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Complaint - California
|Complaint Form. This is a California form and can be used in USDC Eastern Federal .||
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Plaintiff's Name: CDC No: Address: IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF CALIFORNIA AT FRESNO ) ) ) ) ) ) ) ) ) ) ) ) (Name of Plaintiff) vs. (Case Number) COMPLAINT Civil Rights Act, 42 U.S.C. 1983 (Names of all Defendants) I. Previous Lawsuits: A. Have you brought any other lawsuits while a prisoner? Yes No B. If your answer to A is yes, how many?: Describe previous or pending lawsuits in the space below. (If more than one, use back of paper to continue outlining all lawsuits.) 1. Parties to this previous lawsuit: Plaintiff Defendant s 2. Court (if Federal Court, give name of District; if State Court, give name of County) 3. Docket Number 5. Disposition 4. Assigned Judge (For example: Was the case dismissed? Was it appealed? Is it still pending?) 6. Filing date (approx.) 7. Disposition date (approx.) (List all other previous or pending lawsuits on back of this form) 1 2001 © American LegalNet, Inc. II. Exhaustion of Administrative Remedies A. Is there a grievance procedure available at your institution? Yes No No B. Have you filed a grievance concerning the facts of this complaint? Yes If your answer is no, explain why not C. Is the grievance process completed? Yes Date process completed, and disposition III. Defendants No (In Item A below, place the full name of the defendant in the first blank, his/her official position in the second blank, and his/her place of employment in the third blank. Use item B for the names, positions and places of employment of any additional defendants.) A. Defendant at B. Additional defendants is employed as IV. Statement of Claim (State here as briefly as possible the facts of your case. Describe how each defendant is involved, including dates and places. Do not give any legal arguments or cite any cases or statutes. Attach extra sheets if necessary.) 2 2001 © American LegalNet, Inc. v. Relief (State briefly exactly what you want the court to do for you. Make no legal arguments. Cite no cases or statutes.) I declare under penalty of perjury that the foregoing is true and correct. (Date) (Signature of Plaintiff) 3 2001 © American LegalNet, Inc.