Johnson v. Scottsdale Police Department et al

Filing 5

ORDER that Plaintiff's 2 APPLICATION to Proceed In Forma Pauperis is granted. Plaintiff must pay the $350.00 filing fee. The 1 Complaint is dismissed for failure to state a claim. Plaintiff has 30 days from the date this Ord er is filed to file a first amended complaint in compliance with this Order. If Plaintiff fails to comply, 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). The Clerk must mail Plaintiff a court-approved form for filing a civil rights complaint by a prisoner. Signed by Judge David G Campbell on 3/2/2015. (LFIG)

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1 2 SKC WO 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA 8 9 Michael David Johnson, 10 11 12 No. CV15-0094-PHX-DGC (MEA) Plaintiff, v. ORDER Scottsdale Police Department, et al., 13 Defendants. 14 Plaintiff Michael David Johnson, who is confined in the Maricopa County Lower 15 16 Buckeye Jail in Phoenix, Arizona, has filed a pro se civil rights Complaint pursuant to 42 17 U.S.C. § 1983 (Doc. 1) and an Application to Proceed In Forma Pauperis (Doc. 2). The 18 Court will dismiss the Complaint with leave to amend. 19 I. 20 Application to Proceed In Forma Pauperis and Filing Fee Plaintiff’s Application to Proceed In Forma Pauperis will be granted. 28 U.S.C. 21 § 1915(a). Plaintiff must pay the statutory filing fee of $350.00. 28 U.S.C. § 1915(b)(1). 22 The Court will not assess an initial partial filing fee. Id. The statutory filing fee will be 23 collected monthly in payments of 20% of the previous month’s income credited to 24 Plaintiff’s trust account each time the amount in the account exceeds $10.00. 28 U.S.C. 25 § 1915(b)(2). The Court will enter a separate Order requiring the appropriate government 26 agency to collect and forward the fees according to the statutory formula. 27 28 1 II. 2 Statutory Screening of Prisoner Complaints The Court is required to screen complaints brought by prisoners seeking relief 3 against a governmental entity or an officer or an employee of a governmental entity. 28 4 U.S.C. § 1915A(a). The Court must dismiss a complaint or portion thereof if a plaintiff 5 has raised claims that are legally frivolous or malicious, that fail to state a claim upon 6 which relief may be granted, or that seek monetary relief from a defendant who is 7 immune from such relief. 28 U.S.C. § 1915A(b)(1)–(2). 8 9 A pleading must contain a “short and plain statement of the claim showing that the pleader is entitled to relief.” Fed. R. Civ. P. 8(a)(2) (emphasis added). While Rule 8 10 does not demand detailed factual allegations, “it demands more than an unadorned, the- 11 defendant-unlawfully-harmed-me accusation.” Ashcroft v. Iqbal, 556 U.S. 662, 678 12 (2009). “Threadbare recitals of the elements of a cause of action, supported by mere 13 conclusory statements, do not suffice.” Id. 14 “[A] complaint must contain sufficient factual matter, accepted as true, to ‘state a 15 claim to relief that is plausible on its face.’” Id. (quoting Bell Atlantic Corp. v. Twombly, 16 550 U.S. 544, 570 (2007)). A claim is plausible “when the plaintiff pleads factual 17 content that allows the court to draw the reasonable inference that the defendant is liable 18 for the misconduct alleged.” Id. “Determining whether a complaint states a plausible 19 claim for relief [is] . . . a context-specific task that requires the reviewing court to draw 20 on its judicial experience and common sense.” Id. at 679. Thus, although a plaintiff’s 21 specific factual allegations may be consistent with a constitutional claim, a court must 22 assess whether there are other “more likely explanations” for a defendant’s conduct. Id. 23 at 681. 24 But as the United States Court of Appeals for the Ninth Circuit has instructed, 25 courts must “continue to construe pro se filings liberally.” Hebbe v. Pliler, 627 F.3d 338, 26 342 (9th Cir. 2010). A “complaint [filed by a pro se prisoner] ‘must be held to less 27 stringent standards than formal pleadings drafted by lawyers.’” Id. (quoting Erickson v. 28 Pardus, 551 U.S. 89, 94 (2007) (per curiam)). -2- 1 If the Court determines that a pleading could be cured by the allegation of other 2 facts, a pro se litigant is entitled to an opportunity to amend a complaint before dismissal 3 of the action. See Lopez v. Smith, 203 F.3d 1122, 1127-29 (9th Cir. 2000) (en banc). 4 Plaintiff’s Complaint will be dismissed for failure to state a claim, but because it may 5 possibly be amended to state a claim, the Court will dismiss it with leave to amend. 6 III. 7 8 Complaint In his three-count Complaint, Plaintiff sues the Scottsdale Police Department and Scottsdale Police Detective Darren Hyman. Plaintiff seeks monetary relief. 9 In Count One, Plaintiff asserts a Fourth Amendment Claim of illegal search and 10 seizure. In Count Two, Plaintiff asserts a Fourteenth Amendment Claim of deprivation 11 of personal property without due process of law. In Count Three, Plaintiff asserts that 12 Defendants stole his personal property, but he does not identify a separate constitutional 13 basis for this claim. All three counts arise from what appears to be a warrant-based 14 search of Plaintiff’s vehicle. 15 Plaintiff alleges that on May 20, 2014, Scottsdale Police Detectives Leal and 16 Hyman searched his vehicle and seized documents “outside of the scope of the warrant.” 17 These documents consisted of “evidence, legal notes, research and strategy” for Plaintiff 18 to represent himself in other legal proceedings. Defendant Hyman “misled the court” by 19 stating that these documents were “necessary to obtain the warrant.” 20 Plaintiff went to the Scottsdale Police station seeking to retrieve the documents, 21 and his requests were denied. Plaintiff called Defendant Hyman’s supervisor who told 22 him to contact Defendant Hyman. Plaintiff called Defendant Hyman and wrote to “the 23 Prosecutors Office, the Superior Court Justice David Seyer, [and] Scottsdale P.D. Legal 24 Department,” and either got no response or was told “no” to his requests to have his 25 documents returned. 26 On August 6, 2014, Plaintiff appeared at a civil hearing for which he needed the 27 seized documents. Defendant Hyman knew about the hearing and even appeared as a 28 witness in it, “even though he was not involved in that civil case whatsoever.” Plaintiff -3- 1 lost the hearing, and that case is now on appeal, but Plaintiff still does not have the seized 2 documents. Plaintiff believes that the Scottsdale Police Department’s refusal to return his 3 documents is a deliberate interference in his legal process, and he alleges that he lost his 4 first hearing and may lose on appeal as a result of this interference. 5 IV. Failure to State a Claim 6 To state a claim under § 1983, a plaintiff must allege facts supporting that (1) the 7 conduct about which he complains was committed by a person acting under the color of 8 state law and (2) the conduct deprived him of a federal constitutional or statutory right. 9 Wood v. Ostrander, 879 F.2d 583, 587 (9th Cir. 1989). In addition, a plaintiff must 10 allege that he suffered a specific injury as a result of the conduct of a particular defendant 11 and he must allege an affirmative link between the injury and the conduct of that 12 defendant. Rizzo v. Goode, 423 U.S. 362, 371-72, 377 (1976). 13 A. 14 A municipal police department is not a “person” within the meaning of § 1983. Scottsdale Police Department 15 See e.g., Petaway v. City of New Haven Police Dep’t, 541 F. Supp.2d 504 (D. Conn. 16 2008); Pahle v. Colebrookdale Tp., 227 F. Supp.2d 361 (E.D. Pa. 2002). But a 17 municipality is a “person” for purposes of § 1983 and may be sued. See Leatherman v. 18 Tarrant County Narcotics Intelligence and Coordination Unit , 507 U.S. 163, 166 (1993); 19 Monell v. Dep’t of Soc. Servs., 436 U.S. 658, 694 (1978). A municipality may not be 20 sued solely because an injury was inflicted by one of its employees or agents. Long v. 21 County of Los Angeles, 442 F.3d 1178, 1185 (9th Cir. 2006). A § 1983 claim against a 22 municipal defendant “cannot succeed as a matter of law” unless a plaintiff: (1) contends 23 that the municipal defendant maintains a policy or custom pertinent to the plaintiff’s 24 alleged injury; and (2) explains how such policy or custom caused the plaintiff’s injury. 25 Sadoski v. Mosley, 435 F.3d 1076, 1080 (9th Cir. 2006) (affirming dismissal of a 26 municipal defendant pursuant to Fed. R. Civ. P. 12(b)(6)). 27 The Scottsdale Police Department is not a proper Defendant and it will be 28 dismissed. To the extent that Plaintiff attempts to sue the City of Scottsdale, he fails to -4- 1 allege facts to support that the City of Scottsdale maintained a policy or custom that 2 resulted in the violation of Plaintiff’s federal constitutional rights or to explain how his 3 injuries were caused by any municipal policy or custom. Accordingly, Plaintiff also fails 4 to state a claim against the City of Scottsdale. 5 B. 6 The Fourth Amendment protects the “right of people to be secure in their persons, 7 houses, papers, and effects, against unreasonable searches and seizures” and decrees that 8 “no warrants shall issue, but upon probable cause, supported by oath or affirmation, and 9 particularly describing the place to be searched, and the persons or things to be seized.” Fourth Amendment 10 There are, however, exceptions to the warrant requirement. See, e.g., United States v. 11 Jenkins, 876 F.2d 1085, 1088 (2d Cir. 1989) (consent); United States v. Soussi, 29 F.3d 12 565, 571-72 (10th Cir. 1994) (consent); Roberts v. Spielman, 643 F.3d 899, 905 (11th 13 Cir. 2011) (exigent circumstances); and United States v. Hudson, 100 F.3d 1409, 1420 14 (9th Cir. 1996) (plain view). A seizure of property occurs when there is some meaningful 15 interference with an individual’s possessory interests in that property. Soldal v. Cook 16 County, Ill., 506 U.S. 56, 61 (1992) (citation and quotation omitted). 17 Plaintiff alleges sufficient facts to show a meaningful interference with his 18 possessory interests in his documents. He does not allege sufficient facts, however, to 19 show that this interference violated the Fourth Amendment. Although Plaintiff asserts 20 that his personal documents were “outside the scope of the warrant,” he fails to allege any 21 facts about the apparent warrant to show that the documents seized were outside its 22 scope. Moreover, Plaintiff’s allegation that Defendant Hyman “misled the court” by 23 saying these documents were “necessary to obtain the warrant” is vague and confusing. 24 Insofar as Plaintiff implies that Defendant Hyman falsely claimed the seized documents 25 were needed to obtain the warrant used to search Plaintiff’s vehicle, this allegation is 26 implausible. Defendant Hyman would not need to seize documents to obtain a warrant 27 he already had. Insofar as Plaintiff implies that Defendant Hyman seized documents 28 discovered during a warranted search and then falsely claimed they were necessary to -5- 1 obtain another warrant, Plaintiff fails to allege any facts about what ensued after the 2 seizure of his documents to show that Defendant Hyman’s alleged claim was false. 3 “The ‘plain view’ exception to the warrant requirement allows for the seizure of 4 evidence in plain view where two criteria are met: (1) ‘the initial intrusion must be 5 lawful’ and (2) ‘the incriminatory nature of the evidence must be immediately apparent to 6 the officers.’” Hudson, 100 F.3d at 1420 (citation omitted). Absent additional facts 7 showing what prompted the search of Plaintiff’s vehicle, what was included in the 8 warrant, where and how Plaintiff’s personal documents were discovered, and what 9 charges ensued, Plaintiff’s allegations are too vague and conclusory to state a Fourth 10 Amendment claim. 11 B. 12 Plaintiff fails to state a Fourteenth Amendment due process claim for the reasons Fourteenth Amendment 13 already discussed above. Plaintiff appears to assert that after seizing his personal 14 documents, Defendants held them without legal justification despite his repeated requests 15 to have them returned. As already noted, it is not clear from the allegations in the 16 complaint that the initial seizure of the documents was unlawful. Plaintiff fails to allege 17 facts showing that these documents were “outside of the scope of the warrant” and, even 18 if they were, that their seizure failed to meet an exception—such as the “plain view” 19 exception—to the warrant requirement. Additionally, Plaintiff fails to allege any facts 20 about the resulting charges and legal processes that ensued after his documents were 21 seized to show that the alleged ongoing seizure was “without due process of law.” 22 Absent additional facts, Plaintiff fails to state a Fourteenth Amendment due process 23 claim. 24 V. 25 Leave to Amend For the foregoing reasons, Plaintiff’s Complaint will be dismissed for failure to 26 state a claim upon which relief may be granted. Within 30 days, Plaintiff may submit a 27 first amended complaint to cure the deficiencies outlined above. The Clerk of Court will 28 mail Plaintiff a court-approved form to use for filing a first amended complaint. If -6- 1 Plaintiff fails to use the court-approved form, the Court may strike the amended 2 complaint and dismiss this action without further notice to Plaintiff. 3 Plaintiff must clearly designate on the face of the document that it is the “First 4 Amended Complaint.” The first amended complaint must be retyped or rewritten in its 5 entirety on the court-approved form and may not incorporate any part of the original 6 Complaint by reference. Plaintiff may include only one claim per count. 7 A first amended complaint supersedes the original complaint. Ferdik v. Bonzelet, 8 963 F.2d 1258, 1262 (9th Cir. 1992); Hal Roach Studios v. Richard Feiner & Co., 896 9 F.2d 1542, 1546 (9th Cir. 1990). After amendment, the Court will treat an original 10 complaint as nonexistent. Ferdik, 963 F.2d at 1262. Any cause of action that was raised 11 in the original complaint and that was voluntarily dismissed or was dismissed without 12 prejudice is waived if it is not alleged in a first amended complaint. Lacey v. Maricopa 13 County, 693 F.3d 896, 928 (9th Cir. 2012) (en banc). 14 VI. Warnings 15 A. 16 If Plaintiff is released while this case remains pending, and the filing fee has not Release 17 been paid in full, Plaintiff must, within 30 days of his release, either (1) notify the Court 18 that he intends to pay the unpaid balance of his filing fee within 120 days of his release or 19 (2) file a non-prisoner application to proceed in forma pauperis. Failure to comply may 20 result in dismissal of this action. 21 B. 22 Plaintiff must file and serve a notice of a change of address in accordance with Address Changes 23 Rule 83.3(d) of the Local Rules of Civil Procedure. Plaintiff must not include a motion 24 for other relief with a notice of change of address. Failure to comply may result in 25 dismissal of this action. 26 27 28 -7- 1 C. 2 Plaintiff must submit an additional copy of every filing for use by the Court. See Copies 3 LRCiv 5.4. Failure to comply may result in the filing being stricken without further 4 notice to Plaintiff. 5 D. 6 Because the Complaint has been dismissed for failure to state a claim, if Plaintiff Possible “Strike” 7 fails to file an amended complaint correcting the deficiencies identified in this Order, the 8 dismissal may count as a “strike” under the “3-strikes” provision of 28 U.S.C. § 1915(g). 9 Under the 3-strikes provision, a prisoner may not bring a civil action or appeal a civil 10 judgment in forma pauperis under 28 U.S.C. § 1915 “if the prisoner has, on 3 or more 11 prior occasions, while incarcerated or detained in any facility, brought an action or appeal 12 in a court of the United States that was dismissed on the grounds that it is frivolous, 13 malicious, or fails to state a claim upon which relief may be granted, unless the prisoner 14 is under imminent danger of serious physical injury.” 28 U.S.C. § 1915(g). 15 E. 16 If Plaintiff fails to timely comply with every provision of this Order, including Possible Dismissal 17 these warnings, the Court may dismiss this action without further notice. See Ferdik, 963 18 F.2d at 1260-61 (a district court may dismiss an action for failure to comply with any 19 order of the Court). 20 IT IS ORDERED: 21 (1) Plaintiff’s Application to Proceed In Forma Pauperis (Doc. 2) 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 not assessed an initial partial 24 filing fee. 25 (3) The Complaint (Doc. 1) is dismissed for failure to state a claim. Plaintiff 26 has 30 days from the date this Order is filed to file a first amended complaint in 27 compliance with this Order. 28 -8- 1 (4) If Plaintiff fails to file an amended complaint within 30 days, the Clerk of 2 Court must, without further notice, enter a judgment of dismissal of this action with 3 prejudice that states that the dismissal may count as a “strike” under 28 U.S.C. § 1915(g). 4 5 6 (5) The Clerk of Court must mail Plaintiff a court-approved form for filing a civil rights complaint by a prisoner. Dated this 2nd day of March, 2015. 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 -9- 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 and Administrative Fees. The total fees for this action are $400.00 ($350.00 filing fee plus $50.00 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. 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 $400 filing and administrative fees or the application to proceed in forma pauperis to: Revised 5/1/2013 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 court-approved 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 “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,” “2B,” 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, 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 5/1/2013 1 550/555 B. DEFENDANTS 1. Name of first Defendant: . The first Defendant is employed as: at . (Position and Title) 2. (Institution) . The second Defendant is employed as: Name of second Defendant: at . (Position and Title) 3. (Institution) Name of third Defendant: . The third Defendant is employed as: at . (Position and Title) 4. (Institution) Name of fourth Defendant: at (Position and Title) . The fourth Defendant is employed as: . (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 at your G Yes G No 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 at your G Yes G No 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

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