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Civil Complaint Form. This is a Missouri form and can be use in District Court Federal.
Tags: Civil Complaint, Missouri Federal, District Court
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
Index No.
UNITED STATES DISTRICT COURT
:
Calendar No.
WESTERN DISTRICT OF MISSOURI
:
Plaintiff(s)
JUDICIAL SUBPOENA
DIVISION
:
-against-
:
CIVIL COMPLAINT
:
Defendant(s)
:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .). . . . . . . . . .
)
)
Enter above the full name of Plaintiff or Plaintiffs in this action
)
THE PEOPLE OF THE STATE OF NEW YORK
)
vs.
) CASE NO. ____________
TO
)
)
)
GREETINGS:
)
)
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
Enter above the full
)
,
the Honorable name of Defendant or Defendants in this action
at the
Court
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
orI.
adjourned date, to this Civil Action
Parties to testify and give evidence as a witness in this action on the part of the
(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, if any, on back side of this sheet.)
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
A. Name of Plaintiff
result of your failure to comply.
Address
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
(Attorney must sign above and type name below)
(In item B below, place the full name of the defendant in the first blank, his official position in the second
adding word blank, and his place of employment in the third blank. Use item C for the names, positions, and
places of employment of any additional defendants.)
Attorney(s) for
B. Defendant,
is employed as
at
.
Office and P.O. Address
C. Additional Defendants
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
1
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COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
II. Statement of Claim
:
Index No.
:
(State here as briefly as possible the facts of your claim. Describe how each named defendants is involved.
Calendar No.
Include the names of other persons involved, dates, and places. Do not give any legal arguments or cite
any cases or statutes. If you intend to allege a number of related claims, number and set forth each claim in
:
JUDICIAL SUBPOENA
Plaintiff(s)
a separate paragraph. [Use as much space as you need to state the facts. Attach extra sheets if necessary.]
Unrelated separate claims should be raised in separate civil actions.)
-against:
:
:
Defendant(s)
:
. .III.. . . . Relief . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
..
......
State briefly exactly what you want the Court to do for you.
THE PEOPLE OF THE STATE OF NEW YORK
TO
GREETINGS:
Make no legal arguments. Cite no cases or statutes.
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
IV.
Do you claim the wrongs alleged in your complaint are continuing to occur at the
located at
County of
present ,time?
in room
on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
Yes G
V.
No G
Do you claim actual or punitive monetary damages for the acts alleged in your
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
complaint?
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
Yes G
No G
Witness, Honorable
, one of the Justices of the
the of
Court in If you answered yes, state day amounts claimed and the reasons you claim you are entitled to
County,
, 20
recover money damages
(Attorney must sign above and type name below)
VI.
Attorney(s) for
Counsel
Do you have an attorney to represent you in this civil action?
Yes G
A.
Office and P.O. Address
No G
Have you made any effort to contact a private attorney to determine if he or she would
Telephone No.:
represent you in this civil action?
Yes G
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
No G
2
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COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
B.
If you answered yes, state the names and addresses of the attorneys contracted, and
:
Index No.
give the results of those efforts.
:
Plaintiff(s)
-against-
Calendar No.
:
JUDICIAL SUBPOENA
:
:
C.
If you answered no, state your reasons why no such efforts have been made.
:
Defendant(s)
:
......................................................
THE PEOPLE OF THE STATE OF NEW YORK
VII.
TO
Administrative Procedures
A.
Have the claims which you make in this civil action been presented through any type of
Administrative Procedure within any government agency?
GREETINGS:
Yes G
No G
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
B.
If you answered yes, state the date your claims were so presented, how they were
located at
County of
presented, andday of
the result of that procedure.
in room
, on the
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
C.
If you answered no, give the reasons, if any, why the claims made in this action have not
been presented through Administrative Procedures.
Witness, Honorable
Court in
County,
day of
, 20
, one of the Justices of the
(Attorney must sign above and type name below)
Signed this
day of
, 20
Attorney(s) for
Office and P.O. Address
Signature of Plaintiff or Plaintiffs
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
3
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COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
VERIFICATION :
State of
)
)
) Plaintiff(s)
County of
-against-
Index No.
:
Calendar No.
:
JUDICIAL SUBPOENA
:
:
, being first duly sworn under oath, presents that he is the plaintiff
in this action; that he knows the contents of the complaint; and that the information contained therein is
:
true to the best of his knowledge and belief.
Defendant(s)
:
......................................................
THE PEOPLE OF THE STATE OF NEW YORK
Signature of Plaintiff or Plaintiffs
TO
All parties must verify
GREETINGS:
SUBSCRIBED AND SWORN TO before me this
day of
, 20
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
Notary Public
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
My Commission Expires
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
4
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