Page 1 of 3 Revised 10/7/16 UNITED STATES DISTRICT COURT DISTRICT OF NEVADA INSTRUCTIONS FOR FILING A CIVIL RIGHTS COMPLAINT BY AN INMATE UNDER 42 U.S.C. 247 1983 A. Who May Use This Form You must use the attached form if you are an inmate. The attached 42 U.S.C. 247 1983 civil rights complaint form is designed to help inmates prepare a complaint seeking relief for alleged violations of their federal civil rights. These complaints typically concern, but are not limited to, conditions of confinement. Do not use this form if you are challenging the length of your sentence or the validity of your conviction. If you want to challenge a state conviction or sentence, you should file a petition under 28 U.S.C. 247 2254 for writ of habeas corpus by a person in state custody. If you want to challenge a federal conviction or sentence, you should file a motion under 28 U.S.C. 247 2255 to vacate sentence in the federal court that entered judgment. B. Filing a 247 1983 Civil Rights Action To initiate a 247 1983 civil rights action, you must submit: (1) a completed complaint form and (2) a check or money order for $400 (which includes the $350 filing fee and the $50 administrative fee), or an inmate application to proceed in forma pauperis. If you have the money to pay the full $400 filing fee, please send a check or money If you are unable to pay the entire filing fee at the time you submit your complaint, please complete an application to proceed in forma pauperis. You may request the packet iling an Application to Proceed In Forma Pauperis by an Inmate under 28 U.S.C. 247 In civil actions filed by pro se (self-represented) inmates, the action must be filed in the unofficial division of the court in which the inmate is incarcerated when the complaint is submitted for filing. See Local Rules of Practice for the United States District Court for the IA 1-6, 1-8. The Clerk of the Court maintains offices in Las Vegas and Reno at the following addresses: Unofficial Southern Division (Clark, Esmeralda, Lincoln, & Nye counties): U.S. District Court Office of the Clerk 333 Las Vegas Boulevard, South, Room #1334 Las Vegas, NV 89101 Unofficial Northern Division (all other counties): U.S. District Court Office of the Clerk 400 S. Virginia Street, Room #301 Reno, NV 89501 If you are incarcerated at a facility that uses electronic filing, please continue to use electronic filing. American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 3 Revised 10/7/16 C. Completing the Civil Rights Complaint Form General Information You must complete the form in its entirety. All questions must be answered in order for your action to proceed. Your responses must be typewritten or legibly handwritten. You must sign page 9 of the form and declare under penalty of perjury that the facts stated in the complaint are true and correct. Do not write on the back of any of the pages. All information must be clearly and concisely written in the space provided on the form. Do not write in the margins. If you attach additional pages to the form, you must identify which section of the complaint is being continued and number the pages accordingly (e.g., 2-A, 2-B, 3-A, 3-B, etc.). All inmate-litigants are required to follow the Local Rules of Practice for the United States District Court for the District of Nevada. A copy of the Local Rules is maintained at each Nevada Department of Corrections Facility. Heading/Caption Your Name: Print your full name, prison or inmate number, and institutional mailing address on the lines provided. Defendants: If there are five or fewer defendants, print the name of each. If you are suing more than five defendants, print the name of the first defendant on the first line page, you must list the names of all defendants. Insert this additional page after page 1 and number the - Jury Demand 247 Bivens Action: If you are filing a complaint in which you are naming a federal officer as a 247 BIVENS Part A: Jurisdiction Page 1: Fill in all of the requested information about you on page 1 in the spaces provided. Page 2: Fill in all of the requested information about each of the defendants in the spaces provided. If you are naming more than five defendants, then make a copy of page 2 of the form and provide the necessary information for the additional defendants. --page(s) immediately behind page 2. Page 3: If you wish to assert jurisdiction under a different or additional statute(s), list them on page 3. /// American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 3 Revised 10/7/16 Part B: Nature of the Case Briefly give an overview of your case by providing general facts about your case. This is not the place to provide detailed information about what each defendant did to violate your rights (see Part C). Part C: Cause of Action This is where you identify what rights you claim the defendant(s) violated. The form provides three pages for alleging three counts. If you are alleging more than three counts, then attach an additional page for each additional count (so that there is only --the pages immediately behind page 6. You must identify which civil rights you claim have been violated. You need to state facts supporting the violation. You should be as specific as possible and describe what each individual defendant did to violate your rights. You should name the individual defendants and include dates when possible. Part D: Previous Lawsuits and Administrative Relief You must identify any other lawsuit you have filed in either state or federal court that relates to the same or similar claims that you have alleged in this civil rights complaint. You must exhaust any available administrative remedies before you file a civil rights complaint. See 42 U.S.C. 247 1997e. Consequently, you should disclose whether you have exhausted the inmate grievance procedures or administrative appeals for each claim in your complaint. If the grievance procedures were not available for any of your claims, fully explain why on the lines provided. Part E: Request for Relief Print the relief you are seeking in the space provided. Signature You must sign your name and print the date you signed the complaint. Failure to sign the complaint will delay the processing of your action. If someone wrote this civil rights complaint for you (such as an inmate law clerk), that person must write their name on the line next to your signature. D. Amended Complaints If you need to change any information in the initial complaint, you must file an amended complaint. The amended complaint must be written on the court-approved civil rights form. The amended complaint must be complete in itself and may not incorporate by reference any part of your prior complaint. Any allegations or defendants not included in the amended complaint are considered abandoned. Please refer to LR 15-1 and Fed. R. Civ. P. 15 for how and when a party may move the court to file an amended complaint. American LegalNet, Inc. www.FormsWorkFlow.com Name Prison NumberUNITED STATES DISTRICT COURTDISTRICT OF NEVADA ,)Plaintiff,))vs.)CASE NO. )(To be supplied by the Clerk) ,)) , )CIVIL RIGHTS COMPLAINT) PURSUANT TO ,)42 U.S.C. 247 1983) ,)) ,)Defendant(s).)A. JURISDICTION1)This complaint alleges that the civil rights of Plaintiff, , (Print Plaintiff222s name)who presently resides at , were violated by the actions of the below named individuals which were directed againstPlaintiff at on the following dates(institution/city where violation occurred) , , and .(Count I) (Count II)(Count III) American LegalNet, Inc. www.FormsWorkFlow.com 2Make a copy of this page to provide the belowinformation if you are naming more than five (5) defendants2) Defendant resides at , (full name of first defendant) (address if first defendant) and is employed as . This defendant is sued in his/her (defendant222s position and title, if any) individual official capacity. (Check one or both). Explain how this defendant wasacting under color of law: 3) Defendant resides at , (full name of first defendant) (address if first defendant) and is employed as . This defendant is sued in his/her (defendant222s position and title, if any) individual official capacity. (Check one or