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Civil Complaint - Missouri
| Civil Complaint Form. This is a Missouri form and can be used in Western District District Court Federal . |
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UNITED STATES DISTRICT COURT WESTERN DISTRICT OF MISSOURI DIVISION CIVIL COMPLAINT ) ) )Enter above the full name of Plaintiff or Plaintiffs in this action) ) vs. ) CASE NO. ____________ ) ) ) ) )Enter above the full name of Defendant or Defendants in this action)I. Parties to this Civil Action (In item A below, place your name in the first blank and place your present address in the second blank. Do the same for additional plaintiffs, if any, on back side of this sheet.) A. Name of Plaintiff Address (In item B below, place the full name of the defendant in the first blank, his official position in the second adding word blank, and his place of employment in the third blank. Use item C for the names, positions, and places of employment of any additional defendants.) B. Defendant, is employed as at . C. Additional Defendants 1 <<<<<<<<<********>>>>>>>>>>>>> 2 II. Statement of Claim (State here as briefly as possible the facts of your claim. Describe how each named defendants is involved. Include the names of other persons involved, dates, and places. Do not give any legal arguments or cite any cases or statutes. If you intend to allege a number of related claims, number and set forth each claim in a separate paragraph. [Use as much space as you need to state the facts. Attach extra sheets if necessary.] Unrelated separate claims should be raised in separate civil actions.) III. Relief State briefly exactly what you want the Court to do for you. Make no legal arguments. Cite no cases or statutes.IV. Do you claim the wrongs alleged in your complaint are continuing to occur at the present time? Yes G No G V. Do you claim actual or punitive monetary damages for the acts alleged in your complaint? Yes G No G If you answered yes, state the amounts claimed and the reasons you claim you are entitled to recover money damages VI. Counsel Do you have an attorney to represent you in this civil action? Yes G No G A. Have you made any effort to contact a private attorney to determine if he or she would represent you in this civil action? Yes G No G 2<<<<<<<<<********>>>>>>>>>>>>> 3 B. If you answered yes, state the names and addresses of the attorneys contracted, and give the results of those efforts. C. If you answered no, state your reasons why no such efforts have been made. VII. Administrative Procedures A. Have the claims which you make in this civil action been presented through any type of Administrative Procedure within any government agency? Yes G No G B. If you answered yes, state the date your claims were so presented, how they were presented, and the result of that procedure. C. If you answered no, give the reasons, if any, why the claims made in this action have not been presented through Administrative Procedures. Signed this day of , 20 Signature of Plaintiff or Plaintiffs 3<<<<<<<<<********>>>>>>>>>>>>> 4 VERIFICATIONState of ) ) County of ) , being first duly sworn under oath, presents that he is the plaintiffin this action; that he knows the contents of the complaint; and that the information contained therein istrue to the best of his knowledge and belief. Signature of Plaintiff or Plaintiffs All parties must verifySUBSCRIBED AND SWORN TO before me this day of , 20 Notary Public My Commission Expires 4
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