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Complaint For Violation Of Civil Rights (Prisoner) Form. This is a Minnesota form and can be use in District Court Federal.
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Tags: Complaint For Violation Of Civil Rights (Prisoner), Minnesota Federal, District Court
PLEASE REVIEW THE ATTACHED MEMORANDUM REGARDING
CHANGES EFFECTED BY THE RECENTLY ENACTED
"PRISON LITIGATION REFORM ACT"
INSTRUCTIONS - CIVIL RIGHTS COMPLAINT
When Mailing the forms:
1.
If you are not proceeding In Forma Pauperis (IFP), you must submit
a.
the original complaint;
b.
a properly completed Civil Cover Sheet (JS-44);
c.
Original summons (no form provided) prepared for Clerk’s signature;
d.
the full amount of the $350.00 civil action filing fee
Make check payable to Clerk, US District Court
2.
If you are proceeding In Forma Pauperis (IFP), you must submit
a.
the original complaint;
b.
a properly completed Civil Cover Sheet (JS-44);
c.
an AO 240 (10/96) Application to Proceed In Forma Pauperis,
i.
ii.
d.
fully completed and properly certified by an authorized prison official
Each plaintiff must submit a fully completed AO 240 form;
the full and correct amount of the initial partial filing fee
i.
ii.
3.
Note: Under the “Prison Litigation Reform Act” prisoner IFP litigants must pay
an initial filing fee equal to 20% of the greater of their average monthly balance
or average monthly deposits for the last six months
Also see attached Page 3, #13 for subsequent payment information
Mail all of your submissions to:
Clerk of Court
U.S. District Court
100 Federal Bldg.
316 North Robert Street
St. Paul, MN 55101
(See attached additional instructions)
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ADDITIONAL INSTRUCTIONS
The following instructions are offered to assist prisoners who intend to file an action in federal court.
Failure to comply with these instructions will cause delays in handling your case and could even cause
the case to be dismissed.
1.
The complaint must be legible -- printed or typewritten and all documents must be signed by all
plaintiffs.
2.
The complaint should clearly identify each individual defendant who is being sued, and it should
include a brief description of the facts giving rise to the claim(s) against each individual
defendant.
3.
The event(s) giving rise to the claim(s) must have occurred in Minnesota and/or the named
defendant(s) must reside in Minnesota.
4.
All of the claims described in the complaint should arise out of the same set of facts. (Claims
arising out of different sets of facts should be presented in separate actions.)
5.
Each section of the form complaint should be completed; all of the information required by the
form complaint should be provided.
6.
The complaint should clearly describe the relief that is requested.
a.
Injunctive relief and/or money damages may be available under 42 U.S.C. § 1983 for
state prisoners who have been deprived of a federal constitutional right by a person acting
under color of state law.
b.
Similar relief may be available under Bivens v. Six Unknown Named Agents of the
Federal Bureau of Narcotics, 403 U.S. 388 (1971) for federal prisoners who have been
deprived of a federal constitutional right by a person acting under color of federal law.
c.
However, a prisoner cannot challenge the fact or duration of his or her confinement in a
civil rights action.
d.
A prisoner can challenge a conviction, an original sentence, or any action extending the
time that must be served in prison ONLY in a habeas corpus proceeding.
7.
The complaint must be signed by the prisoner making the claim, under penalty of perjury. (Any
false statement of a material fact may result in criminal prosecution for perjury.)
8.
If you are NOT applying for IFP status (i.e., if you are paying the full $350.00 file fee), you
must:
a.
b.
9.
prepare your own summonses (one for each defendant), and
make your own arrangements for serving a copy of the summons and complaint on each
defendant. (See service of process requirements at Rule 4 of the Federal Rules of Civil
Procedure.)
If you apply for IFP status, and if your application is granted, then the Court will order the U. S.
Marshal Service to complete service of process for you – the clerk of court will provide you with
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the needed U.S. Marshal Forms to be completed and returned to the Clerk’s office once your IFP
is granted.
10.
After a case has been filed, all further pleadings, papers or correspondence filed with the Court
must indicate the Civil Case number and the judge to whom the case is assigned.
11.
A copy of all written materials sent to the Court also must be sent to the attorney(s) representing
the defendant(s).
12.
The prisoner must notify the Court in writing whenever there is a change in the prisoner’s
address, (including address changes that occur when and after the prisoner is released from
custody).
13.
When an IFP application is filed and only an initial partial filing fee is paid, the unpaid balance
of the full filing fee ($350.00) must be paid through regular monthly installment payments.
Prison authorities are required to deduct such installment payments from prisoner trust accounts,
but prisoner litigants should ensure that such payments are being made. See 28 U.S.C. §
1915(b)(2). Prison authorities are required to continue withdrawing funds from the prisoner's
account until the $350.00 filing fee is paid, even if the prisoner's action is dismissed or
voluntarily withdrawn before the full fee is paid.
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UNITED STATES DISTRICT COURT
DISTRICT OF MINNESOTA
(Enter the full name of ALL plaintiff(s) and prisoner
number(s) in this action)
Civil No.
vs
COMPLAINT FOR VIOLATION OF
CIVIL RIGHTS UNDER 42 U.S.C.
1983
(Enter the full name of ALL defendant(s) in this action)
1.
PREVIOUS LAWSUITS
A
Have you begun other lawsuits in state or federal court dealing with the same facts involved in this
action or otherwise relating to your imprisonment in the last three years?
Yes
B.
No
If your answer to A is Yes, describe each lawsuit in the space below. (If there is more than one
lawsuit, describe the additional lawsuits on another piece of paper, using the same outline.)
1.
Parties to this previous lawsuit:
Plaintiffs
Defendants
2.
Court (if federal court, name the district. If state court, also name the county)
3.
Case Number
4.
Name of judge to whom case was assigned
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5.
6.
Disposition (For example: Was the case dismissed? Appealed? Still pending?
7.
Approximate date of
filing of lawsuit
8.
Approximate date of
disposition
9.
II.
Cause of Action (Cite statute under which you filed and write a brief statement of the case):
Attach copy of disposition it not from Federal District Court of Minnesota.
PLACE OF PRESENT CONFINEMENT
A.
Is there a prisoner grievance procedure in the institution?
Yes
B.
Did you present the facts relating your complaint in the prisoner grievance procedure?
Yes
C.
What steps did you take?
2.
What was the result?
3.
III
No
If your answer is Yes:
1.
D.
No
Attach a copy of disposition
If your answer is No, explain why not:
PARTIES
(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)
A.
Name of Plaintiff:
Address:
Additional Plaintiffs:
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( In Item B below, place the full name of the defendant in the first blank, official position in the second
blank, and place of employment in the third blank. Do the same for all additional defendants, using a
separate page, if necessary)
B.
Name of Defendant:
employed as:
at:
Additional
Defendants
IV.
STATEMENT OF
CLAIM
Provide a concise summary of the facts on which your claim is based. Describe how each individual
defendant is personally involved, including dates, places and specific wrongful acts or omissions or each
defendant. Each factual allegation should be set forth in a separate numbered paragraph. (All
paragraphs in the “STATEMENT OF CLAIM”
should be consecutively numbered.) Do not give any legal arguments or cite any cases or statutes.
Attach extra sheets if necessary.
V.
RELIEF
State briefly exactly what you want the court to do for you:
Make no legal arguments. Cite no case or statutes.
I (We) hereby certify under penalty of perjury that the above petition is true to the best of my (our)
information, knowledge and belief.
Signed this
day of
, 20
Signature(s) of Plaintiff(s)
(3/7/01)
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