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Form To Be Used In Filing Complaint Under Civil Rights Act 42 USC 1983 (Prisoner Complaint Form) Form. This is a New York form and can be use in District Court Federal.
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Revised 05/01 WDNY UNITED STATES DISTRICT COURT WESTERN DISTRICT OF NEW YORK HOW TO FILE YOUR CIVIL RIGHTS CASE UNDER 42 U.S.C. 1983 (Instructions for Prisoners Complaint) The Western Districts web site at www.nywd.uscourts.gov contains copies of many of the Courts forms and other useful information.IMPORTANT: This packet includes the civil rights complaint forms and additional materials you have requested.Although you are not required to submit your complaint on the complaint form, you must provide all theinformation requested on that form. If you choose not to use the official form, be sure that you provide all theinformation that is requested on the official form and that you enclose the proper number of correctly filledout supporting documents. If your papers are not properly completed, your papers will be returned to you forcorrection of any deficiencies. Based on the mandates of 28 U.S.C. 1915 and 1915A, the Court will conduct an initial review of any complaintof a prisoner who either is seeking in forma pauperis status under 1915 or who is suing a governmental entity,officer or employee. Because until this review is conducted, it is not certain that all of your claims against all ofyour defendants will remain when the Court directs service of your complaint, the Court will not send you U.S.Marshal forms and summons forms at this time. Additionally, based on its review of the complaint, the Court may dismissed the claims in whole or in part and itmay also require you to file an amended complaint. Therefore, you should wait until the initial review of thecomplaint is completed and you know which complaint will be going forward and how many copies of thecomplaint will be needed before you make more than one set of copies of your papers. (You should keep for yourown records one copy of the papers you send to the Court.)You will be sent the correct number of U.S. Marshal and summons forms when the Court directs service of thecomplaint. At that time, you should complete the forms and return them to the Court, together with the appropriatenumber of exact copies of your complaint, so that the U.S. Marshal may serve your summons and complaint on thedefendants. Your new action will be accepted for filing if your papers include the following: (1) one completed and signed complaint form, (2) one signed Authorization, together with a completed and signed application to proceed in forma pauperis (in which the prison certification section has been filled in and signed by the appropriate person in your correctional facility), and (3) one completed and signed Civil Cover Sheet.Follow the instructions below for completing each form and gathering the documents together for filing. Note thatthese instructions also deal with other issues which will arise in your case.>>>> 2I. COMPLAINT FORM 1. To start an action, you must file a complaint which contains an original signature. You should also keep an exact copy of the complaint for your records. After the Court has determined that your case is going forward and against whom it is going forward, you will be required to provide an exact copy of the complaint which is going forward (note that it may be an amended complaint at that point) for each defendant against whom the case is proceeding, and one extra copy. For example, if the case is going forward against two defendants, you must file the original and three copies of the complaint (one original, plus a copy for each of the two defendants plus one extra copy). All copies of the complaint must be identical to the original. Do not prepare these copies for the defendants until the Court advises you of the form of the complaint which is going forward and the number of copies which will be needed.2. Your complaint must be legibly handwritten or typewritten, in blue or black ink if possible, preferably on the enclosed forms. If you need additional space to answer a question, you may attach additional pages. However, additional pages should be used only if absolutely necessary; your complaint should be specific but as brief as possible; you should not include legal argument or case citations in your complaint allegations. Just tell your story simply and clearly. Please refer to Rules 8(a)(2) and 10(b) of the Federal Rules of Civil Procedure for the requirements governing the format and content of your complaint. Failure to comply with these requirements may lead to a Court order rejecting your complaint until it does comply.3. Section 1: Caption This section requires you to list your name and prisoner number as the plaintiff and the names of all of the defendants. Do not use abbreviations such as "etc." or "et al." Also, note that only those defendants whose names are listed in this Section (or in the caption if you do not use the official forms) will be considered by the Court as defendants. 4. Section 2: Jurisdiction This section states that you have brought this action pursuant to the Civil Rights Statute, 42 U.S.C. 1983, and that the Court has jurisdiction over your claims under 28 U.S.C. 1331, 1343(3) and (4), and 2201. You may add additional jurisdictional statutes, if appropriate.5. Section 3: Parties to This Action This section requires you to identify the parties to the lawsuit. (You should set out in Section 1: Caption only the parties names and perhaps their titles (such as Dr. or Sergeant)). In Section 3: Parties, you must provide the parties official positions and addresses, and you may provide any other information which may assist in identifying or locating the parties. If you are not using the official forms, your complaint must have a section which identifies and locates the parties in this way.6. Section 4: Previous Lawsuits This section requires you to provide detailed, accurate and thorough information about all previous lawsuits you have filed. If you cannot provide all of the details requested, you must provide as much information as you can. Deliberate misrepresentation or omission of information is perjury and is punishable by law. 7. Section 5: Statement of Claim This section, which is divided into separate sub-sections for each claim, requires you to tell the Court when each alleged constitutional violation occurred, which defendant(s) did the violation and specifically what each of the defendant(s) did to you. You must provide specific facts 2>>>> 3 regarding each claim; these facts should demonstrate to the Court how y