Valez v. Corrections Corporation of America et al

Filing 4

*ORDER: The Complaint #1 is dismissed for failure to state a claim. Plaintiff has 30 days from the date this Order is filed to file a first amended complaint in compliance with this Order. If Plaintiff fails to file an 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) and deny any pending unrelated motions as moot. Plaintiff's Motion for Appointment of Counsel #2 is denied without prejudice. Signed by Senior Judge James A Teilborg on 9/08/2020. (REK) *Modified text on 9/8/2020 (REK).

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IN THE UNITED STATES DISTRICT COURT

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FOR THE DISTRICT OF ARIZONA

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Carlos Valez,

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No. CV 20-01400-PHX-JAT (DMF)
Plaintiff,

v.

ORDER

Corrections Corporation of America, et
al.,

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Defendants.

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On July 15, 2020, Plaintiff Carlos Valez, who is confined in the Northern Nevada

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Correctional Center in Carson City, Nevada, filed a pro se civil rights Complaint pursuant
to 42 U.S.C. § 1983 (Doc. 1) and a Motion for Appointment of Counsel (Doc. 2) and paid
the filing and administrative fees. The Court will dismiss the Complaint with leave to
amend and will deny without prejudice the Motion for Appointment of Counsel.
I.

Statutory Screening of Prisoner Complaints
The Court is required to screen complaints brought by prisoners seeking relief

against a governmental entity or an officer or an employee of a governmental entity. 28
U.S.C. § 1915A(a). The Court must dismiss a complaint or portion thereof if a plaintiff
has raised claims that are legally frivolous or malicious, that fail to state a claim upon which
relief may be granted, or that seek monetary relief from a defendant who is immune from
such relief. 28 U.S.C. § 1915A(b)(1)–(2).
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 does

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not demand detailed factual allegations, “it demands more than an unadorned, the-

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defendant-unlawfully-harmed-me accusation.”

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(2009). “Threadbare recitals of the elements of a cause of action, supported by mere

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conclusory statements, do not suffice.” Id.

Ashcroft v. Iqbal, 556 U.S. 662, 678

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

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

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

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

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

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

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experience and common sense.” Id. at 679. Thus, although a plaintiff’s specific factual

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

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are other “more likely explanations” for a defendant’s conduct. Id. at 681.

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

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

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(9th Cir. 2010). A “complaint [filed by a pro se prisoner] ‘must be held to less stringent

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

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U.S. 89, 94 (2007) (per curiam)).

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

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facts, a pro se litigant is entitled to an opportunity to amend a complaint before dismissal

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

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Plaintiff’s Complaint will be dismissed for failure to state a claim, but because it may

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possibly be amended to state a claim, the Court will dismiss it with leave to amend.

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II.

Complaint

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In his two-count Complaint, Plaintiff names as Defendants Corrections Corporation

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of America (CCA),1 Warden Thomas B., Lieutenant Perez, Case Counselor Ortega,

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Corrections Corporation of America (CCA) has changed its name to CoreCivic as
part of a rebranding.
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Investigator Bawlick, and Case Manager Norvaes. In his Request for Relief, Plaintiff seeks

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monetary damages, a federal investigator to investigate the treatment of inmates at all CCA

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facilities, and his attorney’s fees and filing fees.

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In Count One, Plaintiff alleges he was subjected to excessive force. He claims that

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when he was confined at CCA’s Saguaro Correctional Center in Eloy, Arizona, he woke

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up at 11:00 a.m., and noticed there was a lot of noise on his tier. Plaintiff contends

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Defendant Perez came to his cell door and, using Defendant Norvaes to communicate to

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Plaintiff in Spanish, ordered Plaintiff to strip naked. Plaintiff alleges he did and was

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standing naked in front of his cell door. He claims Defendant Perez opened Plaintiff’s food

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slot and pointed at Plaintiff’s penis and Defendants Ortega, Bawlick, and Norvaes were

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laughing at him. Plaintiff alleges he asked if he could put his boxer shorts back on, but

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Defendant Perez, through Defendant Norvaes, told him that he could not and told him to

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come out of his cell onto the tier. Plaintiff alleges he was embarrassed and, therefore,

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refused. He asserts he then was sprayed in the mouth with pepper spray, without warning,

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and “they” opened his cell door, rushed in, hit him in the head, and kicked him in the side.

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Plaintiff claims he passed out and, when he regained consciousness, his boxers were on

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and “they” told him that they had found a weapon. Plaintiff asserts he never had a weapon.

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He alleges he suffered lung issues, long-term breathing difficulty, a bloody nose, a skin

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rash, and bruised ribs.

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to July 23, 2018. He claims he was denied an informal grievance, access to a law library,

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pen and paper, his property containing his legal work, the addresses of his family members,

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stamps, and envelopes. Plaintiff contends he verbally requested these items daily to

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numerous corrections officers, but most corrections officers did not speak Spanish and

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ignored him. He claims he was denied an opportunity to pursue administrative remedies,

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access to the law library to get help, and pens and paper to communicate.

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....

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In Count Two, Plaintiff alleges he was denied access to the court from February 2

....

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III.

Failure to State a Claim

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Although pro se pleadings are liberally construed, Haines v. Kerner, 404 U.S. 519,

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520-21 (1972), conclusory and vague allegations will not support a cause of action. Ivey

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v. Bd. of Regents, 673 F.2d 266, 268 (9th Cir. 1982). Further, a liberal interpretation of a

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civil rights complaint may not supply essential elements of the claim that were not initially

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pled. Id.

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A.

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To state a claim under § 1983 against a private entity performing a traditional public

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function, such as housing prisoners, a plaintiff must allege facts to support that his

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constitutional rights were violated as a result of a policy, decision, or custom promulgated

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or endorsed by the private entity. See Tsao v. Desert Palace, Inc., 698 F.3d 1128, 1138-

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39 (9th Cir. 2012); Buckner v. Toro, 116 F.3d 450, 452 (11th Cir. 1997) (per curiam). A

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plaintiff must allege the specific policy or custom and how it violated his constitutional

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rights. A private entity is not liable merely because it employs persons who allegedly

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violated a plaintiff’s constitutional rights. See Tsao, 698 F.3d at 1139; Buckner, 116 F.3d

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at 452.

Defendant CCA

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Plaintiff does not allege that any of the conduct described in the Complaint was the

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result of a specific policy or custom of Defendant CCA. Thus, the Court will dismiss

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without prejudice Defendant CCA.

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To state a valid claim under § 1983, plaintiffs must allege that they suffered a

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specific injury as a result of specific conduct of a defendant and show an affirmative link

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between the injury and the conduct of that defendant. See Rizzo v. Goode, 423 U.S. 362,

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371-72, 377 (1976). There is no respondeat superior liability under § 1983, and therefore,

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a defendant’s position as the supervisor of persons who allegedly violated Plaintiff’s

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constitutional rights does not impose liability. Monell v. Dep’t of Soc. Servs., 436 U.S. 658

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(1978); Hamilton v. Endell, 981 F.2d 1062, 1067 (9th Cir. 1992); Taylor v. List, 880 F.2d

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B.

1040, 1045 (9th Cir. 1989). “Because vicarious liability is inapplicable to . . . § 1983 suits,

Defendant Thomas B.

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a plaintiff must plead that each Government-official defendant, through the official’s own

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individual actions, has violated the Constitution.” Iqbal, 556 U.S. at 676.

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Plaintiff has not alleged that Defendant Thomas B. personally participated in a

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deprivation of Plaintiff’s constitutional rights, was aware of a deprivation and failed to act,

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or formed policies that resulted in Plaintiff’s injuries. Plaintiff has made no allegations at

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all against Defendant Thomas B. Thus, the Court will dismiss without prejudice Defendant

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Thomas B.

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C.

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When an inmate claims that prison officials violated his Eighth Amendment rights

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by using excessive physical force, the relevant inquiry is “whether force was applied in a

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good-faith effort to maintain or restore discipline, or maliciously and sadistically to cause

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harm.” Hudson v. McMillian, 503 U.S. 1, 7 (1992). However, the Supreme Court has

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made it clear that not every use of physical force violates the Eighth Amendment:

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That is not to say that every malevolent touch by a prison guard gives
rise to a federal cause of action. See Johnson v. Glick, 481 F.2d [1028,
1033 (2nd Cir. 1973)] (“Not every push or shove, even if it may later
seem unnecessary in the peace of a judge’s chambers, violates a
prisoner’s constitutional rights”).

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Count One

Id. at 9.

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Plaintiff’s allegations are insufficient to state a claim that any Defendant used force

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maliciously or sadistically to cause harm. Plaintiff does not allege that there was no valid

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penological reason for Defendant Perez to direct him to leave his cell, despite being nude,

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and it appears Plaintiff refused this instruction. Absent more, Plaintiff’s allegations are too

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vague and conclusory to state a claim. Thus, the Court will dismiss without prejudice

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Count One.

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Plaintiff has simply made vague and conclusory allegations against groups of

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Defendants, without any factual specificity as to what any particular Defendant did or

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D.

Count Two

failed to do. This is insufficient. See Marcilis v. Twp. of Redford, 693 F.3d 589, 596 (6th

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Cir. 2012) (upholding dismissal of Bivens complaint that referred to all defendants

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“generally and categorically” because the plaintiff had failed to “‘allege, with particularity,

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facts that demonstrate what each defendant did to violate the asserted constitutional right.’”

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(quoting Lanman v. Hinson, 529 F.3d 673, 684 (6th Cir. 2008))); Robbins v. Oklahoma,

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519 F.3d 1242, 1250 (10th Cir. 2008) (“Given the complaint’s use of either the collective

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term ‘Defendants’ or a list of the defendants named individually but with no distinction as

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to what acts are attributable to whom, it is impossible for any of these individuals to

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ascertain what particular unconstitutional acts they are alleged to have committed.”). Thus,

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the Court will dismiss without prejudice Count Two.

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IV.

Leave to Amend

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For the foregoing reasons, Plaintiff’s Complaint will be dismissed for failure to state

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a claim upon which relief may be granted. Within 30 days, Plaintiff may submit a first

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amended complaint to cure the deficiencies outlined above. The Clerk of Court will mail

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Plaintiff a court-approved form to use for filing a first amended complaint. If Plaintiff fails

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to use the court-approved form, the Court may strike the amended complaint and dismiss

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this action without further notice to Plaintiff.

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

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

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

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Complaint by reference. Plaintiff may include only one claim per count.

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963 F.2d 1258, 1262 (9th Cir. 1992); Hal Roach Studios v. Richard Feiner & Co., 896 F.2d

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1542, 1546 (9th Cir. 1990). After amendment, the Court will treat the original Complaint

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as nonexistent. Ferdik, 963 F.2d at 1262. Any cause of action that was raised in the

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original Complaint and that was voluntarily dismissed or was dismissed without prejudice

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is waived if it is not alleged in a first amended complaint. Lacey v. Maricopa County, 693

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F.3d 896, 928 (9th Cir. 2012) (en banc).

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A first amended complaint supersedes the original Complaint. Ferdik v. Bonzelet,

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If Plaintiff files an amended complaint, Plaintiff must write short, plain statements

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telling the Court: (1) the constitutional right Plaintiff believes was violated; (2) the name

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of the Defendant who violated the right; (3) exactly what that Defendant did or failed to

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do; (4) how the action or inaction of that Defendant is connected to the violation of

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Plaintiff’s constitutional right; and (5) what specific injury Plaintiff suffered because of

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that Defendant’s conduct. See Rizzo, 423 U.S. at 371-72, 377.

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Plaintiff must repeat this process for each person he names as a Defendant. If

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Plaintiff fails to affirmatively link the conduct of each named Defendant with the specific

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injury suffered by Plaintiff, the allegations against that Defendant will be dismissed for

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failure to state a claim.

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Defendants has violated a constitutional right are not acceptable and will be

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dismissed.

Conclusory allegations that a Defendant or group of

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If Plaintiff files an amended complaint, he should be aware that prisoners have a

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right under the First and Fourteenth Amendments to litigate their claims “without active

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interference by prison officials.” Silva v. DiVittorio, 658 F.3d 1090, 1103 (9th Cir. 2011)

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(emphasis in original), overruled on other grounds as stated in Richey v. Dahne, 807 F.3d

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1202, 1209 n.6 (9th Cir. 2015). The right of access to the courts is only a right to bring

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petitions or complaints to federal court and not a right to discover such claims or even to

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ligate them effectively once filed with a court. Lewis v. Casey, 518 U.S. 343, 354 (1996).

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The right “guarantees no particular methodology but rather the conferral of a capability–

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the capability of bringing contemplated challenges to sentences or conditions of

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confinement before the courts.” Id. at 356.

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suffered an “actual injury”—i.e., “actual prejudice with respect to contemplated or existing

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litigation, such as the inability to meet a filing deadline or to present a claim.” Id. at 348

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(citation omitted); see also Davis v. Goord, 320 F.3d 346, 352 (2d Cir. 2003) (“Mere ‘delay

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in being able to work on one’s legal action or communicate with the courts does not rise to

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As a matter of standing for an access-to-courts claim, a plaintiff must show that he

the level of a constitutional violation.’”) (citations omitted); cf. Silva, 658 F.3d at 1104

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(actual injury alleged where plaintiff claimed pending lawsuits had been dismissed as the

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result of defendants’ actions). A prisoner must demonstrate that defendants’ conduct

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frustrated or impeded him from bringing to court a nonfrivolous or arguable claim he

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wished to present. Lewis, 518 U.S. at 353 and n.3.

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Plaintiff should also take note that although prisoners have a First Amendment right

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to file prison grievances, Rhodes v. Robinson, 408 F.3d 559, 567 (9th Cir. 2005), “[t]here

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is no legitimate claim of entitlement to a grievance procedure,” Mann v. Adams, 855 F.2d

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639, 640 (9th Cir. 1988), and the failure to follow grievance procedures does not give rise

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to a due process claim. See Flournoy v. Fairman, 897 F. Supp. 350, 354 (N.D. Ill. 1995)

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(jail grievance procedures did not create a substantive right enforceable under § 1983);

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Spencer v. Moore, 638 F. Supp. 315, 316 (E.D. Mo. 1986) (violations of grievance system

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procedures do not deprive inmates of constitutional rights). In addition, “[t]he right to

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petition the government for redress of grievances . . . does not guarantee a favorable

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response, or indeed any response, from state officials. Moreover, the First Amendment’s

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right to redress of grievances is satisfied by the availability of a judicial remedy.” Baltoski

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v. Pretorius, 291 F. Supp. 2d 807, 811 (N.D. Ind. 2003); see also Ashann-Ra v. Virginia,

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112 F. Supp. 2d 559, 569 (W.D. Va. 2000) (failure to comply with state’s grievance

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procedure is not actionable under § 1983 and does not compromise an inmate’s right of

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access to the courts).

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V.

Motion for Appointment of Counsel

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counsel, the “substantive issues and procedural matters in this case are too complex for

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[his] comprehension and abilities,” and he is housed in a restricted unit, does not

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understand American law, only speaks Spanish, and is unable to read or write very well.

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He attaches a letter from another inmate who indicates that he prepared the Complaint for

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Plaintiff to the best of his abilities, but it is very difficult for Plaintiff to communicate; the

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other inmate is being transferred and will be unable to help Plaintiff; and other inmates

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In his Motion for Appointment of Counsel, Plaintiff alleges he is unable to afford

cannot come into Plaintiff’s restricted unit to help him.

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There is no constitutional right to the appointment of counsel in a civil case. See

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Ivey v. Bd. of Regents, 673 F.2d 266, 269 (9th Cir. 1982). In proceedings in forma pauperis,

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the court may request an attorney to represent any person unable to afford one. 28 U.S.C.

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§ 1915(e)(1). Appointment of counsel under 28 U.S.C. § 1915(e)(1) is required only when

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“exceptional circumstances” are present. Terrell v. Brewer, 935 F.2d 1015, 1017 (9th Cir.

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1991). A determination with respect to exceptional circumstances requires an evaluation

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of the likelihood of success on the merits as well as the ability of Plaintiff to articulate his

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claims pro se in light of the complexity of the legal issue involved. Id. “Neither of these

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factors is dispositive and both must be viewed together before reaching a decision.” Id.

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(quoting Wilborn v. Escalderon, 789 F.2d 1328, 1331 (9th Cir. 1986)).

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Having considered both elements, it does not appear at this time that exceptional

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circumstances are present that would require the appointment of counsel in this case.

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Plaintiff is in no different position than many pro se prisoner litigants. Thus, the Court will

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deny without prejudice Plaintiff’s Motion for Appointment of Counsel.

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VI.

Warnings

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A.

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

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

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

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action.

Address Changes

Possible “Strike”

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Because the Complaint has been dismissed for failure to state a claim, if Plaintiff

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fails to file an amended complaint correcting the deficiencies identified in this Order, the

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dismissal may count as a “strike” under the “3-strikes” provision of 28 U.S.C. § 1915(g).

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Under the 3-strikes provision, a prisoner may not bring a civil action or appeal a civil

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

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

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B.

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

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

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

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C.

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

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

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

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the Court).

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IT IS ORDERED:

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(1)

Possible Dismissal

The Complaint (Doc. 1) is dismissed for failure to state a claim. Plaintiff

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has 30 days from the date this Order is filed to file a first amended complaint in compliance

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with this Order.

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(2)

If Plaintiff fails to file an amended complaint within 30 days, the Clerk of

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

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

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and deny any pending unrelated motions as moot.

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(3)

Plaintiff’s Motion for Appointment of Counsel (Doc. 2) is denied without

prejudice.
(4)

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

civil rights complaint by a prisoner.
Dated this 8th day of September, 2020.

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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(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. 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 $400 filing and
administrative fees or the application to proceed in forma pauperis to:

Revised 3/11/16

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

OR

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. 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.
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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,
CASE NO. __________________________________
(To be supplied by the Clerk)

v.
(1) _______________________________________ ,
(Full Name of Defendant)

CIVIL RIGHTS COMPLAINT
BY A PRISONER

(2) _______________________________________ ,
(3) _______________________________________ ,

G Original Complaint
G First Amended Complaint
G Second Amended Complaint

(4) _______________________________________ ,
Defendant(s).

G Check if there are additional Defendants and attach page 1-A listing them.
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 3/11/16

1

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?

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:
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

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 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

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 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.

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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.

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