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Civil Cover Sheet (PA USDC Western) Form. This is a Pennsylvania form and can be use in USDC Western Federal.
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Tags: Civil Cover Sheet (PA USDC Western), JS 44, Pennsylvania Federal, USDC Western
JS 44 (Rev. 0) CIVIL COVER SHEETThe 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 asprovided 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 thepurpose of initiating the civil docket sheet. (SEE INSTRUCTIONS ON NEXT PAGE OF THIS FORM.)I.(a)PLAINTIFFSDEFENDANTS(b)County of Residence of First Listed PlaintiffCounty of Residence of First Listed Defendant(EXCEPT IN U.S. PLAINTIFF CASES)(IN U.S. PLAINTIFF CASES ONLY)NOTE:IN LAND CONDEMNATION CASES, USE THE LOCATION OF THE TRACT OF LAND INVOLVED.(c)Attorneys (Firm Name, Address, and Telephone Number) Attorneys (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) 1 U.S. Government3 Federal QuestionPTF DEFPTF DEFPlaintiff(U.S. Government Not a Party)Citizen of This State1 1Incorporated or Principal Place44 of Business In This State2 U.S. Government4 DiversityCitizen of Another State2 2Incorporated and Principal Place55Defendant(Indicate Citizenship of Parties in Item III)of Business In Another StateCitizen or Subject of a3 3Foreign Nation66 Foreign CountryIV.NATURE OF SUIT (Place an 223X224 in One Box Only)Click here for: Nature of Suit Code Descriptions .CONTRACTTORTSFORFEITURE/PENALTYBANKRUPTCYOTHER STATUTES110 Insurance PERSONAL INJURY PERSONAL INJURY625 Drug Related Seizure422 Appeal 28 USC 158375 False Claims Act120 Marine310 Airplane365 Personal Injury - of Property 21 USC 881423 Withdrawal376 Qui Tam (31 USC 130 Miller Act315 Airplane Product Product Liability690 Other 28 USC 157 3729(a))140 Negotiable Instrument Liability367 Health Care/400 State Reapportionment150 Recovery of Overpayment320 Assault, Libel & PharmaceuticalPROPERTY RIGHTS410 Antitrust & Enforcement of Judgment Slander Personal Injury820 Copyrights430 Banks and Banking151 Medicare Act330 Federal Employers222 Product Liability830 Patent450 Commerce152 Recovery of Defaulted Liability368 Asbestos Personal835 Patent - Abbreviated460 Deportation Student Loans340 Marine Injury Product New Drug Application470 Racketeer Influenced and (Excludes Veterans)345 Marine Product Liability840 Trademark Corrupt Organizations153 Recovery of Overpayment Liability PERSONAL PROPERTYLABORSOCIAL SECURITY480 Consumer Credit of Veteran222s Benefits350 Motor Vehicle370 Other Fraud710 Fair Labor Standards861 HIA (1395ff)485 Telephone Consumer 160 Stockholders222 Suits355 Motor Vehicle371 Truth in Lending Act862 Black Lung (923) Protection Act190 Other Contract Product Liability380 Other Personal720 Labor/Management863 DIWC/DIWW (405(g))490 Cable/Sat TV195 Contract Product Liability360 Other Personal Property Damage Relations864 SSID Title XVI850 Securities/Commodities/196 Franchise Injury385 Property Damage740 Railway Labor Act865 RSI (405(g)) Exchange362 Personal Injury - Product Liability751 Family and Medical890 Other Statutory Actions Medical Malpractice Leave Act891 Agricultural Acts REAL PROPERTY CIVIL RIGHTS PRISONER PETITIONS790 Other Labor LitigationFEDERAL TAX SUITS893 Environmental Matters210 Land Condemnation440 Other Civil RightsHabeas Corpus:791 Employee Retirement870 Taxes (U.S. Plaintiff895 Freedom of Information220 Foreclosure441 Voting463 Alien Detainee Income Security Act or Defendant) Act230 Rent Lease & Ejectment442 Employment510 Motions to Vacate871 IRS227Third Party896 Arbitration240 Torts to Land443 Housing/ Sentence 26 USC 7609899 Administrative Procedure245 Tort Product Liability Accommodations530 General Act/Review or Appeal of290 All Other Real Property445 Amer. w/Disabilities -535 Death PenaltyIMMIGRATION Agency Decision EmploymentOther:462 Naturalization Application950 Constitutionality of446 Amer. w/Disabilities -540 Mandamus & Other465 Other Immigration State Statutes Other550 Civil Rights Actions448 Education555 Prison Condition560 Civil Detainee - Conditions of ConfinementV.ORIGIN (Place an 223X224 in One Box Only)1OriginalProceeding2Removed fromState Court 3Remanded fromAppellate Court4Reinstated orReopened 5Transferred fromAnother District(specify) 6MultidistrictLitigation -Transfer8 Multidistrict Litigation - Direct FileVI.CAUSE OF ACTIONCite the U.S. Civil Statute under which you are filing (Do not cite jurisdictional statutes unless diversity):Brief description of cause:VII.REQUESTED INCOMPLAINT:CHECK IF THIS IS A CLASS ACTIONUNDER RULE 23, F.R.Cv.P.DEMAND $CHECK YES only if demanded in complaint:JURY DEMAND:YesNoVIII.RELATED CASE(S)IF ANY(See instructions):JUDGEDOCKET NUMBERDATESIGNATURE OF ATTORNEY OF RECORDFOR OFFICE USE ONLYRECEIPT #AMOUNTAPPLYING IFPJUDGEMAG. JUDGE American LegalNet, Inc. www.FormsWorkFlow.com JS 44REVISED June, 2009 IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF PENNSYLVANIA THIS CASE DESIGNATION SHEET MUST BE COMPLETED PART A This case belongs on the ( Erie Johnstown Pittsburgh) calendar. 1.ERIE CALENDAR - If cause of action arose in the counties of Crawford, Elk, Erie,Forest, McKean. Venang or Warren, OR any plaintiff or defendant resides in one of said counties. 2.JOHNSTOWN CALENDAR - If cause of action arose in the counties of Bedford, Blair,Cambria, Clearfield or Somerset OR any plaintiff or defendant resides in one of said counties. 3.Complete if on ERIE CALENDAR: I certify that the cause of action arose in County and that the resides in County. 4.Complete if on JOHNSTOWN CALENDAR: I certify that the cause of action arose in County and that the resides in County. PART B (You are to check ONE of the following) 1.This case is related to Number . Short Caption . 2.This case is not related to a pending or terminated case.DEFINlTIONS OF RELATED CASES: CIVIL: Civil cases are deemed related when a case filed relates to property included in another suit or involves the same issues of fact or it grows out of the same transactions as another suit or involves the validity or infringement of a patent involved in another suit EMINENT DOMAIN: Cases in contiguous closely located groups and in common ownership groups which will lend themselves to consolidation for trial shall be deemed related. HABEAS CORPUS & CIVIL RIGHTS: All habeas corpus petitions filed by the same individual shall be deemed related. All pro se Civil Rights actions by the same individual shall be deemed related. PARTC I. CIVIL CATEGORY (applicable category). 1.Antitrust and Securities Act Cases2.Labor-Management Relations3.Habeas corpus4.Civil Rights5.Patent, Copyright, and Trademark6.Eminent Domain7.All other federal question cases8.All personal and property damage tort cases, including maritime, FELA,Jones Act, Motor vehicle, products liability, assault, defamation, malicious prosecution, and false arrest 9. Insurance indemnity, contract and other diversity cases. 10.Government Collection Cases (shall include HEW Student Loans (Education),V A 0verpayment, Overpayment of Social Security, Enlistment Overpayment (Army, Navy, etc.), HUD Loans, GAO Loans (Misc. Types), Mortgage Foreclosures, SBA Loans, Civil Penalties and Coal Mine Penalty and Reclamation Fees.) I certify that to the best of my knowledge the entries on this Case Designation Sheet are true and correct Date: ATTORNEY AT LAWNOTE: ALL SECTIONS OF BOTH MUST BE COMPLETED BEFORE CASE CAN BE PROCESSED. American LegalNet, Inc. www.FormsWorkFlow.com JS 44 Reverse (Rev. 0) INSTRUCTIONS FOR ATTORNEYS COMPLETING CIVIL COVER SHEET FORM JS 44Authority For Civil Cover SheetThe JS 44 civil cover sheet and the information contained herein neither replaces nor supplements the filings and service of pleading or other papers asrequired by law, except as provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, isrequired for the use of the Clerk of Court for the purpose of initiating the civil docket sheet. Consequently, a civil cover sheet is submitted to the Clerk ofCourt for each civil complaint filed. The attorney filing