transferred into the district under authority of Title 28 U.S.C.
Section 1407.
Multidistrict Litigation – Direct File. (8) Check this box when a multidistrict case is filed in the same district as the Master MDL docket.
PLEASE NOTE THAT THERE IS NOT AN ORIGIN CODE 7. Origin Code 7 was used for historical records and is no longer relevant due to
changes in statue.
VI.
Cause of Action. Report the civil statute directly related to the cause of action and give a brief description of the cause. Do not cite jurisdictional
statutes unless diversity. Example: U.S. Civil Statute: 47 USC 553 Brief Description: Unauthorized reception of cable service.
VII. Requested in Complaint. Class Action. Place an "X" in this box if you are filing a class action under Rule 23, F.R.Cv.P.
Demand. In this space enter the actual dollar amount being demanded or indicate other demand, such as a preliminary injunction.
Jury Demand. Check the appropriate box to indicate whether or not a jury is being demanded.
VIII. Related Cases. This section of the JS 44 is used to reference related pending cases, if any. If there are related pending cases, insert the docket
numbers and the corresponding judge names for such cases.
Date and Attorney Signature. Date and sign the civil cover sheet.
Civil Nature of Suit Code Descriptions
(Rev. 10/20)
Contract
Code
110
Title
Insurance
120
Marine
130
Miller Act
140
Negotiable Instrument
150
Recovery of Overpayment & Enforcement
Judgment
151
Medicare
152
153
160
Recovery of Defaulted Student Loans
(Excludes Veterans)
Recovery of Overpayment of Veterans'
Benefits
Stockholders' Suits
190
Other Contract
195
Contract Product Liability
Actions primarily alleging personal injury
or property damage caused by a defective
product should be classified under the
appropriate nature of suit code under
“TORTS.”
Franchise
196
Description
Action alleging breach of insurance contract, tort claim, or other cause
related to an insurance contract, except for maritime insurance
contracts.
Action (Admiralty or Maritime) based on service, employment,
insurance or other contracts relating to maritime vessels and other
maritime contractual matters.
Action based on performance and payment bonds agreed to by
contractors on federal construction projects as required under the
Miller Act, 40 U.S.C. § 3131-3134.
Action relating to an agreement to pay a specific amount of money,
including promissory notes, loan agreements and checks.
Action to recover debt owed to the United States, including
enforcement of judgments, based on overpayments and restitution
agreements involving matters other than Medicare benefits, student
loans and veterans’ benefits.
Action relating to Medicare payments, including actions for payments of
benefits, to recover overpayments, and for judicial review of
administrative decisions.
Action to recover debt owed to the United States from defaulted
student loan.
Action relating to payments of veterans’ benefits, primarily including
actions to recover overpayments.
Action brought by stockholder(s) of a corporation (including both
stockholder derivative suits and direct actions based on plaintiff’s rights
as a stockholder), usually alleging claims based on contract and/or tort
law and/or fiduciary obligations.
Action primarily based on rights and obligations under a contract not
classifiable elsewhere under the specific natures of suit under
“Contract.”
Action concerning damages caused by a defective product, not primarily
involving personal injury or property damage, and based primarily on
breach of contract, breach of warranty, misrepresentation, and/or
violation of consumer protection laws.
Action arising from a dispute over a franchise agreement, typically
alleging breach of contract, misrepresentation or unfair trade practices.
Page 1 of 8
Civil Nature of Suit Code Descriptions
(Rev. 10/20)
Real Property
Code
210
Title
Land Condemnation
220
230
240
Foreclosure
Rent Lease & Ejectment
Torts to Land
245
Tort Product Liability
290
All Other Real Property
Torts/Personal Injury
Title
Airplane
(Excludes airplane product liability
claims)
Airplane Product Liability
Description
Action by a governmental entity to take privately-owned real property
(land or buildings) for public use for compensation.
Action to enjoin foreclosure on real property by mortgage lender.
Action for rental or lease payments owed on real property and/or to
eject a party occupying real property illegally.
Action alleging trespass to land, nuisance, contamination or other
unlawful entry on or interference with real property possessed by
another.
Action alleging harm by an unsafe product based on negligence, breach
of warranty, misrepresentation, and strict tort liability.
Action primarily based on unlawful conduct relating to real property
that cannot be classified under any other nature of suit.
Description
Action alleging personal injury or wrongful death from an air crash or
other occurrence involving an airplane.
Code
310
315
320
330
340
345
350
355
360
362
365
367
368
Motor Vehicle
Marine Product Liability
Marine
(Excludes marine product liability claims)
Assault, Libel & Slander
(Excludes a government employee)
Federal Employers' Liability
Action alleging personal injury or death from an air crash or other
occurrence involving an airplane and caused by a defective product.
Action alleging intentional acts of assault, libel, trade libel or slander by
a private party.
Action for personal injury or wrongful death brought by a railroad
employee or his survivors under the Federal Employers’ Liability Act
(FELA), 45 U.S.C. § 51, et. seq.
Action (Admiralty and Maritime) alleging personal injury or death from
an accident involving a water vessel or harbor/dock facilities, including
suits brought under the Jones Act and the Limitation of Liability Act.
Action (Admiralty and Maritime) alleging personal injury or wrongful
death from an accident involving a water vessel or harbor/dock
facilities and caused by a defective product.
Action alleging personal injury or wrongful death from negligence
involving a motor vehicle but not caused by a defective product.
Action alleging personal injury or wrongful death involving a motor
vehicle and caused by a defective product.
Action primarily based on personal injury or death caused by
negligence or intentional misconduct, including suits brought against
the United States under the Federal Tort Claims Act, and which cannot
be classified under any other nature of suit.
Action alleging personal injury or wrongful death caused by negligence
in medical care provided by a doctor or other health care professional.
Action alleging personal injury or death resulting from a defective
Personal Injury - Product Liability
product.
(Excludes a marine or airplane product)
Action alleging personal injury or death caused by a defective medical
Health Care/Pharmaceutical Personal
or pharmaceutical product.
Injury Product Liability
Asbestos Personal Injury Product Liability Action alleging personal injury or death caused by exposure to asbestos
Personal Injury - Medical Malpractice
Motor Vehicle Product Liability
Other Personal Injury
products.
Page 2 of 8
Civil Nature of Suit Code Descriptions
(Rev. 10/20)
Personal Property
Code
370
371
Title
Other Fraud
(Excludes any property that is not real
property)
Truth in Lending
Actions relating to fraud or
misrepresentation in the transfer of real
property should be classified under
nature of suit 290, “All Other Real
Property,” or, if foreclosure is involved,
under nature of suit 220, “Foreclosure.”
Other Personal Property Damage
380
385
Property Damage Product Liability
Civil Rights
Code
440
441
442
443
445
446
Title
Other Civil Rights
(Excludes claims against corrections
officials)
Voting
Employment
Housing/Accommodations
Americans With Disabilities -
Employment
Americans With Disabilities - Other
448
Education
Description
Action primarily based on fraud relating to personal property that
cannot be classified under any other nature of suit.
Action alleging violation of the federal Truth in Lending Act arising from
consumer loan transactions involving personal property including
automobile loans and revolving credit accounts.
Action primarily based on damage to personal property caused by
harmful conduct such as negligence, misrepresentation, interference
with business relationships or unfair trade practices.
Action alleging damage to personal property caused by a defective
product.
Description
Action alleging a civil rights violation other than the specific civil rights
categories listed below or a violation related to prison. Example:
Action alleging excessive force by police incident to an arrest.
Action filed under Civil Rights Act, 52 U.S.C. § 10101, and Voting Rights
Act, 52 U.S.C. § 10301
Action filed under Age Discrimination in Employment Act 29:621:634,
Equal Employment Opportunity Act (Title VII) 42:2000E, Performance
Rating Act of 1950 5:4303
Action filed under the Fair Housing Act (Title VII), 42 U.S.C. § 3601 &
3602.
Action of discrimination against an employee with disabilities of any
type in the work place, filed under 42 U.S.C. § 12117
Action of discrimination against an individual with disabilities in areas
other than employment, filed under 42 U.S.C. § 12133 (exclusion or
discrimination in provision of services, programs or activities of a public
entity) or 42 U.S.C. § 12188 (public accommodations)
Action filed under the Individuals with Disabilities Educations Act, 20
U.S.C. § 1401 and Title IX of the Education Amendment of 1972, 20
U.S.C. § 1681 et seq.
Page 3 of 8
Civil Nature of Suit Code Descriptions
(Rev. 10/20)
Prisoner Petitions
Habeas Corpus
Title
Alien Detainee
Code
463
510
Motions to Vacate Sentence
530
General
535
Death Penalty
Other
Prisoner Petitions
Code
540
Title
Mandamus & Other
550
Civil Rights
555
Prison Condition
560
Civil Detainee - Conditions of
Confinement (Excludes actions by alien
detainees)
Description
Immigration habeas petition under 28 U.S.C. § 2241. All cases filed
with this nature of suit code are restricted to case participants and
public terminals. Petition is filed by an alien detainee.
Action by a prisoner to vacate or modify a sentence imposed in federal
court, other than a death sentence, under 28 U.S.C. § 2255.
Action by a federal or state prisoner currently in custody challenging
the legality of confinement or other punishment. This includes claims
alleging illegalities that occurred in trial (for example, ineffective
assistance of counsel), sentencing (including fines and restitution
orders), or disciplinary proceedings in prison (for example, loss of good
time credits). Habeas petition under 28 U.S.C. § 2254 or prisoner
habeas under 28 U.S.C. § 2241.
Action by a federal or state prisoner challenging a death sentence.
Description
Action by prisoner currently in custody for a writ of mandamus to
compel action by a judge or government official relating to the
prisoner’s confinement, including conditions of confinement. This
category also includes any actions other than mandamus brought by a
prisoner currently in custody, whether or not it relates to his
confinement, if it is not classifiable under any other nature of suit
category under Prisoner Petitions (for example, action by prisoner to
recover property taken by the government in a criminal case).
Action by current or former prisoner alleging a civil rights violation by
corrections officials that is not related to a condition of prison life.
Action by current prisoner, or former prisoner or their families alleging
a civil rights, Federal Tort Claims Act, or state law claim with respect to
a condition of prison life, whether general circumstances or particular
episodes. Examples: inadequate medical care or excessive force by
prison guards. Includes non-habeas actions by alien detainees alleging
unlawful prison conditions.
Action by former prisoner who was involuntarily committed to a non-
criminal facility after expiration of his or her prison term alleging
unlawful conditions of confinement while in the non-criminal facility.
This category includes, for example, an action by a former prisoner
classified as a Sexually Dangerous Person or Sexually Violent Predator
alleging civil rights violations during his detention in a medical facility.
Page 4 of 8
Civil Nature of Suit Code Descriptions
(Rev. 10/20)
Forfeiture/Penalty
Code
625
Title
Drug Related Seizure of Property 21
U.S.C. § 881
Description
Action (Forfeiture) by which property itself is accused of wrongdoing
and is forfeited to the government as a result.
690
Other
Labor
Code
710
Title
Fair Labor
Standards Act (Non-Union)
720
Labor/Management Relations (Union)
740
Railway Labor Act
Action primarily based on Acts or Bills that cannot be classified under
any other nature of suit, such as: Endangered Species Act, Federal
Hazardous Substance Act 15:1261, Game & Wildlife Act 15:256C et seq.
(Penalty), Federal Trade Commission Act 15:41-51 (Penalty), Federal
Coal Mine Health & Safety Act 30:801 et seq. (Penalty), Load Line Act
46:85-85G, McGuire Bill (Federal Fair Trade) 15:45L Penalty, Marihuana
Tax Act 50 STAT 551, Motorboat Act 46:526-526T, National Traffic &
Motor Vehicle Safety Act penalty 49:1655, Veterans' Benefit Act, Title
38 Penalty.
Description
Action relating to non-union workplace related disputes filed under the
Fair Labor Standards Act, 29 U.S.C. § 201 including but not limited to
wage discrimination, paid leave, minimum wage and overtime pay.
Action relating to disputes between labor unions and employers as well
as all petitions regarding actions of the Nation Labor Relations Board
(NLRB)
Action relating to disputes filed under the Railway Labor Act, 45 U.S.C.
§ 151 including labor disputes, individual claims, and response to
sanctions.
751
790
791
Family and Medical Leave Act
Action filed under the Family Medical Leave Act, 29 U.S.C. § 2601
Other Labor Litigation
Employee Retirement Income Security
Act
Action primarily based on labor disputes not addressed by other NOS
codes (includes Labor/Management Reporting and Disclosure Act)
Action filed under the Employee Retirement Income Security Act, 29
U.S.C. § 1132 by individuals and labor organizations.
Immigration
Code
462
Title
Naturalization Application
465
Other Immigration
Actions
Description
Action seeking review of denial of an application for naturalization [8
U.S.C. § 1447(b)] or alleging failure to make a determination regarding
an application for naturalization [8 U.S.C. § 1421(c)].
Action (Immigration-related) that do not involve Naturalization
Applications or petitions for Writ of Habeas Corpus, such as complaints
alleging failure to adjudicate an application to adjust immigration
status to permanent resident.
Page 5 of 8
Civil Nature of Suit Code Descriptions
(Rev. 10/20)
Bankruptcy
Code
422
Title
Appeal 28 USC § 158
423
Withdrawal of Reference 28 USC § 157
Property Rights
Title
Copyright
Code
820
Patent
Patent – Abbreviated New Drug
Application (ANDA)
Trademark
830
835
840
880
Description
All appeals of previous bankruptcy decisions filed under
28 U.S.C. § 158
Action held in bankruptcy court requesting withdrawal under the
provisions of 28 U.S.C. § 157
Description
Action filed in support or to dispute a copyright claim.
Action filed in support or to dispute a patent claim.
Action filed in support or to dispute a patent claim involving an
Abbreviated New Drug Application (ANDA). These cases are also known
as “Hatch-Waxman” cases.
Action filed in support or to dispute a trademark claim
Defend Trade Secrets Act of 2016 (DTSA)
Action filed in support or to dispute a trade secret misappropriation
Social Security
Title
HIA (1395ff)
Code
861
862
Black Lung (923)
863
DIWC/DIWW (405(g))
864
865
SSID Title XVI
RSI (405(g))
Federal Tax Suits
Code
870
871
Title
Taxes (U.S. Plaintiff or Defendant)
IRS-Third Party 26 USC 7609
Description
Action filed with regard to social security benefits associated with
Health Insurance Part A Medicare
Action filed with regard to social security benefits provided for those
who contracted Black Lung or their beneficiaries
Action filed with regard to social security benefits provided to disabled
individuals: worker or child, or widow
Action filed with regard to social security benefits provided to
Supplemental Security Income Disability under Title XVI
Action filed with regard to social security benefits provided for
Retirement, Survivor Insurance under 42 U.S.C. § 405
Description
Action filed under the Internal Revenue Code (General)
Action filed under the Internal Revenue Code - Tax Reform Act of 1976
(P.L. 94-455) Third Party
Page 6 of 8
Civil Nature of Suit Code Descriptions
(Rev. 10/20)
Other Statutes
Title
False Claims Act
Code
375
376
Qui Tam (31 U.S.C. § 3729(a))
400
State Reapportionment
410
Antitrust
430
450
460
470
480
485
Banks and Banking
Commerce
Deportation
Racketeer Influenced and Corrupt
Organizations
Consumer Credit
Telephone Consumer Protection Act
(TCPA)
490
Cable/Satellite TV
850
Securities/Commodities/Exchange
890
Other Statutory Actions
891
Agricultural Acts
893
Environmental Matters
Description
Action filed by private individuals alleging fraud against the U.S.
Government under 31 U.S.C. § 3729.
Action brought under the False Claims Act by private persons (also
known as "whistleblowers") on their own behalf and on behalf of the
United States to recover damages against another person or entity that
acted fraudulently in receiving payments or property from, or avoiding
debts owed to, the United States Government, 31 U.S.C. § 3730
Action filed under the Reapportionment Act of 1929 Ch. 28, 46 Stat. 21,
2 U.S.C. § 2a.
Action brought under the Clayton Act 15 U.S.C. § 12 - 27 alleging
undue restriction of trade and commerce by designated methods that
limit free competition in the market place amongst consumers such as
anti-competitive price discrimination, corporate mergers, interlocking
directorates or tying and exclusive dealing contracts.
Action filed under the Federal Home Loan Bank Act 12:1421-1449,
Home Owners Loan Act 12:1461 or Federal Reserve Acts 12:142 et seq.
Action filed under the Interstate Commerce Acts 49:1 et seq., 49:301
Action filed under the Immigration Acts (Habeas Corpus & Review)
8:1101/18:1546
Racketeer Influenced and Corrupt Organization Act, RICO 18:1961-1968
Action filed under the Fair Credit Reporting Act, 15 U.S.C. 1681n or
15 U.S.C. 1681o, and the Fair Debt Collection Practices Act,
15 U.S.C. § 1692k
Action filed under the Telephone Consumer Protection Act 47 U.S.C. §
227
Action filed involving unauthorized reception of cable/satellite TV
service under 47 U.S.C. § 553 (unauthorized reception of cable/satellite
TV), or 47 U.S.C. § 605 (e)(3) (unauthorized use or publication of a
communication)
Action filed under Small Business Investment Act 15:681, Securities
Exchange Act 15:78, Securities Act 15:77, Investment Advisers Act
15:80B(1-21)
Action primarily based on Statutes that cannot be classified under any
other nature of suit, such as: Foreign Agents Registration Act 22:611-
621, Klamath Termination Act 25:564-564W-L, Federal Aid Highway Act
23:101-142, Federal Corrupt Practices Act 2:241-256, Federal Election
Campaign Act, Highway Safety Act 23:401 Immigration & Nationality
Act 8:1503, Natural Gas Pipeline Safety Act 49:1671-1700,
Naturalization Acts 8:1421/18:911, 1015, 1421, et seq., 3282 or Federal
Aviation Act 49:1301 et seq.
Action filed under the Federal Crop Insurance Act 7:1501-1550,
Commodity Credit Corporation Act 15:713A-L & 4.
Action filed under Air Pollution Control Act 42:1857-57L, Clean Air Act
42:1857:57L, Federal Environment Pesticide Control Act, Federal
Insecticide, Fungicide & Rodenticide Act 7:135, Federal Water Pollution
Control Act 33:1151 et seq., Land & Water Conservation Fund Act
16:4602,460 1-4, Motor Vehicle Air Pollution Control Act 42:1857F-1-8,
Page 7 of 8
Civil Nature of Suit Code Descriptions
(Rev. 10/20)
National Environmental Policy Act 42:4321, 4331-35G, 4341-47, River &
Harbor Act penalty 3:401-437, 1251.
Other Statutes (Continued)
Title
Freedom of Information Act
Arbitration
Code
895
896
899
Administrative Procedure Act/Review or
Appeal of Agency Decision
950
Constitutionality of State Statutes
Description
Action filed under the Freedom of Information Act 5:552.
Action involving actions to confirm or modify arbitration awards filed
under Title 9 of the U.S. Code.
Action filed under the Administrative Procedures Act, 5 U.S.C. § 701, or
civil actions to review or appeal a federal agency decision.
Action drawing into question the constitutionality of a federal or state
statute filed under (Rule 5.1). Rule 5.1 implements 28 U.S.C. §2403.
Note: The statutes listed above are not all-inclusive, and other statues might be applicable to each nature of suit.
Statutes that are included in the descriptions should be viewed as examples.
Page 8 of 8
|