Civil Rights Complaint Pursuant To 28 USC Section 1331 Form. This is a Kansas form and can be use in District Court Federal.
Tags: Civil Rights Complaint Pursuant To 28 USC Section 1331, Kansas Federal, District Court
UNITED STATES DISTRICT COURT FOR THE DISTRICT OF KANSAS INFORMATION AND INSTRUCTIONS FOR PRISONERS FILING CIVIL RIGHTS COMPLAINTS UNDER 42 U.S.C. § 1983 or BIVENS ACTIONS 1. FORMS The attached form is to assist you in the preparation of a complaint seeking relief for violation of civil rights under either 42 U.S.C. §1983 (defendants are state officials) or a Bivens action (defendants are federal officials). These forms may be filled out by typewriter or by hand. Handwriting MUST be clear and readable. Every question on the forms must be answered, even if your answer is "none," or "don't know." The use of forms is required by Local Rule 9.1(a). Do not write on the back of the complaint forms. If you need more space, use additional sheets of paper. Federal Rules require that the complaint be a BRIEF statement. Stick to the facts (who, what, when, where, why, how). Always include dates, times, places, and names. Pursuant to D. Kan. Rule 7.1(e), the argument and authorities section of a brief or memorandum in a civil action may not exceed 30 pages absent an order of the court. 2. COPIES You must submit one original copy, one courtesy copy for the court, plus one copy of the complaint and all attachments or exhibits for each defendant you name. For example, if you name two defendants, you must file an original and three copies of the complaint and all attachments. All copies of the complaint must be identical to the original. IT IS YOUR RESPONSIBILITY TO KEEP A COPY FOR YOUR RECORDS OF EVERY COMPLAINT AND OTHER DOCUMENT OR LETTER THAT YOU SEND TO THE COURT. 3. VERIFICATION You must personally sign the complaint. If there is more than one plaintiff, each person must sign. You may not sign for anyone else. Each plaintiff must verify each complaint form by signing a verification which attests to the truthfulness of all statements and contents of the complaint. 4. MAILING When your complaint is completed, it should be mailed with the necessary copies and filing fee or in forma pauperis motion to: RALPH L. DeLOACH, CLERK TIMOTHY M. O'BRIEN, CLERK OF COURT UNITED STATES DISTRICT COURT 444 S.E. QUINCY TOPEKA, KANSAS 66683 Revised - April 7, 2006 American LegalNet, Inc. www.FormsWorkFlow.com 5. FILING FEES The complaint must be accompanied by a filing fee or a motion for leave to proceed in forma pauperis. The statutory filing fee for civil rights complaints is $350.00. If you cannot afford to prepay the filing fee, you may request permission to proceed in forma pauperis by completing a form motion available from the court and submitting certified copies of your institutional financial records for the six months preceding your motion for leave to proceed in forma pauperis. After receiving these materials, the court will assess an initial partial filing fee that is the greater of (a) 20% of the average monthly deposits in your account for the past six months; OR (b) 20% of the average monthly balance in your account for the past six months. If your motion is granted, you will be allowed to pay the filing fee in installments, and you must pay 20% of each month's income in every month your institutional account balance exceeds ten dollars ($10.00) until the full filing fee is paid. See 28 U.S.C. § 1915(b). The financial officer of the facility where you are incarcerated will be directed to make these payments, and it is your responsibility to cooperate with facility personnel to authorize these arrangements. The failure to cooperate may result in sanctions by the court. You must pay the full filing fee even if your case is dismissed by the court. If you have no assets, you will not be prohibited from bringing an action without payment of an initial partial fee. See 28 U.S.C. 9 1915(b)(4). However, when you receive assets, you must pay the filing fee as described. If you have had three or more civil actions or appeals dismissed as frivolous, malicious, or for failure to state a claim, you are no longer eligible to proceed without prepayment of the full filing fee unless you are under imminent danger of serious physical injury. 6. SERVICE Once you have submitted the portion of the filing fee directed by the court, the court will review your claims to determine whether summons or waiver of summons forms should be issued to the defendants. Your complaint should list the complete name and address of each person named as a defendant. Without this information, the Clerk cannot prepare summons or waivers for issuance by the Marshal. See Rule 4(j) of the Federal Rules of Civil Procedure. 7. AFTER THE COMPLAINT IS FILED You must comply with court rules, which include KEEPING THE COURT INFORMED OF YOUR CURRENT ADDRESS. If you fail to comply with this or any other court rule, or fail Revised - April 7, 2006 American LegalNet, Inc. www.FormsWorkFlow.com to comply with any court imposed deadline, YOUR CASE MAY BE DISMISSED for want of prosecution. You must file a proper motion if you seek any kind of relief from the court. A letter requesting relief will be not be treated as a proper motion. Exhibits included with the complaint or any pleading are considered part of the record and will not be returned. 8. MOTIONS Request for any type of relief must be in the form of a proper motion beginning with the case caption and title of the motion. You must serve the defendant(s) or their counsel with a copy of every motion, letter, or other document submitted for consideration by the Court. The original of all documents filed with the Clerk should have a proper ''Certificate of Service'' stating the date a copy of the document was mailed and the address to which it was mailed. The following certificate should appear at the end of each document. I hereby certify that a copy of the foregoing pleading/document was mailed to (Opposing Party or Counsel) at (Address) on , 20__. (Date) (Signature) Any pleading or other document received which fails to include a certificate of service may be disregarded by the court or returned. 9. COMMUNICATION WITH THE COURT It is improper to communicate directly with Judges or Magistrate Judges concerning matters which are or may become a subject in their Court. Procedural questions may be directed to the clerk's office, but Judges, Magistrate Judges, and court staff are prohibited from giving legal advice. 10. EXHAUSTION OF ADMINISTRATIVE REMEDIES UNDER THE PRISON LITIGATION REFORM ACT ("PLRA") You may not bring an action challenging prison conditions under 42 U.S.C. § 1983 or any other federal law until you have exhausted available administrative remedies. Revised - April 7, 2006 American LegalNet, Inc. www.FormsWorkFlow.com (Name) (Institution Register No.) (Current Mailing Address) UNITED STATES DISTRICT COURT FOR THE DISTRICT OF KANSAS CASE NO. _____________________________ ____________________________, Plaintiff (To be supplied by the Clerk) (Full and Correct Name) vs. ____________________________ CIVIL RIGHTS COMPLAINT PURSUANT TO 28 U.S.C. 1331 ____________________________, Defendants A. JURISDICTION 1) ____________________________________, is a resident of ______________________ (Plaintiff) (State of residency prior to incarceration) who presently located at ____________________________________________________ (Mailing address or place of confinement.) 2) Defendant ______________________________________________ is a resident of (Name of first defendant) ______________________________________________________, and is employed as (City, State) __________________________________________________________, and may be (Position and title, if any) located at __________________________________________________. At the time the claim(s) alleged (Address for service of process) in this complaint arose, was this defendant acting under the color of state law? Yes No If your answer is “Yes”, briefly explain: _______________________________________ ________________________________________________________________________ 1 XE-2 (F) CIVIL RIGHTS COMPLAINT (28 U.S.C. §1331) American LegalNet, Inc. www.FormsWorkFlow.com 3) Defendant __________________________________________________ is a resident of (Name of first defendant) _______________________________________________________, and is employed as (City, state) _____________________________________________________, and may be located at (Position and title, if any) ___________________________________________________________. At the time the (Address for service of process) claim (s) alleged in this complaint arose was this defendant acting under the color of state law? Yes No . If your answer is “Yes”, briefly explain: ________________________________________________________________________ ________________________________________________________________________ (Use the back of this page to furnish the above information for additional defendants.) 4) Jurisdiction is invoked pursuant to 28 U.S.C. §1331(3). (If you wish to assert jurisdiction under different or additional statuses, you may list them below.) ________________________________________________________________________ ________________________________________________________________________ B. NATURE OF THE CASE 1) Briefly state the background of your case: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 2 XE-2 (F) CIVIL RIGHTS COMPLAINT (28 U.S.C. §1331) American LegalNet, Inc. www.FormsWorkFlow.com C. CAUSE OF ACTION 1) I allege that my claims arise under the following constitutional provisions or laws of the United States and that the following facts form the basis for my allegations: (If necessary you may attach up to two additional pages (8 1/2” x 11”) to explain any allegation or to list additional supporting facts.) A) (1) Count I: ___________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ (2) Supporting Facts: (Include all facts you consider important, including names of persons involved, places and dates. Describe exactly how each defendant is involved. State the facts clearly in your own words without citing legal authority or argument.): _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ B) (1) Count II: _________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ (2) Supporting Facts: ___________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ C) (1) Count III: _________________________________________________________ 3 XE-2 (F) CIVIL RIGHTS COMPLAINT (28 U.S.C. §1331) American LegalNet, Inc. www.FormsWorkFlow.com _____________________________________________________________________ _____________________________________________________________________ (2) Supporting Facts: ___________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ D. PREVIOUS LAWSUITS AND ADMINISTRATIVE RELIEF 1) Have you begun other lawsuits in state or federal court dealing with the same facts involved in this action or otherwise relating to the conditions of your imprisonment? Yes No . If your answer is “Yes”, describe each lawsuit. (If there is more than one lawsuit, describe the additional lawsuits on another piece of paper, using the same outline.) a) Parties to previous lawsuit: Plaintiffs: _________________________________________________________ Defendants: _______________________________________________________ b) Name of court and docket number ______________________________________ __________________________________________________________________ c) Disposition (for example: Was the case dismissed? Was it appealed? Is it still pending?) _________________________________________________________ __________________________________________________________________ d) Issues raised _______________________________________________________ e) Approximate date of filing lawsuit _____________________________________ f) Approximate date of disposition _______________________________________ 4 XE-2 (F) CIVIL RIGHTS COMPLAINT (28 U.S.C. §1331) American LegalNet, Inc. www.FormsWorkFlow.com E. ADMINISTRATIVE RELIEF 1) Have you presented all grounds for relief raised in this complaint by way of BP-9, BP-10, and BP-11 grievances? Yes No . 2) If your answer to (1) is “Yes”, state the date of disposition, result and reasons given for the administrative decision ____________________________________________ _____________________________________________________________________ 3) If your answer to (1) is “No”, list each ground not fully presented through the administrative grievance process and explain why it was not ____________________ _____________________________________________________________________ 4) Describe all other procedures you have used (such as tort claim or Parole Commission administrative appeals procedures) to exhaust administrative remedies as to each issue raised. ____________________________________________________ _____________________________________________________________________ F. REQUEST FOR RELIEF 5) I believe that I am entitled to the following relief: _____________________________________________________________________ _____________________________________________________________________ _____________________________________ Signature of Attorney (if any) ____________________________________ Signature of Petitioner _____________________________________ _____________________________________ _____________________________________ (Attorney’s full address and telephone number) 5 XE-2 (F) CIVIL RIGHTS COMPLAINT (28 U.S.C. §1331) American LegalNet, Inc. www.FormsWorkFlow.com