UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK KIM VASQUEZ, Plaintiff, -against- 20-CV-5851 (CS) JOHN DOE(S), ORANGETOWN POLICE VALENTIN ORDER OFFICERS, ET AL., Defendants. CATHY SEIBEL, United States District Judge: Plaintiff, currently held in the Rockland County Correctional Center, brings this action pro se. By order dated October 1, 2020, the Court granted Plaintiff’s request to proceed without prepayment of fees, that is, in forma pauperis (IFP),! Under Valentin y. Dinkins, a pro se litigant is entitled to assistance from the district court in identifying a defendant. 121 F.3d 72, 76 (2d Cir. 1997). In his letter of November 2, 2020 (ECF No. 16), Plaintiff supplies sufficient information to permit the Town of Orangetown to identify the Orangetown Police Sergeant who is referenced in the “Supervisory Use of Force Report” that Plaintiff attaches to his letter, It is therefore ordered that the Town Attorney for the Town of Orangetown, who is the attorney for and agent of the Town of Orangetown, must ascertain the identity and badge number of the Orangetown Police Sergeant whom Plaintiff seeks to sue here, and the address where the defendant may be served. The Town Attorney for the Town of Orangetown must provide this information to Plaintiff and the Court within sixty days of the date of this order.
' Prisoners are not exempt from paying the full filing fee even when they have been granted permission to proceed IFP. See 28 U.S.C. § 1915(b)(1).
Within thirty days of receiving this information, Plaintiff must file a second amended complaint naming the John Doe defendant. The second amended complaint will replace, not supplement, the original and amended complaints. A second amended complaint form that Plaintiff should complete is attached to this order. Once Plaintiff has filed a second amended complaint, the Court will screen the amended complaint and, if necessary, issue an order directing the Clerk of Court to complete the USM-285 forms with the address for the named John Doe Defendant and deliver all documents necessary to effect service to the U.S. Marshals Service. CONCLUSION The Clerk of Court is directed to mail a copy of this order to Plaintiff and note service on the docket. The Clerk of Court is directed to mail a copy of this order, the amended complaint (ECF No. 12), and Plaintiff’s November 2, 2020 letter (ECF No. 16) to Town Attorney for the Town of Orangetown at: 26 Orangeburg Road, Orangeburg, New York 10962. SO ORDERED. Dated: (| | ww White Plains, New York f / Pp Why fehx United States District Judge
UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK.
SECOND (in the space above enter the full name(s) of the plaintiff(s}.) AMENDED COMPLAINT -against- under the Civil Rights Act, 42 U.S.C, § 1983
Jury Trial: O Yes o No (check one) ie
(in the space above enter the full name(s) of the defendant(s). Ifyou cannot fil 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 in the above caption must be identical to those contained in Part I, Addresses should not be included here.} I. Parties in this complaint: A. List your name, identification number, and the name and address of your current place of confinement. Do the same for any additional plaintiffs named. Attach additional sheets of paper as necessary. Plaintiff's Name WH Current Institution __ __ Address
B. List all defendants’ names, positions, places of employment, and the address where cach defendant may be served. Make sure that the defendant(s) listed below are identical to those contained in the above caption, Attach additional sheets of paper as necessary.
Defendant No. | Name ee ee _ Shield # Where Currently Employed __ __ __ Address
Rev. 01/2010
Defendant No, 2 Name _ __ —sShield #_ Where Currently Employed _ _ Address
Defendant No. 3 Name _ _____ Shield # □□□ Where Currently Employed □□ _ _ _ Address
_—_——___ —— what? . Defendant No.4 Name _ __ □□ _ Shield # Where Currently Employed __ _ _ Address
Defendant No, 3 Name __ ee _ Shield # Where Currently Employed _ _ Address
Il. Statement of Claim: State as briefly as possible the facts of your case, Describe how each of the defendants named in the caption of this complaint is involved in this action, along with the dates and locations of all relevant events. You may wish to include further details such as the names of other persons involved in the events giving rise to your claims. Do not cite any cases or statutes, If you intend to allege a number of related claims, number and set forth each claim in a separate paragraph. Attach additional sheets of paper as necessary.
A, In what institution did the events giving rise to your claim(s) occur?
B. Where in the institution did the events giving rise to your claim(s) occur?
C. What date and approximate time did the events giving rise to your claim(s) □□□□□□
D. Facts:
happened to you?
Rev, 04/2010
Was i else involved? nn i i ee
Who else h a? Wl. ‘Injuries: If you sustained injuries related to the events alleged above, describe them and state what medical treatment, if any, you required and received,
IV. Exhaustion of Administrative Remedies: The Prison Litigation Reform Act ("PLRA"), 42 U.S.C. § 1997e(a), requires that “(njo action shall be brought with respect to prison conditions under section 1983 of this title, or any other Federal law, by a prisoner confined in any jail, prison, or other correctional facility until such administrative remedies as are available are exhausted.” Administrative remedies are also known as grievance procedures. A. Did your claim(s) arise while you were confined in a jail, prison, or other correctional facility? —séNNo
Rev, 01/2010
If YES, name the jail, prison, or other correctional facility where you were confined at the time of the events giving rise to your claim(s).
B. Does the jail, prison or other correctional facility where your claim(s) arose have a grievance procedure? Yes No Do Not Know Cc. Does the grievance procedure at the jail, prison or other correctional facility where your claim(s) arose cover some or all of your claim(s)? Yes No ..—_- Da Not Know If YES, which claim(s)? D. Did you file a grievance in the jail, prison, or other correctional facility where your claim(s) arose? Yes is NO If NO, did you file a grievance about the events described in this complaint at any other jail, prison, or other correctional facility? Yes No E. If you did file a grievance, about the events described in this complaint, where did you file the grievance?
1. Which claim(s) in this complaint did you grieve?
2. What was the result, if any?
3. What steps, if any, did you take to appeal that decision? Describe all efforts to appeal to the highest level of the grievance process.
F. If you did not file a grievance: 1. If there are any reasons why you did not file a grievance, state them here:
Rev. 01/2010
2. If you did not file a grievance but informed any officials of your claim, state who you informed, when and how, and their response, if any:
G. Please set forth any additional information that is relevant to the exhaustion of your administrative remedies,
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UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK KIM VASQUEZ, Plaintiff, -against- 20-CV-5851 (CS) JOHN DOE(S), ORANGETOWN POLICE VALENTIN ORDER OFFICERS, ET AL., Defendants. CATHY SEIBEL, United States District Judge: Plaintiff, currently held in the Rockland County Correctional Center, brings this action pro se. By order dated October 1, 2020, the Court granted Plaintiff’s request to proceed without prepayment of fees, that is, in forma pauperis (IFP),! Under Valentin y. Dinkins, a pro se litigant is entitled to assistance from the district court in identifying a defendant. 121 F.3d 72, 76 (2d Cir. 1997). In his letter of November 2, 2020 (ECF No. 16), Plaintiff supplies sufficient information to permit the Town of Orangetown to identify the Orangetown Police Sergeant who is referenced in the “Supervisory Use of Force Report” that Plaintiff attaches to his letter, It is therefore ordered that the Town Attorney for the Town of Orangetown, who is the attorney for and agent of the Town of Orangetown, must ascertain the identity and badge number of the Orangetown Police Sergeant whom Plaintiff seeks to sue here, and the address where the defendant may be served. The Town Attorney for the Town of Orangetown must provide this information to Plaintiff and the Court within sixty days of the date of this order.
' Prisoners are not exempt from paying the full filing fee even when they have been granted permission to proceed IFP. See 28 U.S.C. § 1915(b)(1).
Within thirty days of receiving this information, Plaintiff must file a second amended complaint naming the John Doe defendant. The second amended complaint will replace, not supplement, the original and amended complaints. A second amended complaint form that Plaintiff should complete is attached to this order. Once Plaintiff has filed a second amended complaint, the Court will screen the amended complaint and, if necessary, issue an order directing the Clerk of Court to complete the USM-285 forms with the address for the named John Doe Defendant and deliver all documents necessary to effect service to the U.S. Marshals Service. CONCLUSION The Clerk of Court is directed to mail a copy of this order to Plaintiff and note service on the docket. The Clerk of Court is directed to mail a copy of this order, the amended complaint (ECF No. 12), and Plaintiff’s November 2, 2020 letter (ECF No. 16) to Town Attorney for the Town of Orangetown at: 26 Orangeburg Road, Orangeburg, New York 10962. SO ORDERED. Dated: (| | ww White Plains, New York f / Pp Why fehx United States District Judge
UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK.
SECOND (in the space above enter the full name(s) of the plaintiff(s}.) AMENDED COMPLAINT -against- under the Civil Rights Act, 42 U.S.C, § 1983
Jury Trial: O Yes o No (check one) ie
(in the space above enter the full name(s) of the defendant(s). Ifyou cannot fil 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 in the above caption must be identical to those contained in Part I, Addresses should not be included here.} I. Parties in this complaint: A. List your name, identification number, and the name and address of your current place of confinement. Do the same for any additional plaintiffs named. Attach additional sheets of paper as necessary. Plaintiff's Name WH Current Institution __ __ Address
B. List all defendants’ names, positions, places of employment, and the address where cach defendant may be served. Make sure that the defendant(s) listed below are identical to those contained in the above caption, Attach additional sheets of paper as necessary.
Defendant No. | Name ee ee _ Shield # Where Currently Employed __ __ __ Address
Rev. 01/2010
Defendant No, 2 Name _ __ —sShield #_ Where Currently Employed _ _ Address
Defendant No. 3 Name _ _____ Shield # □□□ Where Currently Employed □□ _ _ _ Address
_—_——___ —— what? . Defendant No.4 Name _ __ □□ _ Shield # Where Currently Employed __ _ _ Address
Defendant No, 3 Name __ ee _ Shield # Where Currently Employed _ _ Address
Il. Statement of Claim: State as briefly as possible the facts of your case, Describe how each of the defendants named in the caption of this complaint is involved in this action, along with the dates and locations of all relevant events. You may wish to include further details such as the names of other persons involved in the events giving rise to your claims. Do not cite any cases or statutes, If you intend to allege a number of related claims, number and set forth each claim in a separate paragraph. Attach additional sheets of paper as necessary.
A, In what institution did the events giving rise to your claim(s) occur?
B. Where in the institution did the events giving rise to your claim(s) occur?
C. What date and approximate time did the events giving rise to your claim(s) □□□□□□
D. Facts:
happened to you?
Rev, 04/2010
Was i else involved? nn i i ee
Who else h a? Wl. ‘Injuries: If you sustained injuries related to the events alleged above, describe them and state what medical treatment, if any, you required and received,
IV. Exhaustion of Administrative Remedies: The Prison Litigation Reform Act ("PLRA"), 42 U.S.C. § 1997e(a), requires that “(njo action shall be brought with respect to prison conditions under section 1983 of this title, or any other Federal law, by a prisoner confined in any jail, prison, or other correctional facility until such administrative remedies as are available are exhausted.” Administrative remedies are also known as grievance procedures. A. Did your claim(s) arise while you were confined in a jail, prison, or other correctional facility? —séNNo
Rev, 01/2010
If YES, name the jail, prison, or other correctional facility where you were confined at the time of the events giving rise to your claim(s).
B. Does the jail, prison or other correctional facility where your claim(s) arose have a grievance procedure? Yes No Do Not Know Cc. Does the grievance procedure at the jail, prison or other correctional facility where your claim(s) arose cover some or all of your claim(s)? Yes No ..—_- Da Not Know If YES, which claim(s)? D. Did you file a grievance in the jail, prison, or other correctional facility where your claim(s) arose? Yes is NO If NO, did you file a grievance about the events described in this complaint at any other jail, prison, or other correctional facility? Yes No E. If you did file a grievance, about the events described in this complaint, where did you file the grievance?
1. Which claim(s) in this complaint did you grieve?
2. What was the result, if any?
3. What steps, if any, did you take to appeal that decision? Describe all efforts to appeal to the highest level of the grievance process.
F. If you did not file a grievance: 1. If there are any reasons why you did not file a grievance, state them here:
Rev. 01/2010
2. If you did not file a grievance but informed any officials of your claim, state who you informed, when and how, and their response, if any:
G. Please set forth any additional information that is relevant to the exhaustion of your administrative remedies,
Note: You may attach as exhibits to this complaint any documents related to the exhaustion of your administrative remedies.
V, Relief: State what you want the Court to do for you (including the amount of monetary compensation, if any, that you are seeking and the basis for such amount). eg nt np □ lh ER
Rev. 01/2010
et i Nt
VIL Previous lawsuits: A, Have you filed other lawsuits in state or federal court dealing with the same facts involved in this action?
Yes sé B. if your answer to A is YES, describe each lawsuit by answering questions | through 7 below, {If there is more than one lawsuit, describe the additional lawsuits on another sheet of paper, using the same format.) 1. Parties to the previous lawsuit: Plamtiff Defendants 2.Court (if federal court, name the district; if state court, name the county) 3. Docket or Index number 4, Name of Judge assigned to your case _. _ _ 5. Approximate date of filing lawsuit 6. Is the case still pending? Yess «No If NO, give the approximate date of disposition __ _ _ □ 7. What was the result of the case? (For example: Was the case dismissed? Was there judgment in your favor? Was the case appealed?) __. _ _
On C. Have you filed other lawsuits in state or federal court otherwise relating to your imprisonment? other Yes No : claims — —— dD. If your answer to C is YES, describe each lawsuit by answering questions ! through 7 below. (If there is more than one lawsuit, describe the additional lawsuits on another piece of paper, using the same format.) 1. Parties to the previous lawsuit: Plaintiff Defendants
2. Court (if federal court, name the district; if state court, name the county) nn 3, Docket or Index number 4. Name of Judge assigned to your case _ □□ 5. Approximate date of filing lawsuit Rey. 01/2010
6. Is the case still pending? Yes No. If NO, give the approximate date of disposition __ 7. ‘What was the result of the case? (For example: Was the case dismissed? Was there judgment in your favor? Was the case appealed?)
I declare under penalty of perjury that the foregoing is true and correct. Signed this day of , 20. Signature of Plaintiff _ □ Inmate Number _ __ Institution Address _. ___
Note: All plaintiffs named in the caption of the complaint must date and sign the complaint and provide their inmate numbers and addresses.
I] declare under penalty of perjury that on this _dayof __, 20__, Iam delivering this complaint to prison authorities to be mailed to the Pro Se Office of the United States District Court for the Southern District of New York.
Signature of Plaintrff: __. _ _
Rev, 01/2010