1 WO JL 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA 8 9 Joseph Benedict Melone, No. CV 21-02097-PHX-MTL (MTM) 10 Plaintiff, 11 v. ORDER 12 Federal Bureau of Investigation, et al., 13 Defendants.
14 15 On December 9, 2021, Plaintiff Joseph Benedict Melone, who is confined in the 16 Arizona State Prison Complex-Yuma, filed a pro se civil rights Complaint pursuant to 42 17 U.S.C. § 1983 and an Application to Proceed In Forma Pauperis. On December 15, 2021, 18 the Court denied the deficient Application to Proceed, dismissed the Complaint because it 19 was not filed on a court-approved form, and gave Plaintiff 30 days to (1) pay the filing and 20 administrative fees or file a complete Application to Proceed In Forma Pauperis and (2) file 21 an amended complaint using the court-approved form included with the Order. 22 On January 7, 2022, Plaintiff filed a second Application to Proceed In Forma 23 Pauperis and a First Amended Complaint (Doc. 5), which superseded the original 24 Complaint in its entirety. On January 11, 2022, the Court denied the deficient Application 25 to Proceed and gave Plaintiff 30 days to pay the filing and administrative fees or file a 26 complete Application to Proceed In Forma Pauperis. Plaintiff subsequently filed two more 27 deficient Applications to Proceed, both of which the Court denied. 28 . . . . 1 On March 30, 2022, Plaintiff filed another Application to Proceed In Forma 2 Pauperis (Doc. 15). The Court will grant the March 30, 2022 Application to Proceed and 3 dismiss the First Amended Complaint with leave to amend. 4 I. Application to Proceed In Forma Pauperis and Filing Fee 5 The Court will grant Plaintiff’s Application to Proceed In Forma Pauperis. 28 6 U.S.C. § 1915(a). Plaintiff must pay the statutory filing fee of $350.00. 28 U.S.C. 7 § 1915(b)(1). The Court will assess an initial partial filing fee of $28.98. The remainder 8 of the fee will be collected monthly in payments of 20% of the previous month’s income 9 credited to Plaintiff’s trust account each time the amount in the account exceeds $10.00. 10 28 U.S.C. § 1915(b)(2). The Court will enter a separate Order requiring the appropriate 11 government agency to collect and forward the fees according to the statutory formula. 12 II. Statutory Screening of Prisoner Complaints 13 The Court is required to screen complaints brought by prisoners seeking relief 14 against a governmental entity or an officer or an employee of a governmental entity. 28 15 U.S.C. § 1915A(a). The Court must dismiss a complaint or portion thereof if a plaintiff 16 has raised claims that are legally frivolous or malicious, that fail to state a claim upon which 17 relief may be granted, or that seek monetary relief from a defendant who is immune from 18 such relief. 28 U.S.C. § 1915A(b)(1)–(2). 19 A pleading must contain a “short and plain statement of the claim showing that the 20 pleader is entitled to relief.” Fed. R. Civ. P. 8(a)(2) (emphasis added). While Rule 8 does 21 not demand detailed factual allegations, “it demands more than an unadorned, the- 22 defendant-unlawfully-harmed-me accusation.” Ashcroft v. Iqbal, 556 U.S. 662, 678 23 (2009). “Threadbare recitals of the elements of a cause of action, supported by mere 24 conclusory statements, do not suffice.” Id. 25 “[A] complaint must contain sufficient factual matter, accepted as true, to ‘state a 26 claim to relief that is plausible on its face.’” Id. (quoting Bell Atlantic Corp. v. Twombly, 27 550 U.S. 544, 570 (2007)). A claim is plausible “when the plaintiff pleads factual content 28 that allows the court to draw the reasonable inference that the defendant is liable for the 1 misconduct alleged.” Id. “Determining whether a complaint states a plausible claim for 2 relief [is] . . . a context-specific task that requires the reviewing court to draw on its judicial 3 experience and common sense.” Id. at 679. Thus, although a plaintiff’s specific factual 4 allegations may be consistent with a constitutional claim, a court must assess whether there 5 are other “more likely explanations” for a defendant’s conduct. Id. at 681. 6 But as the United States Court of Appeals for the Ninth Circuit has instructed, courts 7 must “continue to construe pro se filings liberally.” Hebbe v. Pliler, 627 F.3d 338, 342 8 (9th Cir. 2010). A “complaint [filed by a pro se prisoner] ‘must be held to less stringent 9 standards than formal pleadings drafted by lawyers.’” Id. (quoting Erickson v. Pardus, 551 10 U.S. 89, 94 (2007) (per curiam)). 11 If the Court determines that a pleading could be cured by the allegation of other 12 facts, a pro se litigant is entitled to an opportunity to amend a complaint before dismissal 13 of the action. See Lopez v. Smith, 203 F.3d 1122, 1127-29 (9th Cir. 2000) (en banc). 14 Plaintiff’s First Amended Complaint will be dismissed for failure to state a claim, but 15 because it may possibly be amended to state a claim, the Court will dismiss it with leave 16 to amend. 17 III. Background 18 Plaintiff pleaded guilty in Maricopa County Superior Court case #CR2013-428089 19 to one count of aggravated driving under the influence and was sentenced to probation.1 20 On December 17, 2019, Plaintiff was charged in this Court with one count of possession 21 of a firearm by a person subject to a court order. United States v. Melone, CR 19-01415- 22 PHX-DGC (D. Ariz. 2019). The Court required Plaintiff to be detained pending trial in 23 that case. Id. (Doc. 14). 24 Also on December 17, 2019, the State filed a petition to revoke Plaintiff’s probation 25 in his state court proceeding.2 On December 16, 2020, Plaintiff pleaded guilty to the charge 26
27 1 See http://www.superiorcourt.maricopa.gov/docket/CriminalCourtCases/caseInfo .asp?caseNumber=CR2013-428089 (last accessed Mar. 30, 2022). 28 2 Id. 1 in CR 19-01415, and the next day, the Court sentenced him to a 24-month term of 2 imprisonment, followed by 2 years on supervised release. Id. (Docs. 67, 68). 3 On July 7, 2021, the trial court in Plaintiff’s state criminal proceeding revoked his 4 probation and sentenced him to 2.5 years in prison.3 5 IV. First Amended Complaint 6 In his two-count First Amended Complaint, Plaintiff sues the Federal Bureau of 7 Investigation (FBI), Special Agents Jason Saitta and Jennifer Banszowski, Maricopa 8 County Adult Probation, and Probation Officers Carrie Ward and Arthur Christian. 9 Plaintiff asserts claims relating to a search of his home and his subsequent arrest. He seeks 10 a declaration that 18 U.S.C. § 922(g)(1) and (g)(8) are unconstitutional, as well as monetary 11 relief. 12 In Count One, Plaintiff alleges that on December 13, 2019, three non-party FBI 13 Agents verbally opened an investigation into Plaintiff. Defendant Saitta “drafted” the 14 investigation. Plaintiff alleges that federal agents contacted Defendant Maricopa County 15 Adult Probation, without probable cause, to “use a date” that Defendant Christian had 16 scheduled for a home visit at Plaintiff’s residence “for a mechanism as subterfuge for a 17 valid warrant.” Plaintiff claims federal agents conspired with Defendant Maricopa County 18 Adult Probation to conduct an illegal search of Plaintiff’s residence in violation of his 19 Fourth Amendment rights. As his injury, Plaintiff asserts his privacy was unjustly invaded, 20 he was unjustly detained in his home, and he was incarcerated and denied bail. 21 In Count Two, Plaintiff alleges that Defendants Christian, Ward, and Banszowski 22 illegally entered Plaintiff’s residence, conducted an illegal search, and illegally seized a 23 Glock 43 handgun that Plaintiff kept in his home for self-defense purposes, in violation of 24 his Second Amendment rights. 25 V. Failure to State a Claim 26 To prevail in a § 1983 claim, a plaintiff must show that (1) acts by the defendants 27 (2) under color of state law (3) deprived him of federal rights, privileges or immunities and
28 3 Id. 1 (4) caused him damage. Thornton v. City of St. Helens, 425 F.3d 1158, 1163-64 (9th Cir. 2 2005) (quoting Shoshone-Bannock Tribes v. Idaho Fish & Game Comm’n, 42 F.3d 1278, 3 1284 (9th Cir. 1994)). In addition, a plaintiff must allege that he suffered a specific injury 4 as a result of the conduct of a particular defendant and he must allege an affirmative link 5 between the injury and the conduct of that defendant. Rizzo v. Goode, 423 U.S. 362, 371- 6 72, 377 (1976). 7 A. Fourth Amendment 8 The Fourth Amendment protects “[t]he right of the people to be secure in their 9 persons, houses, papers, and effects, against unreasonable searches and seizures.” 10 (Emphasis added.) Plaintiff alleges that federal agents “use[d] a date” that Defendant 11 Christian had scheduled for a home visit at Plaintiff’s residence “for a mechanism as 12 subterfuge for a valid warrant.” It is unclear whether Plaintiff alleges that the search was 13 conducted pursuant to a warrant. But even if the search was warrantless, Plaintiff has not 14 identified the crime for which he was on probation and whether warrantless searches or 15 suspicionless searches were authorized as a condition of his probation. See United States 16 v. Knights, 534 U.S. 112, 122 (2001) (warrantless search, “supported by reasonable 17 suspicion and authorized by a condition of probation, was reasonable within the meaning 18 of the Fourth Amendment”); United States v. King, 736 F.3d 805, 810 (9th Cir. 2013) (“a 19 suspicionless search, conducted pursuant to a suspicionless-search condition of a violent 20 felon’s probation agreement, does not violate the Fourth Amendment”). Thus, Plaintiff has 21 not stated a Fourth Amendment claim with respect to the search of his home or the seizure 22 of the handgun. 23 B. Second Amendment 24 The Second Amendment provides: “A well regulated Militia, being necessary to the 25 security of a free State, the right of the people to keep and bear Arms, shall not be 26 infringed.” In District of Columbia v. Heller, 554 U.S. 570 (2008), the Supreme Court 27 held that “the Second Amendment protects the right to keep and bear arms for the purpose 28 of self-defense,” and that a “law that banned the possession of handguns in the home” was 1 therefore unconstitutional. McDonald v. City of Chicago, 561 U.S. 742, 791 (2010). The 2 Supreme Court noted, however, that “[l]ike most rights, the right secured by the Second 3 Amendment is not unlimited,” and that “nothing in [the] opinion should be taken to cast 4 doubt on longstanding prohibitions on the possession of firearms by felons and the mentally 5 ill, or laws forbidding the carrying of firearms in sensitive places such as schools and 6 government buildings, or laws imposing conditions on the commercial sale of arms.” 7 Heller, 554 U.S. at 626-27. Thus, the Supreme Court emphasized that the core of the 8 Second Amendment is “the right of law-abiding, responsible citizens to use arms in defense 9 of hearth and home.” Id. at 635. 10 Section 922(g)(8) imposes one such limitation on citizens’ Second Amendment 11 rights, and various federal appellate courts have concluded that on its face, § 922(g)(8) 12 does not violate the Second Amendment. See, e.g., United States v. Boyd, 999 F.3d 171 13 (3d Cir. 2021); United States v. McGinnis, 956 F.3d 747 (5th Cir. 2020); United States v. 14 Chapman, 666 F.3d 220 (4th Cir. 2012); United States v. Bena, 664 F.3d 1180 (8th Cir. 15 2011); United States v. Reese, 627 F.3d 792 (10th Cir. 2010); United States v. Napier, 233 16 F.3d 394 (6th Cir. 2000); cf. United States v. Chovan, 735 F.3d 1127, 1138 (9th Cir. 2013) 17 (concluding in a case involving § 922(g)(9) that defendant’s Second Amendment claim— 18 that he has a right to possess a firearm in his home for the purpose of self-defense—was 19 “not within the core right identified in Heller—the right of a law-abiding, responsible 20 citizen to possess and carry a weapon for self-defense”) (quoting United States v. Chester, 21 628 F.3d 673, 682-83 (4th Cir. 2010)). 22 Here, Plaintiff acknowledged in the plea agreement in his federal criminal case that 23 he was subject to an order of protection and was not permitted to possess firearms during 24 the pendency of the order of protection. A weapon was found in his residence. Thus, 25 Defendants did not violate Plaintiff’s Second Amendment rights by seizing a weapon that 26 Plaintiff was prohibited to possess. Thus, Plaintiff has failed to state a Second Amendment 27 claim. 28 . . . . 1 VI. Leave to Amend 2 Within 30 days, Plaintiff may submit a second amended complaint to cure the 3 deficiencies outlined above. The Clerk of Court will mail Plaintiff a court-approved form 4 to use for filing a second amended complaint. If Plaintiff fails to use the court-approved 5 form, the Court may strike the second amended complaint and dismiss this action without 6 further notice to Plaintiff. 7 Plaintiff must clearly designate on the face of the document that it is the “Second 8 Amended Complaint.” The second amended complaint must be retyped or rewritten in its 9 entirety on the court-approved form and may not incorporate any part of the original 10 Complaint or First Amended Complaint by reference. Plaintiff may include only one claim 11 per count. 12 A second amended complaint supersedes the original Complaint and First Amended 13 Complaint. Ferdik v. Bonzelet, 963 F.2d 1258, 1262 (9th Cir. 1992); Hal Roach Studios v. 14 Richard Feiner & Co., 896 F.2d 1542, 1546 (9th Cir. 1990). After amendment, the Court 15 will treat the original Complaint and First Amended Complaint as nonexistent. Ferdik, 16 963 F.2d at 1262. Any cause of action that was raised in the original Complaint or First 17 Amended Complaint and that was voluntarily dismissed or was dismissed without 18 prejudice is waived if it is not alleged in a second amended complaint. Lacey v. Maricopa 19 County, 693 F.3d 896, 928 (9th Cir. 2012) (en banc). 20 VII. Warnings 21 A. Release 22 If Plaintiff is released while this case remains pending, and the filing fee has not 23 been paid in full, Plaintiff must, within 30 days of his release, either (1) notify the Court 24 that he intends to pay the unpaid balance of his filing fee within 120 days of his release or 25 (2) file a non-prisoner application to proceed in forma pauperis. Failure to comply may 26 result in dismissal of this action. 27 B. Address Changes 28 Plaintiff must file and serve a notice of a change of address in accordance with Rule 1 83.3(d) of the Local Rules of Civil Procedure. Plaintiff must not include a motion for other 2 relief with a notice of change of address. Failure to comply may result in dismissal of this 3 action. 4 C. Possible “Strike” 5 Because the First Amended Complaint has been dismissed for failure to state a 6 claim, if Plaintiff fails to file a second amended complaint correcting the deficiencies 7 identified in this Order, the dismissal may count as a “strike” under the “3-strikes” 8 provision of 28 U.S.C. § 1915(g). Under the 3-strikes provision, a prisoner may not bring 9 a civil action or appeal a civil judgment in forma pauperis under 28 U.S.C. § 1915 “if the 10 prisoner has, on 3 or more prior occasions, while incarcerated or detained in any facility, 11 brought an action or appeal in a court of the United States that was dismissed on the 12 grounds that it is frivolous, malicious, or fails to state a claim upon which relief may be 13 granted, unless the prisoner is under imminent danger of serious physical injury.” 28 14 U.S.C. § 1915(g). 15 D. Possible Dismissal 16 If Plaintiff fails to timely comply with every provision of this Order, including these 17 warnings, the Court may dismiss this action without further notice. See Ferdik, 963 F.2d 18 at 1260-61 (a district court may dismiss an action for failure to comply with any order of 19 the Court). 20 IT IS ORDERED: 21 (1) Plaintiff’s Application to Proceed In Forma Pauperis (Doc. 15) is granted. 22 (2) As required by the accompanying Order to the appropriate government 23 agency, Plaintiff must pay the $350.00 filing fee and is assessed an initial partial filing fee 24 of $28.98. 25 (3) The First Amended Complaint (Doc. 5) is dismissed for failure to state a 26 claim. Plaintiff has 30 days from the date this Order is filed to file a second amended 27 complaint in compliance with this Order. 28 (4) If Plaintiff fails to file a second amended complaint within 30 days, the Clerk of Court must, without further notice, enter a judgment of dismissal of this action with prejudice that states that the dismissal may count as a “strike” under 28 U.S.C. § 1915(g) 3| and deny any pending unrelated motions as moot. 4 (5) The Clerk of Court must mail Plaintiff a court-approved form for filing a 5 | civil rights complaint by a prisoner. 6 Dated this 4th day of April, 2022. 7 WM clacl T. Hburde Michael T. Liburdi 10 United States District Judge 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
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Instructions for a Prisoner Filing a Civil Rights Complaint in the United States District Court for the District of Arizona
1. Who May Use This Form. The civil rights complaint form is designed to help incarcerated persons prepare a complaint seeking relief for a violation of their federal civil rights. These complaints typically concern, but are not limited to, conditions of confinement. This form should not be used to challenge your conviction or sentence. If you want to challenge a state conviction or sentence, you should file a petition under 28 U.S.C. ' 2254 for a writ of habeas corpus by a person in state custody. If you want to challenge a federal conviction or sentence, you should file a motion under 28 U.S.C. § 2255 to vacate sentence in the federal court that entered the judgment.
2. The Form. Local Rule of Civil Procedure (LRCiv) 3.4 provides that complaints by incarcerated persons must be filed on the court-approved form. The form must be typed or neatly handwritten. The form must be completely filled in to the extent applicable. All questions must be answered clearly and concisely in the appropriate space on the form. If needed, you may attach additional pages, but no more than fifteen additional pages, of standard letter-sized paper. You must identify which part of the complaint is being continued and number all pages. If you do not fill out the form properly, you will be asked to submit additional or corrected information, which may delay the processing of your action. You do not need to cite law.
3. Your Signature. You must tell the truth and sign the form. If you make a false statement of a material fact, you may be prosecuted for perjury.
4. The Filing and Administrative Fees. The total fees for this action are $402.00 ($350.00 filing fee plus $52.00 administrative fee). If you are unable to immediately pay the fees, you may request leave to proceed in forma pauperis. Please review the “Information for Prisoners Seeking Leave to Proceed with a (Non-Habeas) Civil Action in Federal Court In Forma Pauperis Pursuant to 28 U.S.C. ' 1915” for additional instructions.
5. Original and Judge=s Copy. You must send an original plus one copy of your complaint and of any other documents submitted to the Court. You must send one additional copy to the Court if you wish to have a file-stamped copy of the document returned to you. All copies must be identical to the original. Copies may be legibly handwritten. This section does not apply to inmates housed at an Arizona Department of Corrections facility that participates in electronic filing.
6. Where to File. You should file your complaint in the division where you were confined when your rights were allegedly violated. See LRCiv 5.1(a) and 77.1(a). If you were confined in Maricopa, Pinal, Yuma, La Paz, or Gila County, file in the Phoenix Division. If you were confined in Apache, Navajo, Coconino, Mohave, or Yavapai County, file in the Prescott Division. If you were confined in Pima, Cochise, Santa Cruz, Graham, or Greenlee County, file in the Tucson Division. Mail the original and one copy of the complaint with the $402 filing and administrative fees or the application to proceed in forma pauperis to:
1 Revised 12/1/20 Phoenix & Prescott Divisions: OR Tucson Division: U.S. District Court Clerk U.S. District Court Clerk U.S. Courthouse, Suite 130 U.S. Courthouse, Suite 1500 401 West Washington Street, SPC 10 405 West Congress Street Phoenix, Arizona 85003-2119 Tucson, Arizona 85701-5010
7. Change of Address. You must immediately notify the Court and the defendants in writing of any change in your mailing address. Failure to notify the Court of any change in your mailing address may result in the dismissal of your case.
8. Certificate of Service. You must furnish the defendants with a copy of any document you submit to the Court (except the initial complaint and application to proceed in forma pauperis). Each original document (except the initial complaint and application to proceed in forma pauperis) must include a certificate of service on the last page of the document stating the date a copy of the document was mailed to the defendants and the address to which it was mailed. See Fed. R. Civ. P. 5(a), (d). Any document received by the Court that does not include a certificate of service may be stricken. This section does not apply to inmates housed at an Arizona Department of Corrections facility that participates in electronic filing. A certificate of service should be in the following form:
I hereby certify that a copy of the foregoing document was mailed this (month, day, year) to: Name: Address: Attorney for Defendant(s)
(Signature)
9. Amended Complaint. If you need to change any of the information in the initial complaint, you must file an amended complaint. The amended complaint must be written on the court- approved civil rights complaint form. You may file one amended complaint without leave (permission) of Court within 21 days after serving it or within 21 days after any defendant has filed an answer, whichever is earlier. See Fed. R. Civ. P. 15(a). Thereafter, you must file a motion for leave to amend and lodge (submit) a proposed amended complaint. LRCiv 15.1. In addition, an amended complaint may not incorporate by reference any part of your prior complaint. LRCiv 15.1(a)(2). Any allegations or defendants not included in the amended complaint are considered dismissed. All amended complaints are subject to screening under the Prison Litigation Reform Act; screening your amendment will take additional processing time.
10. Exhibits. You should not submit exhibits with the complaint or amended complaint. Instead, the relevant information should be paraphrased. You should keep the exhibits to use to support or oppose a motion to dismiss, a motion for summary judgment, or at trial.
11. Letters and Motions. It is generally inappropriate to write a letter to any judge or the staff of any judge. The only appropriate way to communicate with the Court is by filing a written pleading or motion.
2 12. Completing the Civil Rights Complaint Form.
HEADING: 1. Your Name. Print your name, prison or inmate number, and institutional mailing address on the lines provided.
2. Defendants. If there are four or fewer defendants, print the name of each. If you name more than four defendants, print the name of the first defendant on the first line, write the words “and others” on the second line, and attach an additional page listing the names of all of the defendants. Insert the additional page after page 1 and number it “1- A” at the bottom.
3. Jury Demand. If you want a jury trial, you must write “JURY TRIAL DEMANDED” in the space below “CIVIL RIGHTS COMPLAINT BY A PRISONER.” Failure to do so may result in the loss of the right to a jury trial. A jury trial is not available if you are seeking only injunctive relief.
Part A. JURISDICTION: 1. Nature of Suit. Mark whether you are filing the complaint pursuant to 42 U.S.C. ' 1983 for state, county, or city defendants; “Bivens v. Six Unknown Federal Narcotics Agents” for federal defendants; or “other.” If you mark “other,” identify the source of that authority.
2. Location. Identify the institution and city where the alleged violation of your rights occurred.
3. Defendants. Print all of the requested information about each of the defendants in the spaces provided. If you are naming more than four defendants, you must provide the necessary information about each additional defendant on separate pages labeled “2-A,” “2-B,” etc., at the bottom. Insert the additional page(s) immediately behind page 2.
Part B. PREVIOUS LAWSUITS: You must identify any other lawsuit you have filed in either state or federal court while you were a prisoner. Print all of the requested information about each lawsuit in the spaces provided. If you have filed more than three lawsuits, you must provide the necessary information about each additional lawsuit on a separate page. Label the page(s) as “2-A,” “2-B,” etc., at the bottom of the page and insert the additional page(s) immediately behind page 2.
Part C. CAUSE OF ACTION: You must identify what rights each defendant violated. The form provides space to allege three separate counts (one violation per count). If you are alleging more than three counts, you must provide the necessary information about each additional count on a separate page. Number the additional pages “5-A,” “5-B,” etc., and insert them immediately behind page 5. Remember that you are limited to a total of fifteen additional pages.
3 1. Counts. You must identify which civil right was violated. You may allege the violation of only one civil right per count.
2. Issue Involved. Check the box that most closely identifies the issue involved in your claim. You may check only one box per count. If you check the box marked “Other,” you must identify the specific issue involved.
3. Supporting Facts. After you have identified which civil right was violated, you must state the supporting facts. Be as specific as possible. You must state what each individual defendant did to violate your rights. If there is more than one defendant, you must identify which defendant did what act. You also should state the date(s) on which the act(s) occurred, if possible.
4. Injury. State precisely how you were injured by the alleged violation of your rights.
5. Administrative Remedies. You must exhaust any available administrative remedies before you file a civil rights complaint. See 42 U.S.C. § 1997e. Consequently, you should disclose whether you have exhausted the inmate grievance procedures or administrative appeals for each count in your complaint. If the grievance procedures were not available for any of your counts, fully explain why on the lines provided.
Part D. REQUEST FOR RELIEF: Print the relief you are seeking in the space provided.
SIGNATURE: You must sign your name and print the date you signed the complaint. Failure to sign the complaint will delay the processing of your action. Unless you are an attorney, you may not bring an action on behalf of anyone but yourself.
FINAL NOTE
You should follow these instructions carefully. Failure to do so may result in your complaint being stricken or dismissed. All questions must be answered concisely in the proper space on the form. If you need more space, you may attach no more than fifteen additional pages. But the form must be completely filled in to the extent applicable. If you attach additional pages, be sure to identify which section of the complaint is being continued and number the pages.
4 ___________________________________________ Name and Prisoner/Booking Number ___________________________________________ Place of Confinement ___________________________________________ Mailing Address ___________________________________________ City, State, Zip Code (Failure to notify the Court of your change of address may result in dismissal of this action.)
IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF ARIZONA
_________________________________________ , (Full Name of Plaintiff) ) Plaintiff, v. CASE NO. __________________________________ (To be supplied by the Clerk) (1) _______________________________________ ,
(Full Name of Defendant) CIVIL RIGHTS COMPLAINT (2) _______________________________________ , BY A PRISONER
(3) _______________________________________ , G Original Complaint (4) _______________________________________ , G First Amended Complaint G Second Amended Complaint Defendant(s).
G Check if there are additional Defendants and attach page 1-A listing them.
A. JURISDICTION
1. This Court has jurisdiction over this action pursuant to: G 28 U.S.C. § 1343(a); 42 U.S.C. § 1983 G 28 U.S.C. § 1331; Bivens v. Six Unknown Federal Narcotics Agents, 403 U.S. 388 (1971). G Other: .
2. Institution/city where violation occurred: .
550/555 B. DEFENDANTS
1. Name of first Defendant: . The first Defendant is employed as: ______________________________________________ at_______________________________________. (Position and Title) (Institution)
2. Name of second Defendant: . The second Defendant is employed as: as: ______________________________________________ at_______________________________________. (Position and Title) (Institution)
3. Name of third Defendant: . The third Defendant is employed as: ______________________________________________ at_______________________________________. (Position and Title) (Institution)
4. Name of fourth Defendant: . The fourth Defendant is employed as: ______________________________________________ at_______________________________________. (Position and Title) (Institution)
If you name more than four Defendants, answer the questions listed above for each additional Defendant on a separate page.
C. PREVIOUS LAWSUITS
1. Have you filed any other lawsuits while you were a prisoner? G Yes G No
2. If yes, how many lawsuits have you filed? . Describe the previous lawsuits:
a. First prior lawsuit: 1. Parties: v. 2. Court and case number: . 3. Result: (Was the case dismissed? Was it appealed? Is it still pending?) .
b. Second prior lawsuit: 1. Parties: v. 2. Court and case number: . 3. Result: (Was the case dismissed? Was it appealed? Is it still pending?) .
c. Third prior lawsuit: 1. Parties: v. 2. Court and case number: . 3. Result: (Was the case dismissed? Was it appealed? Is it still pending?) .
If you filed more than three lawsuits, answer the questions listed above for each additional lawsuit on a separate page. 2 D. CAUSE OF ACTION
COUNT I 1. State the constitutional or other federal civil right that was violated: .
2. Count I. Identify the issue involved. Check only one. State additional issues in separate counts. G Basic necessities G Mail G Access to the court G Medical care G Disciplinary proceedings G Property G Exercise of religion G Retaliation G Excessive force by an officer G Threat to safety G Other: .
3. Supporting Facts. State as briefly as possible the FACTS supporting Count I. Describe exactly what each Defendant did or did not do that violated your rights. State the facts clearly in your own words without citing legal authority or arguments.
.
4. Injury. State how you were injured by the actions or inactions of the Defendant(s).
5. Administrative Remedies: a. Are there any administrative remedies (grievance procedures or administrative appeals) available at your institution? G Yes G No b. Did you submit a request for administrative relief on Count I? G Yes G No c. Did you appeal your request for relief on Count I to the highest level? G Yes G No d. If you did not submit or appeal a request for administrative relief at any level, briefly explain why you did not. .
3 COUNT II 1. State the constitutional or other federal civil right that was violated: .
2. Count II. Identify the issue involved. Check only one. State additional issues in separate counts. G Basic necessities G Mail G Access to the court G Medical care G Disciplinary proceedings G Property G Exercise of religion G Retaliation G Excessive force by an officer G Threat to safety G Other: .
3. Supporting Facts. State as briefly as possible the FACTS supporting Count II. Describe exactly what each Defendant did or did not do that violated your rights. State the facts clearly in your own words without citing legal authority or arguments.
4. Injury. State how you were injured by the actions or inactions of the Defendant(s).
5. Administrative Remedies. a. Are there any administrative remedies (grievance procedures or administrative appeals) available at your institution? G Yes G No b. Did you submit a request for administrative relief on Count II? G Yes G No c. Did you appeal your request for relief on Count II to the highest level? G Yes G No d. If you did not submit or appeal a request for administrative relief at any level, briefly explain why you did not. .
4 COUNT III 1. State the constitutional or other federal civil right that was violated: .
2. Count III. Identify the issue involved. Check only one. State additional issues in separate counts. G Basic necessities G Mail G Access to the court G Medical care G Disciplinary proceedings G Property G Exercise of religion G Retaliation G Excessive force by an officer G Threat to safety G Other: .
3. Supporting Facts. State as briefly as possible the FACTS supporting Count III. Describe exactly what each Defendant did or did not do that violated your rights. State the facts clearly in your own words without citing legal authority or arguments.
4. Injury. State how you were injured by the actions or inactions of the Defendant(s).
5. Administrative Remedies. a. Are there any administrative remedies (grievance procedures or administrative appeals) available at your institution? G Yes G No b. Did you submit a request for administrative relief on Count III? G Yes G No c. Did you appeal your request for relief on Count III to the highest level? G Yes G No d. If you did not submit or appeal a request for administrative relief at any level, briefly explain why you did not. .
If you assert more than three Counts, answer the questions listed above for each additional Count on a separate page.
5 E. REQUEST FOR RELIEF
State the relief you are seeking:
I declare under penalty of perjury that the foregoing is true and correct.
Executed on DATE SIGNATURE OF PLAINTIFF
___________________________________________ (Name and title of paralegal, legal assistant, or other person who helped prepare this complaint)
___________________________________________ (Signature of attorney, if any)
___________________________________________ (Attorney=s address & telephone number)
ADDITIONAL PAGES
All questions must be answered concisely in the proper space on the form. If you need more space, you may attach no more than fifteen additional pages. But the form must be completely filled in to the extent applicable. If you attach additional pages, be sure to identify which section of the complaint is being continued and number all pages.