ILND 44 (Rev. 01/17) CIVIL COVER SHEET The ILND 44 civil cover sheet and the information contained herein neither replace nor supplement the filing and service of pleadings or other papers a s 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. (Se e instructions on next page of this form.) I. (a) PLAINTIFFS DEFENDANTS (b) County of Residence of First Listed Plaintiff County of Residence of First Listed Defendant (Except in U.S. plaintiff cases) (In U.S. plaintiff cases only) Note: In land condemnation cases, use the location of the tract of land involved. (c) Attorneys ( firm n ame, a ddress, and t elephone n umber) At torneys (i f k nown) II.BASIS OF JURISDICTION (Check on e box, only.) III.CITIZENSHIP OF PRINCIPAL PARTIES (For Diversity Cases Only . ) (Check on e box, only for plaintiff and one box for defend ant.) 1 U.S. Government 3 Federal Question PTF DEF PTF DEF Plaintiff (U.S. Government n ot a p arty) Citizen of This State 1 1 Incorporated or Principal Place 4 4 of Business i n This State 2 U.S. Government 4 Diversity Citizen of Another State 2 2 Incorporated and Principal Place 5 5 Defendant (Indicate c itizenship of p arties in I tem III . ) of Business i n Anot her State Citizen or Subject of a 3 3 Foreign Nation 6 6 Foreign Country IV.NATURE OF SUIT (Check one box, only.) CONTRACT TORTS PRISONER PETITIONS LABOR OTHE R STATUTES 110 Insurance PERSONAL INJURY PERSONAL INJURY 710 Fair Labor Standards Act 375 False Claims Act 120 Marine 310 Airp lane 365 Personal Injury - 720 Labor/Management Relations 376 Qui Tam (31 USC 3729 (a)) 130 Miller Act 315 Airplane Produc t Product Liability 740 Railway Labor Act 400 State Reapportionment 140 Negotiable Instrument Liability 367 Health Care/ 751 Family and Medical 410 Antitrust 150 Recovery of Overpayment 320 Assault, Libel & Slander Pharmaceutical Le ave Act 430 Banks and Banking & Enforcement of Judgment 330 Federal Employers222 Personal Injury 790 Other Labor Litigation 450 Commerce 151 Medicare Act Liability Product Liability 791 Employee Retirement 460 Deportation 152 Recovery of Defaulted Student 340 Marine 368 Asbestos Personal Injury Income Security Act 470 Racketeer Influenced and Loans (Excludes Veterans) 345 Marine Product Liability Product Liability Corrupt Organizations 153 Recovery of Veteran222s Benefits 350 Motor Vehicle 480 Consumer Credit 160 Stockho lders222 Suits 355 Motor Vehicle PERSONAL PROPERTY 10 Motions to Vacate Sentence 530 General 535 Death Penalty 540 Mandamus & Other 550 Civil Rights 555 Prison Condition 560 Civil Detainee 226 Conditions of PROPERTY RIGHTS 490 Cable/Sat TV 190 Other Contract Product Liability 370 Other Fraud 820 Copyrights 850 Securities/Commodities/ 195 Contract Product Liability 360 Other Personal Injury 371 Truth in Lending 830 Patent Exchange 196 Franchise 362 Personal Injury - 380 Other Personal 835 Patent 226 Abbreviated 890 Other Statutor y Actions Medical Malpractice Property Damage New Drug Application 891 Agricultural Acts 385 Property Damage 840 Trademark 893 Environmental M atters Product Liability 895 Freedom of Information Act 896 Arbitration REAL PROPERTY CIVIL RIGHTS BANKRUPTCY FORFEITURE/PENALTY SOCIAL SECURITY 899 Administrative Pr ocedure 210 Land Condemnation 440 Other Civil Rights 422 Appeal 28 USC 158 625 Drug Related Seizure 861 HIA (1395ff) Act/Review or Appeal of 220 Foreclosure 441 Voting 423 Withdrawal 28 USC 157 of Property 21 USC 881 862 Black Lung (923) Agency Decision 230 Rent Lease & Ejectment 442 Employme nt 690 Other 863 DIWC/DIWW (405(g)) 950 Constitutionality of 240 Torts to Land 443 Housing/ 864 SSID Title XVI State Statutes 245 Tort Product Liability Accommodations IMMIGRATION 865 RSI (405(g)) 290 All Other Real Property 445 Amer. w/Disabilities - 462 Naturalization Employment 446 Amer. w/Disabilities - FEDERAL TAXES Other 870 Taxes (U.S. Plaintiff 448 Education or Defendant) 871 IRS 227 Third Party 26 USC 7609 V.ORIGIN (Check one box, only.) Transferred from Another District (specify) Multidistrict Litigation Direct File 1 Original Proceeding 2 Removed from State Court 3 Remanded from Appellate Court 4 Reinstated or Reopened 5 6 Multidistrict Litigation 8 VI.CAUSE OF ACTION (Enter U.S. Civil Statute under which you are filing andwrite a brief statement of cause.) VII.Previous Bankruptcy Matters (For nature of suit 422 and 423, enter the case number and judge for any associated bankruptcy matter previously adjudicated by a judge of this Court. Use a separate attachment if necessary.) VIII.REQUESTED IN COMPLAINT: Check if this is a class action nder ule 23, F.R.CV.P. DEMAND $ C heck Yes only if demanded in complaint. JURY DEMAND: Yes No IX.RELATED CASE(S) IF ANY (See instructions) J udge Number X. Date Signature of attorney of record American LegalNet, Inc. www.FormsWorkFlow.com 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 thefull 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 bothname 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 offiling. 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 thissection "(see attachment)". II.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 ofthe 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.) III.Residence (citizenship) of Principal Parties. This section of the JS 44 is to be completed if diversity of citizenship was indicated above. Mark this sectionfor each principal party. IV.Nature of Suit. Place an "X" in the appropriate box. If the nature of suit cannot be determined, be sure the cause of action, in Section VI below, is sufficientto enable the deputy clerk or th