UNITED STATES DISTRICT COURT DISTRICT OF SOUTH DAKOTA DIVISION _________________________________________ _________________________________________ _________________________________________ _________________________________________ (Enter the full name of the Plaintiff[s] in this action) vs. __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ (Enter the full name of ALL Defendant[s] in this action. Fed. R. Civ. P. 10(a) requires that the caption of the complaint include the names of all the parties. Merely listing one party and "et al." is insufficient. Please attach additional sheets if necessary.) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) Case No. __________________ (To be assigned by Clerk of District Court) COMPLAINT I. State the grounds for filing this case in Federal Court (include federal statutes and/or U.S. Constitution provisions, if you know them. Fed .R .Civ. P. 8(a)(1) requires a short and plain statement of the grounds for the court's jurisdiction.): _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ ____________________________________________________________________ 1 American LegalNet, Inc. www.FormsWorkFlow.com II. Plaintiff,___________________________ resides at _____________________________________ (street address) _______________________,__________________, (city) (county) _________________,_______,___________________________ (state) (zip) (telephone number) (If more than one plaintiff, provide the same information for each plaintiff below) _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ III. Defendant, _______________________resides at, or its business is located at _____________________________________ (street address) ___________________________, _____________________, (city) (county) _______________,_______,___________________________ (state) (zip) (telephone number) (If more than one defendant, provide the same information for each defendant below) _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ 2 American LegalNet, Inc. www.FormsWorkFlow.com IV. V. Statement of claim (State as briefly as possible the facts of your case. Describe how each defendant is involved. You must state exactly what each defendant personally did, or failed to do, which resulted in harm to you. Include also the names of other persons involved, dates, and places. Be as specific as possible. You may use additional paper if necessary): _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ Relief (State briefly and exactly what you want the Court to do for you.) _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ ___________________________________________________