CIVIL COVER SHEET(SEE INSTRUCTIONS ON NEXT PAGE OF THIS FORM.)I.(a)PLAINTIFFSDEFENDANTS(b)(EXCEPT IN U.S. PLAINTIFF CASES)(IN U.S. PLAINTIFF CASES ONLY)(c)(Firm Name, Address, and Telephone Number)(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) PTF DEFPTF DEF(U.S. Government Not a Party)orand(Indicate Citizenship of Parties in Item III)IV.NATURE OF SUIT(Place an 223X224 in One Box Only) CONTRACTTORTSFORFEITURE/PENALTYBANKRUPTCYOTHER STATUTES PERSONAL INJURYPERSONAL INJURYPROPERTY RIGHTS PERSONAL PROPERTYLABORSOCIAL SECURITY REAL PROPERTY CIVIL RIGHTS PRISONER PETITIONSFEDERAL TAX SUITSHabeas Corpus:IMMIGRATIONOther:V.ORIGIN(Place an 223X224 in One Box Only)(specify)VI.CAUSE OF ACTION(Do not cite jurisdictional statutes unless diversity)VII.REQUESTED INCOMPLAINT:CLASS ACTIONDEMAND $JURY DEMAND:VIII.RELATED CASE(S)IF ANY(See instructions):FOR OFFICE USE ONLY American LegalNet, Inc. monetary damages sought are in excess of $150,000, exclusive of interest and costs, the complaint seeks injunctive relief, the matter is otherwise ineligible for the following reason DISCLOSURE STATEMENT - FEDERAL RULES CIVIL PROCEDURE 7.1 Identify any parent corporation and any publicly held corporation that owns 10% or more or its stocks: RELATED CASE STATEMENT (Section VIII on the Front of this Form) Please list all cases that are arguably related pursuant to Division of Business Rule 50.3.1 in Section VIII on the front of this form. Rule 50.3.1 (a) provides that 223A civil case is 223related224 to another civil case for purposes of this guideline when, because of the similarity of facts and legal issues or because the cases arise from the same transactions or events, a substantial saving of judicial resources is likely to result from assigning both cases to the same judge and magistrate judge.224 Rule 50.3.1 (b) provides that 223 A civil case shall not be deemed 223related224 to another civil case merely because the civil case: (A) involves identical legal issues, or (B) involves the same parties.224 Rule 50.3.1 (c) further provides that 223Presumptively, and subject to the power of a judge to determine otherwise pursuant to paragraph (d), civil cases shall not be deemed to be 223related224 unless both cases are still pending before the court.224 NY-E DIVISION OF BUSINESS RULE 50.1(d)(2) 1.) Is the civil action being filed in the Eastern District removed from a New York State Court located in Nassau or Suffolk County? Yes No 2.) If you answered 223no224 above: a)Did the events or omissions giving rise to the claim or claims, or a substantial part thereof, occur in Nassau or SuffolkCounty? Yes No b)Did the events or omissions giving rise to the claim or claims, or a substantial part thereof, occur in the EasternDistrict? Yes No c) If your answer to question 2 (b) is 223No,224 does the defendant (or a majority of the defendants, if there is more than one) reside in Nassau or Suffolk County, or, in an interpleader action, does the claimant (or a majority of the claimants, if there is more than one) reside in Nassau or Suffolk County?(Note: A corporation shall be considered a resident of the County in which it has the most significant contacts). BAR ADMISSION I am currently admitted in the Eastern District of New York and currently a member in good standing of the bar of this court. Yes No Are you currently the subject of any disciplinary action (s) in this or any other state or federal court? Yes (If yes, please explain No I certify the accuracy of all information provided above. Signature: