Conj . Chevy (vie ML]oy S0FVing - 20/ □ UNITED STATES DISTRICT COURT CNL. Brigg ett; SOUTHERN DISTRICT OF NEW YORK rm Oo □□ ee ee eee ee nee en ene eee eee ee eee eee X af TERRELL K. BROCK, : Plaintiff, : □□□ ORDER □□ CVS CORPORATION; LEONARDO : □□ (P7, □□ CORONADO; ASHLEY CAMACHO; CITY OF : 22 CV 4014 (VB) “LLY Y. 22 WHITE PLAINS; JOSE LUIS FORMOSO; and _ : P.O, C. BROWNING, Defendants. : ee eee ee ee eee ne nee enn see eee ne ee see eee een X Plaintiff, who is proceeding pro se and in forma pauperis, commenced this action on May 16, 2022. (Doc. #2). By Orders dated November 21, 2022 (Doc. #37), and December 7, 2022 (Doc. #53), the Court set out additional, relevant procedural history of the case. By Order dated December 7, 2022, the Court extended plaintiff’s time to file his third amended complaint to January 23, 2023. (Doc. #53). The Court also directed plaintiff to include in his third amended complaint the names of all defendants, including the officers newly identified by the White Plains Law Department. (Id.). On December 19, 2022, the Court received from plaintiff (i) a third amended complaint, dated November 30, 2022, and postmarked December 12, 2022, which does not contain the names of the newly-identified officers (Doc #58), and (ii) a letter from plaintiff postmarked December 13, 2022, in which plaintiff states he is “unaware if I added all 6 officers names” to his third amended complaint. (Doc. #57). Accordingly, it is HEREBY ORDERED: 1. By January 23, 2023, plaintiff shall file a fourth amended complaint. The fourth amended complaint shall list the full names of all defendants, including White Plains Police Officers Beall, Dipaterio, Glynn, Horgan, Levito, and Schneider. Plaintiff shall use the fourth amended complaint form attached to this Order. The fourth amended complaint will completely replace, not merely supplement, the third amended complaint. Therefore, plaintiff must include in the fourth amended complaint all information necessary for his claims. 2. Because plaintiff is proceeding in forma pauperis, he is entitled to rely on the Court and the U.S. Marshals Service to effect service. Once the Court receives and screens the fourth amended complaint, it will issue an appropriate order directing the Clerk of Court to issue summonses for the newly identified defendants and to deliver to the U.S. Marshals all materials necessary to effect service. To be clear, plaintiff does not need to do anything to effect service on defendants.
3. Plaintiff’s service deadline pursuant to Fed. R. Civ. P. 4(m) is STAYED pending further Court Order. Once the Court receives the fourth amended complaint, it will set a service deadline pursuant to Fed. R. Civ. P. 4(m). 4, The time for all parties to answer, move, or otherwise respond to the complaints and any cross-claims remains STAYED pending further Court Order. The Court certifies under 28 U.S.C. § 1915(a)(3) that any appeal from this Order would not be taken in good faith, and therefore in forma pauperis status is denied for the purpose of an appeal. Cf. Coppedge v. United States, 369 U.S. 438, 444-45 (1962). Chambers will mail a copy of this Order to plaintiff at the address on the docket. Dated: December 20, 2022 White Plains, NY SO ORDERED:
Vincent L, Briccetti United States District Judge
UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK
No. Write the full name of each plaintiff, (To be filled out by Clerk’s Office) FOURTH AMENDED -against- COMPLAINT (Prisoner) Do you want a jury trial? OYes ONo
Write the full name of each defendant. If you cannot fit the names of all of the defendants in the space provided, please write “see attached” in the space above and attach an additional sheet of paper with the full list of names. The names listed above must be identical to those contained in Section IV.
NOTICE The public can access electronic court files. For privacy and security reasons, papers filed with the court should therefore not contain: an individual's full social security number or full birth date; the full name of a person known to be a minor; or a complete financial account number. A filing may include only: the last four digits of a social security number; the year of an individual’s birth; a minor’s initials; and the last four digits of a financial account number. See Federal Rule of Civil Procedure 5.2,
Rev. 5/6/16
I. LEGAL BASIS FOR CLAIM State below the federal legal basis for your claim, if known. This form is designed primarily for prisoners challenging the constitutionality of their conditions of confinement; those claims are often brought under 42 U.S.C. § 1983 (against state, county, or municipal defendants) or in a “Bivens” action (against federal defendants). Violation of my federal constitutional rights C] Other: II. PLAINTIFF INFORMATION Each plaintiff must provide the following information. Attach additional pages if necessary.
First Name Middle Initial Last Name
State any other names (or different forms of your name) you have ever used, including any name you have used in previously filing a lawsuit.
Prisoner ID # (if you have previously been in another agency’s custody, please specify each agency and the ID number (such as your DIN or NYSID) under which you were held)
Current Place of Detention
Institutional Address
County, City . State Zip Code IJ. PRISONER STATUS Indicate below whether you are a prisoner or other confined person: C) Pretrial detainee Civilly committed detainee Immigration detainee CL] Convicted and sentenced prisoner Other:
Page 2
IV. DEFENDANT INFORMATION To the best of your ability, provide the following information for each defendant. If the correct information is not provided, it could delay or prevent service of the complaint on the defendant. Make sure that the defendants listed below are identical to those listed in the caption. Attach additional pages as necessary. Defendant 1: First Name Last Name Shield #
Current Job Title (or other identifying information) Current Work Address County, City State Zip Code Defendant 2: First Name Last Name Shield #
Current Job Title (or other identifying information) Current Work Address
County, City State Zip Code Defendant 3: First Name Last Name Shield #
Current Job Title (or other identifying information)
Current Work Address
County, City State Zip Code Defendant 4: First Name Last Name Shield #
Current Job Title (or other identifying information) Current Work Address
County, City State Zip Code
Page 3
V. STATEMENT OF CLAIM Place(s) of occurrence:
Date(s) of occurrence: FACTS: State here briefly the FACTS that support your case. Describe what happened, how you were harmed, and how each defendant was personally involved in the alleged wrongful actions. Attach additional pages as necessary.
Page 4
INJURIES: If you were injured as a result of these actions, describe your injuries and what medical treatment, if any, you required and received.
VI. RELIEF State briefly what money damages or other relief you want the court to order.
Page 5
VIL.
Free access — add to your briefcase to read the full text and ask questions with AI
Conj . Chevy (vie ML]oy S0FVing - 20/ □ UNITED STATES DISTRICT COURT CNL. Brigg ett; SOUTHERN DISTRICT OF NEW YORK rm Oo □□ ee ee eee ee nee en ene eee eee ee eee eee X af TERRELL K. BROCK, : Plaintiff, : □□□ ORDER □□ CVS CORPORATION; LEONARDO : □□ (P7, □□ CORONADO; ASHLEY CAMACHO; CITY OF : 22 CV 4014 (VB) “LLY Y. 22 WHITE PLAINS; JOSE LUIS FORMOSO; and _ : P.O, C. BROWNING, Defendants. : ee eee ee ee eee ne nee enn see eee ne ee see eee een X Plaintiff, who is proceeding pro se and in forma pauperis, commenced this action on May 16, 2022. (Doc. #2). By Orders dated November 21, 2022 (Doc. #37), and December 7, 2022 (Doc. #53), the Court set out additional, relevant procedural history of the case. By Order dated December 7, 2022, the Court extended plaintiff’s time to file his third amended complaint to January 23, 2023. (Doc. #53). The Court also directed plaintiff to include in his third amended complaint the names of all defendants, including the officers newly identified by the White Plains Law Department. (Id.). On December 19, 2022, the Court received from plaintiff (i) a third amended complaint, dated November 30, 2022, and postmarked December 12, 2022, which does not contain the names of the newly-identified officers (Doc #58), and (ii) a letter from plaintiff postmarked December 13, 2022, in which plaintiff states he is “unaware if I added all 6 officers names” to his third amended complaint. (Doc. #57). Accordingly, it is HEREBY ORDERED: 1. By January 23, 2023, plaintiff shall file a fourth amended complaint. The fourth amended complaint shall list the full names of all defendants, including White Plains Police Officers Beall, Dipaterio, Glynn, Horgan, Levito, and Schneider. Plaintiff shall use the fourth amended complaint form attached to this Order. The fourth amended complaint will completely replace, not merely supplement, the third amended complaint. Therefore, plaintiff must include in the fourth amended complaint all information necessary for his claims. 2. Because plaintiff is proceeding in forma pauperis, he is entitled to rely on the Court and the U.S. Marshals Service to effect service. Once the Court receives and screens the fourth amended complaint, it will issue an appropriate order directing the Clerk of Court to issue summonses for the newly identified defendants and to deliver to the U.S. Marshals all materials necessary to effect service. To be clear, plaintiff does not need to do anything to effect service on defendants.
3. Plaintiff’s service deadline pursuant to Fed. R. Civ. P. 4(m) is STAYED pending further Court Order. Once the Court receives the fourth amended complaint, it will set a service deadline pursuant to Fed. R. Civ. P. 4(m). 4, The time for all parties to answer, move, or otherwise respond to the complaints and any cross-claims remains STAYED pending further Court Order. The Court certifies under 28 U.S.C. § 1915(a)(3) that any appeal from this Order would not be taken in good faith, and therefore in forma pauperis status is denied for the purpose of an appeal. Cf. Coppedge v. United States, 369 U.S. 438, 444-45 (1962). Chambers will mail a copy of this Order to plaintiff at the address on the docket. Dated: December 20, 2022 White Plains, NY SO ORDERED:
Vincent L, Briccetti United States District Judge
UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK
No. Write the full name of each plaintiff, (To be filled out by Clerk’s Office) FOURTH AMENDED -against- COMPLAINT (Prisoner) Do you want a jury trial? OYes ONo
Write the full name of each defendant. If you cannot fit the names of all of the defendants in the space provided, please write “see attached” in the space above and attach an additional sheet of paper with the full list of names. The names listed above must be identical to those contained in Section IV.
NOTICE The public can access electronic court files. For privacy and security reasons, papers filed with the court should therefore not contain: an individual's full social security number or full birth date; the full name of a person known to be a minor; or a complete financial account number. A filing may include only: the last four digits of a social security number; the year of an individual’s birth; a minor’s initials; and the last four digits of a financial account number. See Federal Rule of Civil Procedure 5.2,
Rev. 5/6/16
I. LEGAL BASIS FOR CLAIM State below the federal legal basis for your claim, if known. This form is designed primarily for prisoners challenging the constitutionality of their conditions of confinement; those claims are often brought under 42 U.S.C. § 1983 (against state, county, or municipal defendants) or in a “Bivens” action (against federal defendants). Violation of my federal constitutional rights C] Other: II. PLAINTIFF INFORMATION Each plaintiff must provide the following information. Attach additional pages if necessary.
First Name Middle Initial Last Name
State any other names (or different forms of your name) you have ever used, including any name you have used in previously filing a lawsuit.
Prisoner ID # (if you have previously been in another agency’s custody, please specify each agency and the ID number (such as your DIN or NYSID) under which you were held)
Current Place of Detention
Institutional Address
County, City . State Zip Code IJ. PRISONER STATUS Indicate below whether you are a prisoner or other confined person: C) Pretrial detainee Civilly committed detainee Immigration detainee CL] Convicted and sentenced prisoner Other:
Page 2
IV. DEFENDANT INFORMATION To the best of your ability, provide the following information for each defendant. If the correct information is not provided, it could delay or prevent service of the complaint on the defendant. Make sure that the defendants listed below are identical to those listed in the caption. Attach additional pages as necessary. Defendant 1: First Name Last Name Shield #
Current Job Title (or other identifying information) Current Work Address County, City State Zip Code Defendant 2: First Name Last Name Shield #
Current Job Title (or other identifying information) Current Work Address
County, City State Zip Code Defendant 3: First Name Last Name Shield #
Current Job Title (or other identifying information)
Current Work Address
County, City State Zip Code Defendant 4: First Name Last Name Shield #
Current Job Title (or other identifying information) Current Work Address
County, City State Zip Code
Page 3
V. STATEMENT OF CLAIM Place(s) of occurrence:
Date(s) of occurrence: FACTS: State here briefly the FACTS that support your case. Describe what happened, how you were harmed, and how each defendant was personally involved in the alleged wrongful actions. Attach additional pages as necessary.
Page 4
INJURIES: If you were injured as a result of these actions, describe your injuries and what medical treatment, if any, you required and received.
VI. RELIEF State briefly what money damages or other relief you want the court to order.
Page 5
VIL. PLAINTIFF'S CERTIFICATION AND WARNINGS By signing below, I certify to the best of my knowledge, information, and belief that: (1) the complaint is not being presented for an improper purpose (such as to harass, cause unnecessary delay, or needlessly increase the cost of litigation); (2) the claims are supported by existing law or by anonfrivolous argument to change existing law; (3) the factual contentions have evidentiary support or, if specifically so identified, will likely have evidentiary support after a reasonable opportunity for further investigation or discovery; and (4) the complaint otherwise complies with the requirements of Federal Rule of Civil Procedure 11. I understand that if I file three or more cases while I am a prisoner that are dismissed as frivolous, malicious, or for failure to state a claim, I may be denied in forma pauperis status in future cases. I also understand that prisoners must exhaust administrative procedures before filing an action in federal court about prison conditions, 42 U.S.C. § 1997e(a), and that my case may be dismissed if I have not exhausted administrative remedies as required. I agree to provide the Clerk's Office with any changes to my address, I understand that my failure to keep a current address on file with the Clerk's Office may result in the dismissal of my case,
Each Plaintiff must sign and date the complaint. Attach additional pages if necessary. If seeking to proceed without prepayment of fees, each plaintiff must also submit an IFP application.
Dated Plaintiff's Signature First Name Middle Initial Last Name
Prison Address
Date on which | am delivering this complaint to prison authorities for mailing:
Page 6