PRISONER INSTRUCTIONS FOR FILING A COMPLAINT UNDER THE CIVIL RIGHTS ACT 42 U.S.C. § 1983 (against state, county, or municipal defendants) or A “BIVENS” ACTION, 28 U.S.C. § 1331 (against federal defendants) Complaint Form This packet includes a complaint form and one application to proceed in forma pauperis (as a poor person) with financial affidavit. Local Rule 81.1 of the Local Rules of this court requires prisoners in custody filing suit under 42 U.S.C.§1983 to use the court’s form. This form is not something submitted with the complaint, it is the complaint. All questions on this form must be answered on the form. (You may attach additional sheets if necessary to complete your answer.) It is not permitted to answer a question “see attached” or “see attached complaint.” Such complaints may be summarily dismissed without prejudice. If you should choose to draft your own complaint instead of using the court’s form, you must still include the information asked for in the court’s form. To bring a lawsuit, you must file the original complaint for the court, one copy for the judge, and one copy for each defendant you name. For example, if you name two defendants, you must file the original complaint and three copies. The copies of your complaint may be either photocopied from the original or conformed copies of the original (that is, typed or handwritten word for word from the original). If you do not have access to a photocopier, you may request more copies of the complaint form from the Clerk of the Court so that you may make conformed copies. You should also keep a copy of the complaint for your own records. In forma pauperis status does not entitle you to free copies of court records or documents. Therefore, the Clerk of the Court must charge you if you need photocopies of your complaint or any other motion or document. If your defendants are state, county, or municipal employees, you should file your case under 42 U.S.C. § 1983. If your defendants are employees of the United States Government, you should file your case under 28 U.S.C. § 1331, and you must file an additional three copies of the complaint. If neither statute applies, you should cite the applicable statute, if known. Your complaint and all other documents must be legibly handwritten or typewritten on one side of lettersized (8½” x 11”) paper and signed by all plaintiffs. It is not necessary to swear to the complaint before a notary public. However, you are warned that any false statement of a material fact may subject you to dismissal of your case. All questions must be answered concisely in the proper space on the forms. If you need additional space to answer a question, you may use additional blank pages. Your complaint should not contain legal arguments or citations. You are required only to state the facts. You must describe how each defendant is personally involved in the activities upon which your claim is based. Filing Fee The filing fee is $350. In addition, the United States Marshal may require you to pay the cost of serving the complaint on each of the defendants. If you are unable to pay the filing fee of $350 and service costs for this action, you must ask the court to allow you to proceed in forma pauperis. The Clerk has in forma pauperis applications. The Prison Litigation Reform Act (“PLRA”) has changed the process for proceeding in forma pauperis. Even if you are granted leave to proceed in forma pauperis, you will be responsible for paying the full amount of the $350 fee for filing a complaint or the $455 fee for filing an appeal in installment payments. The initial installment is 20 percent of the greater of (1) the average monthly deposits (including any state pay and gifts) to your inmate trust fund account or (2) the average monthly balance in your account for the six-month period immediately preceding the filing of your complaint or notice of appeal. The court will calculate the initial installment and inform the institution having custody of you to remit this amount. (Continued Over) American LegalNet, Inc. www.FormsWorkflow.com After the first installment is paid, you will be required to make monthly payments of 20 percent of the preceding month’s income credited to your account. You should not send these monthly payments yourself. The institution having custody of you will forward the payments from your account to the clerk of the court each time the amount in your account exceeds $10 until the filing fees are paid in full. If you have no assets or other means to pay the initial installment, you will still be allowed to bring your action or appeal. However, you will be required to pay the entire filing fee in installments as described above as money becomes available in your account. If a court issues a judgment against you that includes the payment of costs, you will be required to pay these costs and they will be collected in the same manner as your filing fee. In Forma Pauperis Application To file your application to proceed in forma pauperis, you must complete, sign, and attest as true and correct under penalty of perjury the enclosed application and financial affidavit. You must have an authorized officer at the correctional institution complete the certificate as to the amount of money and securities on deposit to your credit in any account in the institution. You must also attach a certified copy showing all transactions in your inmate trust fund account from each institution where you resided for the six-month period immediately preceding the filing of your complaint. If you have been in more than one institution during the past six months, you must attach trust fund accounts from each institution . If there is more than one plaintiff, then each plaintiff must complete a separate in forma pauperis application and attach a copy of his or her trust fund account. Each plaintiff must pay the full $350 filing fee. Other PLRA Provisions You should be aware of several other provisions of the PLRA: (1) “Three Strike” Provision. If you file three cases or appeals that are dismissed as frivolous, malicious, or failing to state a claim, you will be barred from filing any more cases in forma pauperis unless you are in imminent danger of serious physical injury. Some common examples of dismissals that will count toward the three-strike limit include, but are not limited to, failure to name a suable and non-immune defendant; failure to allege facts that would indicate a violation of a federal right; dismissal of your action in response to a defendant’s motion to dismiss for failure to state a claim upon which relief may be granted; dismissal of the case in the district court, or dismissal of an appeal as frivolous or not taken in good faith. Note: If the district court dismisses your case for one of these reasons, that will count as one strike. If you appeal the dismissal and the court of appeals dismisses your appeal, that may count as a second strike. (2) Physical Injury. The law now provides that a prisoner, while confined, may not file a federal claim seeking money damages for mental or emotional injury suffered while in custody without a prior showing of physical injury. U.S. Marshal’s Forms and Summons USM 285 forms will be sent directly from the Marshal’s Office if needed, only after summons have been prepared and issued by the Clerk’s office, pursuant to a court order. Therefore, you should not send USM 285 forms with the complaint. However, you must complete these forms if the Marshal sends them to you. You must complete a separate USM 285 form for each named defendant, giving the address where the U.S. Marshal can attempt to serve that defendant. No summons will be sent to you. Where to File Your complaint should be filed in this district only if one or more of the named defendants resides within this district or if the events upon which you base your complaint took place in this district. The following Illinois Correctional Centers are located in the Northern District of Illinois: Stateville, Sheridan and Dixon. In addition there are a number of County Jails in the Northern District of Illinois. A complaint filed in this court against officials at other state prisons may be subject to dismissal or transfer to the proper district. When these forms are properly completed, mail them to Prisoner Correspondent, United States District Court, 219 S. Dearborn Street, Chicago IL 60604. Complaints concerning claims arising at the Dixon Correctional Center should be sent to the Clerk, United States District Court, 211 S. Court Street, Rockford, IL 61101. Always keep the court informed of your address; failure to do so may result in dismissal of your case. 2 American LegalNet, Inc. www.FormsWorkflow.com