Civil Cover Sheet (Ohio Northern District)
Civil Cover Sheet (Ohio Northern District) Form. This is a Ohio form and can be use in USDC Northern Federal.
Tags: Civil Cover Sheet (Ohio Northern District), JS 44, Ohio Federal, USDC Northern
JS 44 (N.D. Ohio) 1 Civil Cover Sheet The JS-44 Civil Cover Sheet and the information contained herein neither replace nor supplement the filing and service of pleadings or other papers as required by law, except as provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is required for the use of the Clerk of Court for the purpose of initiating the civil docket sheet. Please refer to the instructions on page 2. 1. (a) PLAINTIFFS DEFENDANTS (b) COUNTY OF RESIDENCE OF FIRST LISTED PLAINTIFF __________________________ COUNTY OF RESIDENCE OF FIRST LISTED DEFENDANT ____________________________ (IN U.S. PLAINTIFF CASES ONLY) NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF THE TRACT OF LAND (EXCEPT IN U.S. PLAINTIFF CASES) (c) ATTORNEY’S NAME (FIRM NAME, ADDRESS, AND TELEPHONE NUMBER) ATTORNEYS (IF KNOWN) II. BASIS OF JURISDICTION (PLACE A check IN ONE BOX ONLY) G 1 U.S. Government Plaintiff G 3 Federal Question (U.S. Gov’t Not a Party) G 2 U.S. Government Defendant III. CITIZENSHIP OF PRINCIPAL PARTIES (FOR DIVERSITY CASES ONLY) (PLACE A CHECK IN ONE BOX FOR PLAINTIFF AND IN ONE BOX FOR DEFENDANT PTF DEF PTF Citizen of this State G1 G1 Incorporated or Principal G4 Place of Business in this State G 4 Diversity (Indicate Citizenship of Parties in Item III) DEF G4 G 1 Original G 2 Removed from Proceeding State Court G 3 Remanded from Appellate Court V. NATURE OF SUIT Incorporated and Principal G5 Place of Business in another State G5 G3 Foreign Nation G6 (PLACE A CHECK IN ONE BOX ONLY) Transferred from G 4 Reinstated or G 5 another district Reopened (specify) Please click on the appropriate nature of suit TORTS FORFEITURE/PENALTY CONTRACT G 110 Insurance G 120 Marine G 130 Miller Act G 140 Negotiable Instrument PERSONAL INJURY G 310 Airplane G 315 Airplane Product Liability G 320 Assault, Libel, Slander PERSONAL INJURY G 362 Personal Injury– Med. Malpractice G 365 Personal Injury– Product Liability G 150 Overpayment Recovery & Enforcement of Judgment G 151 Medicare Act G 152 Recovery of Defaulted Student Loans G 330 Federal Employer’s G 340 Marine G 345 Marine Product Liability G 350 Motor Vehicle G 355 Motor Vehicle G 368 Asbestos Personal Injury Product Liability (Excluding Veterans) G 153 Recovery of Overpayment of Vet’s Benefits G 160 Stockholders’ Suits G 190 Other Contract G 195 Contract Prod. Liability Product Liability G 360 Other Pers. Injury REAL PROPERTY CIVIL RIGHTS G 441 Voting G 442 Employment G 443 Housing/ Accommodations G 444 Welfare G 440 Other Civil Rights G 210 Land Condemnation G 220 Foreclosure G 230 Rent Lease & Ejectm’t G 240 Torts to Land G 245 Tort Product Liability G 290 All Other Real Prop. G2 Citizen or Subject of a G 3 Foreign Country IV. ORIGIN Citizen of another State G 2 VI. CAUSE OF ACTION G 610 Agriculture G 620 Other Food & Drug G 625 Drug Related Seizure of Property 21 USC § 881 G6 G 6 Multidistrict Litigation BANKRUPTCY G 422 Appeal 28 USC § 158 G 423 Withdrawal 28 USC § 157 Appeal to District Judge from G 7 Magistrate Judgment OTHER STATUTES G 400 State Reapportionment G 410 Antitrust G 430 Banks & Banking G 450 Commerce/ICC Rates, etc. G 630 Liquor Laws G 640 Railroad & Truck G 650 Airline Regulations G 660 Occupational Safety/Health G 690 Other PROPERTY RIGHTS G 380 Other Personal Property Damage G 385 Property Damage Product Liability LABOR G 710 Fair Labor Standards Act G 720 Labor/Management Relations G 730 Labor/Management Reporting and Disclosure Act G 740 Railway Labor Act G 790 Other Labor Litigation SOCIAL SECURITY G 861 HIA (1395ff) G 862 Black Lung (923) G 863 DIWC/DIWW (405(g)) G 864 SSID Title XVI G 865 RSI (405(g)) G 891 Agricultural Acts G 892 Economic Stabilization Act G 893 Environmental Matters G 894 Energy Allocation Act G 895 Freedom of Information Act G 900 Appeal of Fee Determination Under Equal Access to Justice Act PRISONER PETITIONS G 510 Motions to Vacate Sentence HABEAS CORPUS: G 530 General G 535 Death Penalty G 540 Mandamus & Other G 550 Civil Rights G 555 Prison Conditions G 791 Employees Retirement Income Security Act (ERISA) FEDERAL TAX SUITS G 870 Taxes (U.S. Plaintiff or Def.) G 871 IRS–Third Party 26 USC § 7609 G 950 Constitutionality of State Statute G 890 Other Statutory Actions PERSONAL PROPERTY G 370 Other Fraud G 371 Truth in Lending G 820 Copyrights G 830 Patent G 840 Trademark G 460 Deportation G 470 Racketeer Influenced and Corrupt Organizations (Civil RICO) G 810 Selective Service G 850 Securities/Commodities/Exchange G 875 Customer Challenge 12 USC § 3410 (Cite the U.S. civil statute under which you are filing and write brief statement of cause. Do not cite jurisdictional statute unless this is a diversity action) G Check if this is a Fed. R. VII. REQUESTED IN Civ. P. 23 Class Action COMPLAINT: VIII. RELATED CASE(S) JUDGE IF ANY (SEE INSTRUCTIONS) _____________________________ DEMAND: $ CHECK YES ONLY IF DEMANDED IN COMPLAINT: JURY DEMAND: G YES G NO DOCKET NUMBER __________________________________________________ Date Signature of Attorney of Record FOR CLERK’S OFFICE USE ONLY RECEIPT NO. _______________________ AMOUNT $________________ JUDGE ________________________ MAGISTRATE JUDGE _____________________________ UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF OHIO I. Civil Categories: (Please check one category only). 1. 2. 3. General Civil Administrative Review/Social Security Habeas Corpus Death Penalty *If under Title 28, §2255, name the SENTENCING JUDGE: CASE NUMBER: II. RELATED OR REFILED CASES. See LR 3.1 which provides in pertinent part: "If an action is filed or removed to this Court and assigned to a District Judge after which it is discontinued, dismissed or remanded to a State court, and subsequently refiled, it shall be assigned to the same Judge who received the initial case assignment without regardfor the place of holding court in which the case was refiled. Counsel or a party without counsel shall be responsible for bringing such cases to the attention of the Court by responding to the questions included on the Civil Cover Sheet." This action is RELATED to another PENDING civil case. This action is REFILED pursuant to LR 3.1. If applicable, please indicate on page 1 in section VIII, the name of the Judge and case number. III. In accordance with Local Civil Rule 3.8, actions involving counties in the Eastern Division shall be filed at any of the divisional offices therein. Actions involving counties in the Western Division shall be filed at the Toledo office. For the purpose of determining the proper division, and for statistical reasons, the following information is requested. ANSWER ONE PARAGRAPH ONLY. ANSWER PARAGRAPHS 1 THRU 3 IN ORDER. UPON FINDING WHICH PARAGRAPH APPLIES TO YOUR CASE, ANSWER IT AND STOP. (1) Resident defendant. If the defendant resides in a county within this district, please set forth the name of such county COUNTY: Corporation For the purpose of answering the above, a corporation is deemed to be a resident of that county in which it has its principal place of business in that district. Non-Resident defendant. If no defendant is a resident of a county in this district, please set forth the county wherein the cause of action arose or the event complained of occurred. COUNTY: (2) (3) Other Cases. If no defendant is a resident of this district, or if the defendant is a corporation not having a principle place of business within the district, and the cause of action arose or the event complained of occurred outside this district, please set forth the county of the plaintiff's residence. COUNTY: IV. The Counties in the Northern District of Ohio are divided into divisions as shown below. After the county is determined in Section III, please check the appropriate division. EASTERN DIVISION AKRON CLEVELAND YOUNGSTOWN (Counties: Carroll, Holmes, Portage, Stark, Summit, Tuscarawas and Wayne) (Counties: Ashland, Ashtabula, Crawford, Cuyahoga, Geauga, Lake, Lorain, Medina and Richland) (Counties: Columbiana, Mahoning and Trumbull) WESTERN DIVISION TOLEDO (Counties: Allen, Auglaize, Defiance, Erie, Fulton, Hancock, Hardin, Henry, Huron, Lucas, Marion, Mercer, Ottawa, Paulding, Putnam, Sandusky, Seneca VanWert, Williams, Wood and Wyandot)