JS 44 (Rev. 02/19) CIVIL COVER SHEET The JS 44 civil cover sheet and the information contained herein neither replace nor supplement the filing and service of pleadings 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 p ur p ose of initiatin g the civil docket sheet. ( SEE INSTRUCTIONS ON NEXT PAGE OF THIS FORM. ) I. ( a ) PLAINTIFFS DEFENDANTS ( b ) County of Residence of First Listed Plaintiff Count y of Residence of First Listed Defendan t (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 Name, Address, and Telephone Number) Attorneys (If Known) II. BASIS OF JURISDICTION (Place an 223X224 in One Box Only) III. CITIZENSHIP OF PRINCIPAL PARTIES (Place an 223X224 in One Box for Plaintiff (For Diversity Cases Only) and One Box for Defendant) 1 U.S. Government 3 Federal Question PTF DEF PTF DEF Plaintiff ( U.S. Government Not a Part y) Citizen of This State 1 1 Incor p orated o r Princi p al Place 4 4 of Business In This State 2 U.S. Government 4 Diversit y Citizen of Another State 2 2 Incor p orated and Princi p al Place 5 5 Defendant (Indicate Citizenship of Parties in I tem III) of Business In Another State Citizen or Sub j ect of a 3 3 Forei g n Nation 6 6 Foreign Country IV. NATURE OF SUIT (Place an 223X224 in One Box Only) Click here for: Nature of Suit Code Descriptions. CONTRACT TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES 110 Insurance PERSONAL INJURY PERSONAL INJURY 625 Drug Related Seizure 422 Appeal 28 USC 158 375 False Claims Act 120 Marine 310 Airplane 365 Personal Injury - of Property 21 USC 881 423 Withdrawal 376 Qui Tam (31 USC 130 Miller Act 315 Airplane Product Product Liabilit y 690 Othe r 28 USC 157 3729(a)) 140 Negotiable Instrument Liabilit y 367 Health Care/ 400 State Reapportionment 150 Recover y of Over p a y ment 320 Assault , Libel & Pharmaceutical PROPERTY RIGHTS 410 Antitrust & Enforcement of Judgment Slande r Personal Injur y 820 Copyrights 430 Banks and Banking 151 Medicare Act 330 Federal Employers222 Product Liabilit y 830 Patent 450 Commerce 152 Recover y of Defaulte d Liabilit y 368 Asbestos Personal 835 Patent - Abbreviate d 460 De p ortation Student Loans 340 Marine Injury Product New Drug Application 470 Racketeer Influenced an d (Excludes Veterans) 345 Marine Product Liabilit y 840 Trademar k Corrupt Organizations 153 Recover y of Over p a y ment Liabilit y PERSONAL PROPERTY LABO R SOCIAL SECURITY 480 Consumer Credit of Veteran222s Benefits 350 Motor Vehicle 370 Other Frau d 710 Fair Labor Standards 861 HIA (1395ff) 485 Telephone Consumer 160 Stockholders222 Suits 355 Motor Vehicle 371 Truth in Lending Act 862 Black Lung (923) Protection Act 190 Other Contract Product Liabilit y 380 Other Personal 720 Labor/Management 863 DIWC/DIWW (405(g)) 490 Cable/Sat T V 195 Contract Product Liabilit y 360 Other Personal Property Damage Relations 864 SSID Title XVI 850 Securities/Commodities/ 196 Franchise Injury 385 Property Damage 740 Railway Labor Act 865 RSI (405(g)) Exchange 362 Personal Injury - Product Liabilit y 751 Family and Medical 890 Other Statutory Actions Medical Malpractice Leave Act 891 Agricultural Acts REAL PROPERTY CIVIL RIGHTS PRISONER PETITIONS 790 Other Labor Litigation FEDERAL TAX SUITS 893 Environmental Matters 210 Land Condemnation 440 Other Civil Rights Habeas Corpus: 791 Employee Retirement 870 Taxes (U.S. Plaintiff 895 Freedom of Information 220 Foreclosure 441 Voting 463 Alien Detainee Income Security Act or Defendant) Act 230 Rent Lease & Ejectment 442 Employment 510 Motions to Vacate 871 IRS 227 Third Party 896 Arbitration 240 Torts to Lan d 443 Housing/ Sentence 26 USC 7609 899 Administrative Procedure 245 Tort Product Liabilit y Accommodations 530 General Act/Review or Appeal of 290 All Other Real Propert y 445 Amer. w/Disabilities - 535 Death Penalty IMMIG R ATION Agency Decision Em p lo y ment Other: 462 Naturalization A pp lication 950 Constitutionalit y of 446 Amer. w/Disabilities - 540 Mandamus & Othe r 465 Other Immigration State Statutes Othe r 550 Civil Rights Actions 448 Education 555 Prison Condition 560 Civil Detainee - Conditions of Confinement V. ORIGIN (Place an 223X224 in One Box Only) 1 Original Proceeding 2 Removed from State Court 3 Remanded from Appellate Court 4 Reinstated or Reopened 5 Transferred from Another District (specify) 6 Multidistrict Litigation - Transfe r 8 Multidistrict Litigation - Direct File VI. CAUSE OF ACTION Cite the U.S. Civil Statute under which you are filing (Do not cite jurisdictional statutes unless diversity): Brief description of cause: VII. REQUESTED IN COMPLAINT: CHECK IF THIS IS A CLASS ACTION UNDER RULE 23, F.R.Cv.P. DEMAND $ CHECK YES only if demanded in complaint: JURY DEMAND: Yes No VIII. RELATED CASE(S) IF ANY ( See instructions ) : JUDGE DOCKET NUMBER DATE SIGNATURE OF ATTORNEY OF RECORD FOR OFFICE USE ONLY RECEIPT # AMOUNT APPLYING IFP JUDGE MAG. JUDGE American LegalNet, Inc. www.FormsWorkFlow.com PURSUANT TOLOCAL RULE 83.11Yes1.Is this a case that has been previously dismissed?NoIf yes, give the following information:Court:Case No.:Judge:2.Other than stated above, are there any pending or previouslydiscontinued or dismissed companion cases in this or any othercourt, including state court? (Companion cases are matters in whichit appears substantially similar evidence will be offered or the sameor related parties are present and the cases arise out of the sametransaction or occurrence.)YesNoIf yes, give the following information:Court:Case No.:Judge:Notes : American LegalNet, Inc. www.FormsWorkFlow.com JS 44 Reverse (Rev. 02/19) 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 (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 (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 this section "(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" 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 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 section for each principal party. IV. Nature of Suit. Place an "X" in the appropriate box. If there are multiple nature of suit codes associated with