Pro Se Non Prisoner Complaint Form
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Pro Se Non Prisoner Complaint Form. This is a North Carolina form and can be use in USDC Middle Federal.
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Tags: Pro Se Non Prisoner Complaint Form, North Carolina Federal, USDC Middle
Rev. 6/03
UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF NORTH CAROLINA
Pro se [Non-prisoner] Complaint Form
________________________________,
(Your Name)
Plaintiff,
v.
Defendant(s).
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Civil Action No.
(to be assigned by the Clerk)
COMPLAINT
I.
JURISDICTION
______________________________________________________________________
II.
PARTIES
A.
Plaintiff
Name of Plaintiff:
Address:
B.
Defendant(s) (Notice: A person must be identified in subsections B and C in order to be
considered as a defendant.)
Name of Defendant:
Current Address:
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C.
Additional Defendants (please provide the same information for each defendant as listed
in Item B above):
III.
STATEMENT OF CLAIM
(State here as briefly as possible the FACTS of your case. Do this by identifying the
alleged legal wrong and by describing how each defendant named in Section II.B. and C.
above is personally responsible for depriving you of your rights. Include relevant times,
dates, and places. Also, you must state the basis for federal jurisdiction. In other words,
why should the case be in federal court as opposed to state court. DO NOT GIVE LEGAL
ARGUMENTS OR CITE ANY CASES. Number and set forth each separate claim in a separate
paragraph.) (Attach extra sheets if necessary.)
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III.
STATEMENT OF CLAIM - continued.
American LegalNet, Inc.
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IV.
RELIEF
State briefly and exactly what relief you want from this court.
Signed this
day of
, 20
.
Signature of plaintiff
Address
Telephone number
American LegalNet, Inc.
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