Bowler #234066 v. Ryan et al

Filing 13

ORDER - The First Amended Complaint (Doc. 11 ) is dismissed for failure to state a claim. Plaintiff has 30 days from the date this Order is filed to file a second amended complaint in compliance with this Order. If Plaintiff fails to file a secon d 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). (See document for full details). Signed by Senior Judge Robert C Broomfield on 8/12/13. (LAD)

1
2

WO

3
4
5
6

IN THE UNITED STATES DISTRICT COURT

7

FOR THE DISTRICT OF ARIZONA

8
9
10
11

Joshua Erik Bowler,

12

Plaintiff,
vs.

13
14

Charles L. Ryan, et al.,

15

Defendants.

)
)
)
)
)
)
)
)
)
)

No. CV 13-0046-PHX-RCB (JFM)
ORDER

16
17

Plaintiff Joshua Erik Bowler, who is now confined in the Arizona State Prison

18

Complex-Eyman, Browning Unit, in Florence, Arizona, filed a pro se civil rights Complaint

19

pursuant to 42 U.S.C. § 1983, which the Court dismissed for failure to state a claim with

20

leave to amend. (Doc. 6.) Plaintiff has filed a First Amended Complaint. (Doc. 11.) The

21

Court will dismiss the First Amended Complaint with leave to amend.

22

I.

Statutory Screening of Prisoner Complaints

23
24

a governmental entity or an officer or an employee of a governmental entity. 28 U.S.C.

25

§ 1915A(a). The Court must dismiss a complaint or portion thereof if a plaintiff has raised

26

claims that are legally frivolous or malicious, that fail to state a claim upon which relief may

27

be granted, or that seek monetary relief from a defendant who is immune from such relief.

28
JDDL-K

The Court is required to screen complaints brought by prisoners seeking relief against

28 U.S.C. § 1915A(b)(1), (2).

1

A pleading must contain a “short and plain statement of the claim showing that the

2

pleader is entitled to relief.” Fed. R. Civ. P. 8(a)(2) (emphasis added). While Rule 8 does not

3

demand detailed factual allegations, “it demands more than an unadorned, the-defendant-

4

unlawfully-harmed-me accusation.” Ashcroft v. Iqbal, 129 S. Ct. 1937, 1949 (2009).

5

“Threadbare recitals of the elements of a cause of action, supported by mere conclusory

6

statements, do not suffice.” Id.

7

“[A] complaint must contain sufficient factual matter, accepted as true, to ‘state a

8

claim to relief that is plausible on its face.’” Id. (quoting Bell Atlantic Corp. v. Twombly,

9

550 U.S. 544, 570 (2007)). A claim is plausible “when the plaintiff pleads factual content

10

that allows the court to draw the reasonable inference that the defendant is liable for the

11

misconduct alleged.” Id. “Determining whether a complaint states a plausible claim for

12

relief [is] . . . a context-specific task that requires the reviewing court to draw on its judicial

13

experience and common sense.” Id. at 1950. Thus, although a plaintiff’s specific factual

14

allegations may be consistent with a constitutional claim, a court must assess whether there

15

are other “more likely explanations” for a defendant’s conduct. Id. at 1951.

16

But as the United States Court of Appeals for the Ninth Circuit has instructed, courts

17

must “continue to construe pro se filings liberally.” Hebbe v. Pliler, 627 F.3d 338, 342 (9th

18

Cir. 2010). A “complaint [filed by a pro se prisoner] ‘must be held to less stringent standards

19

than formal pleadings drafted by lawyers.’” Id. (quoting Erickson v. Pardus, 551 U.S. 89,

20

94 (2007) (per curiam)).

21
22

a pro se litigant is entitled to an opportunity to amend a complaint before dismissal of the

23

action. See Lopez v. Smith, 203 F.3d 1122, 1127-29 (9th Cir. 2000) (en banc). The Court

24

should not, however, advise the litigant how to cure the defects. This type of advice “would

25

undermine district judges’ role as impartial decisionmakers.” Pliler v. Ford, 542 U.S. 225,

26

231 (2004); see also Lopez, 203 F.3d at 1131 n.13 (declining to decide whether the court was

27

required to inform a litigant of deficiencies). The Court will dismiss Plaintiff’s First

28
JDDL-K

If the Court determines that a pleading could be cured by the allegation of other facts,

Amended Complaint for failure to state a claim, but because it may possibly be saved by
-2-

1

amendment, the Court will dismiss the First Amended Complaint with leave to amend.

2

II.

First Amended Complaint

3

Plaintiff alleges one count for threat to safety. He sues the following current or former

4

employees of the Arizona Department of Corrections (ADC): Lieutenant Sanchez;

5

Corrections Officer (CO) IV Contrell; and CO IIIs Cardenes and Lister. Plaintiff seeks

6

injunctive relief.

7

Plaintiff alleges the following facts in his First Amended Complaint: since being

8

housed in Special Management Unit II (SMU II or Browning Unit), Plaintiff has sought to

9

be housed alone. Plaintiff has tried to write to the warden and deputy warden, but has not

10

received responses. Plaintiff has sent inmate letters to CO III Cardenes also requesting to be

11

housed alone. On April 12, 2013, Plaintiff was assaulted and his nose broken by his then-

12

new cell mate, Mike Oliver. The day before the assault, Plaintiff sent an inmate letter to CO

13

IV Contrell asking to be moved due to a threat to his safety. Plaintiff tried to refuse to house,

14

but Lieutenant Sanchez told Plaintiff to house or he would be moved. Plaintiff contends that

15

he has not been given an opportunity to go through the process to be housed in protective

16

custody under Director’s Order (DO) 805.

17

According to Plaintiff, under DO 805, if an inmate has been convicted of charges that

18

are likely to cause general population (GP) inmates to target him, the inmate should be

19

placed in protective segregation (PS). Plaintiff contends that he has three prostitution

20

charges, which makes him a target of GP inmates, but that the DO 805 policy is not being

21

followed. Plaintiff claims that everywhere he has been housed, he has been targeted by

22

White GP inmates and he fears future assaults, but he does not allege facts to support that

23

assertion, such as where he has been housed and when and how he has been targeted, as well

24

as facts to support that any named Defendant knew of such targeting.1 Plaintiff claims that

25

he requested PS in the Manzanita Unit in the Tucson Complex, the Meadows Unit in the

26
27
28
JDDL-K

1

According to information on ADC’s website, Plaintiff is White and is currently
serving a sentence for aggravated assault. Plaintiff does not allege where, when, or by whom
he was charged or convicted of prostitution.
-3-

1

Florence Complex, and the Cimarron Unit in the Tucson Complex, but all three requests

2

were denied. At some point, Plaintiff asked to go through the DO 805 process, but CO III

3

Lister told him that he had to house on the yard before he could go through the DO 805

4

process. Plaintiff fails to allege other supporting circumstances such as where he was housed

5

at the time and facts to support that Lister knew or should have known housing on the yard

6

posed a substantial threat to Plaintiff’s safety. Plaintiff also contends that Defendants

7

Contrell and Cardenes know that he “has prostitution charges,” which GP inmates view as

8

sex offenses, but Plaintiff continues to be housed with GP inmates.

9

III.

Failure to State a Claim

10

To state a claim under § 1983, a plaintiff must allege facts supporting that (1) the

11

conduct about which he complains was committed by a person acting under the color of state

12

law and (2) the conduct deprived him of a federal constitutional or statutory right. Wood v.

13

Outlander, 879 F.2d 583, 587 (9th Cir. 1989). Negligence is not sufficient to state a claim

14

under § 1983. Daniels v. Williams, 474 U.S. 327, 330-31 (1986). In addition, a plaintiff

15

must allege that he suffered a specific injury as a result of the conduct of a particular

16

defendant and he must allege an affirmative link between the injury and the conduct of that

17

defendant. Rizzo v. Goode, 423 U.S. 362, 371-72, 377 (1976).

18
19

simply conclusions, that show that an individual was personally involved in the deprivation

20

of his civil rights.” Barren v. Harrington, 152 F.3d 1193, 1194 (9th Cir. 1998). For an

21

individual to be liable in his official capacity, a plaintiff must allege that the official acted

22

as a result of a policy, practice, or custom. See Cortez v. County of Los Angeles, 294 F.3d

23

1186, 1188 (9th Cir. 2001). Further, there is no respondeat superior liability under § 1983,

24

so a defendant’s position as the supervisor of someone who allegedly violated a plaintiff’s

25

constitutional rights does not make him liable. Monell v. Dep’t of Soc. Servs., 436 U.S. 658,

26

691 (1978); Taylor v. List, 880 F.2d 1040, 1045 (9th Cir. 1989). A supervisor in his

27

individual capacity, “is only liable for constitutional violations of his subordinates if the

28
JDDL-K

In addition, to state a claim against a defendant, “[a] plaintiff must allege facts, not

supervisor participated in or directed the violations, or knew of the violations and failed to
-4-

1

act to prevent them.” Taylor, 880 F.2d at 1045. In addition, where a defendant’s only

2

involvement in allegedly unconstitutional conduct is the denial of administrative grievances,

3

the failure to intervene on a prisoner’s behalf to remedy the alleged unconstitutional behavior

4

does not amount to active unconstitutional behavior for purposes of § 1983. See Shehee v.

5

Luttrell, 199 F.3d 295, 300 (6th Cir. 1999); accord Proctor v. Applegate, 661 F.Supp.2d 743,

6

765 (W.D. Mich. 2009); Stocker v. Warden, No. 1:07-CV-00589, 2009 WL 981323, at *10

7

(E.D. Cal. Apr. 13, 2009); Mintun v. Blades, No. CV-06-139, 2008 WL 711636, at *7 (D.

8

Idaho Mar. 14, 2008); see also Gregory v. City of Louisville, 444 F.3d 725, 751 (6th Cir.

9

2006) (a plaintiff must allege that a supervisor defendant did more than play a passive role

10

in an alleged violation or mere tacit approval thereof; a plaintiff must allege that the

11

supervisor defendant somehow encouraged or condoned the actions of their subordinates).

12

Plaintiff alleges a claim for threat to safety. To state a claim under § 1983 for failure

13

to protect or threats to safety, an inmate must allege facts to support that he was incarcerated

14

under conditions posing a substantial risk of harm and that prison officials were “deliberately

15

indifferent” to those risks. Farmer v. Brennan, 511 U.S. 825, 832-33 (1994). To adequately

16

allege deliberate indifference, a plaintiff must allege facts to support that a defendant knew

17

of, but disregarded, an excessive risk to inmate safety. Id. at 837. That is, “the official must

18

both [have been] aware of facts from which the inference could be drawn that a substantial

19

risk of serious harm exist[ed], and he must also [have] draw[n] the inference.” Id.

20

Plaintiff alleges that he was assaulted by his cell mate on April 12, 2013, and that one

21

day before, he submitted an inmate letter to Defendant Contrell. Plaintiff does not allege that

22

he informed Contrell that his cell mate posed a substantial threat to his safety and why he

23

believed so. Nor does Plaintiff allege facts to support that Contrell, or any other Defendant,

24

knew or should have known, that Oliver posed a substantial threat to Plaintiff’s safety but

25

nevertheless failed to act to alleviate the threat.2 To the extent that Plaintiff complains that

26
27
28
JDDL-K

2

As to Lieutenant Sanchez, Plaintiff merely states that Sanchez ordered Plaintiff to
house or he would be moved. Absent more, that is not sufficient to support that Sanchez
acted with deliberate indifference to a threat to Plaintiff’s safety.
-5-

1

his requests to be housed in PS were denied, he fails to allege when and from whom he

2

sought placement in PS and facts to support that such persons denied his requests despite

3

knowing or having reason to know that the failure to do so posed a substantial threat to

4

Plaintiff’s safety. Plaintiff also fails to allege what he informed any Defendant about the

5

reasons he sought PS placement and the reasons given, if any, for not placing him in PS.

6

Plaintiff should allege both facts to support the existence of a substantial threat to his safety

7

and facts to support that a properly named defendant knew of such facts, including how or

8

what Plaintiff told such defendant, and that the defendant failed to act to protect Plaintiff.

9

Because Plaintiff has failed to do so in his First Amended Complaint, he fails to state a

10

constitutional claim for failure to protect or threat to safety against any Defendant.

11

IV.

Leave to Amend

12

For the foregoing reasons, Plaintiff’s First Amended Complaint will be dismissed for

13

failure to state a claim upon which relief may be granted. Within 30 days, Plaintiff may

14

submit a second amended complaint to cure the deficiencies outlined above. The Clerk of

15

Court will mail Plaintiff a court-approved form to use for filing a second amended complaint.

16

If Plaintiff fails to use the court-approved form, the Court may strike the second amended

17

complaint and dismiss this action without further notice to Plaintiff.

18

Plaintiff must clearly designate on the face of the document that it is the “Second

19

Amended Complaint.” The second amended complaint must be retyped or rewritten in its

20

entirety on the court-approved form and may not incorporate any part of the original

21

Complaint or First Amended Complaint by reference. Plaintiff may include only one claim

22

per count.

23
24

Complaint. Ferdik v. Bonzelet, 963 F.2d 1258, 1262 (9th Cir. 1992); Hal Roach Studios v.

25

Richard Feiner & Co., 896 F.2d 1542, 1546 (9th Cir. 1990). After amendment, the Court will

26

treat the original Complaint and First Amended Complaint as nonexistent. Ferdik, 963 F.2d

27

at 1262. Any cause of action that was raised in the original Complaint or First Amended

28
JDDL-K

A second amended complaint supersedes the original Complaint and First Amended

complaint is waived if it is not raised in a second amended complaint. King v. Atiyeh, 814
-6-

1

F.2d 565, 567 (9th Cir. 1987).

2

V.

Warnings

3

A.

Release

4

Plaintiff must pay the unpaid balance of the filing fee within 120 days of his release.

5

Also, within 30 days of his release, he must either (1) notify the Court that he intends to pay

6

the balance or (2) show good cause, in writing, why he cannot. Failure to comply may result

7

in dismissal of this action.

8

B.

Address Changes

9

Plaintiff must file and serve a notice of a change of address in accordance with Rule

10

83.3(d) of the Local Rules of Civil Procedure. Plaintiff must not include a motion for other

11

relief with a notice of change of address. Failure to comply may result in dismissal of this

12

action.

13

C.

Copies

14

Plaintiff must submit an additional copy of every filing for use by the Court. See

15

LRCiv 5.4. Failure to comply may result in the filing being stricken without further notice

16

to Plaintiff.

17

D.

Possible “Strike”

18

Because the First Amended Complaint has been dismissed for failure to state a claim,

19

if Plaintiff fails to file a second amended complaint correcting the deficiencies identified in

20

this Order, the dismissal may count as a “strike” under the “3-strikes” provision of 28 U.S.C.

21

§ 1915(g). Under the 3-strikes provision, a prisoner may not bring a civil action or appeal

22

a civil judgment in forma pauperis under 28 U.S.C. § 1915 “if the prisoner has, on 3 or more

23

prior occasions, while incarcerated or detained in any facility, brought an action or appeal

24

in a court of the United States that was dismissed on the grounds that it is frivolous,

25

malicious, or fails to state a claim upon which relief may be granted, unless the prisoner is

26

under imminent danger of serious physical injury.” 28 U.S.C. § 1915(g).

27
28
JDDL-K

E.

Possible Dismissal

If Plaintiff fails to timely comply with every provision of this Order, including these
-7-

1

warnings, the Court may dismiss this action without further notice. See Ferdik, 963 F.2d at

2

1260-61 (a district court may dismiss an action for failure to comply with any order of the

3

Court).

4

IT IS ORDERED:

5

(1)

The First Amended Complaint (Doc. 11) is dismissed for failure to state a

6

claim. Plaintiff has 30 days from the date this Order is filed to file a second amended

7

complaint in compliance with this Order.

8

(2)

If Plaintiff fails to file a second amended complaint within 30 days, the Clerk

9

of Court must, without further notice, enter a judgment of dismissal of this action with

10

prejudice that states that the dismissal may count as a “strike” under 28 U.S.C. § 1915(g).

11
12
13

(3)

The Clerk of Court must mail Plaintiff a court-approved form for filing a civil

rights complaint by a prisoner.
DATED this 12th day of August, 2013.

14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
JDDL-K

-8-

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(a) 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 Fee. The filing fee for this action is $350.00. If you are unable to immediately
pay the filing fee, 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.
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 $350 filing
fee or the application to proceed in forma pauperis to:

Revised 3/9/07

1

Phoenix & Prescott Divisions:
OR
U.S. District Court Clerk
U.S. Courthouse, Suite 130
401 West Washington Street, SPC 10
Phoenix, Arizona 85003-2119

Tucson Division:
U.S. District Court Clerk
U.S. Courthouse, Suite 1500
405 West Congress Street
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. 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 courtapproved civil rights complaint form. You may file one amended complaint without leave
(permission) of Court before any defendant has answered your original complaint. See Fed. R.
Civ. P. 15(a). After any defendant has filed an answer, 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 “1A” 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,” “2B,” 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,
vs.

(1)
(Full Name of Defendant)

(2)
(3)
(4)
Defendant(s).

G

Check if there are additional Defendants and attach page 1-A listing them.

)
, )
)
)
) CASE NO.
)
(To be supplied by the Clerk)
, )
)
, )
CIVIL RIGHTS COMPLAINT
)
, )
BY A PRISONER
)
, )
G Original Complaint
G First Amended Complaint
)
)
G Second Amended Complaint

A. JURISDICTION
1.

2.

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:

.

Institution/city where violation occurred:

.

Revised 3/9/07

1

550/555

B. DEFENDANTS
1.

Name of first Defendant:
at

. The first Defendant is employed as:
.

(Position and Title)

2.

(Institution)

Name of second Defendant:
at

. The second Defendant is employed as:
.

(Position and Title)

3.

(Institution)

Name of third Defendant:
at

. The third Defendant is employed as:
.

(Position and Title)

4.

(Institution)

Name of fourth Defendant:
at

. The fourth Defendant is employed as:
.

(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?

2.

If yes, how many lawsuits have you filed?

G Yes

G No

. 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:
v.
1. Parties:
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

1.

COUNT I
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
G Yes G No
at your institution?
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

1.

COUNT II
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

1.

COUNT III
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
G Yes G No
at your institution?
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.

6