Washington et al v. Fresno County Sheriff et al

Filing 4

ORDER Granting Anthonia Washington's 3 Application to Proceed In Forma Pauperis; Requiring Plaintiff Perry Washington to File An Application to Proceed In Forma Pauperis; and Striking Unsigned Complaint 1 , signed by Magistrate Judge Stanley A. Boone on 2/3/14. Thirty-Day Deadline. (Attachments: # 1 IFP Application & Instructions, # 2 Civil Rights Complaint Form)(Gonzalez, R)

INSTRUCTIONS FOR FILING A COMPLAINT BY A PRISONER UNDER CIVIL RIGHTS
STATUTE 42 U.S.C. § 1983
I. Scope of Section 1983
An action under Section 1983 is available to challenge violations of the federal constitution
or federal statutes which affect the conditions of your confinement or your treatment by government
employees while in custody. Although you may ask for and obtain money damages or an injunction
under Section 1983, the court cannot issue an order which could affect the length of your sentence
in any way. Those types of claims may be raised only through a petition for writ of habeas corpus.
If you want to file a petition for a writ of habeas corpus, you must do so on the correct forms, which
are provided by the Clerk of the Court on request.
A.

Exhaustion of Administrative Remedies

If there is an inmate appeal or administrative remedy process available at your institution,
you may not file an action under Section 1983, or any other federal law, until you have first
completed (exhausted) the process available at your institution. You are required to
complete (exhaust) the inmate appeal or administrative remedy process before filing suit,
regardless of the relief offered by the process. Booth v. Churner, 532 U.S. 731, 741 (2001);
McKinney v. Carey, 311 F.3d 1198, 1199 (9th Cir. 2002). Even if you are seeking only
money damages and the inmate appeal or administrative remedy process does not provide
money, you must exhaust the process before filing suit. Booth, 532 U.S. at 734.
II. Packet
A copy of a complaint form is attached to this instruction sheet. In addition, included in the
packet is an information sheet for prisoners seeking leave to proceed in forma pauperis (without
prepayment of filing fees) and a copy of an application to proceed in forma pauperis. To file an
action, you must send all the following items to the court:
1.

An original and one copy of the complaint. You must keep an additional copy of the
complaint for your own records. All copies of the complaint must be identical to the
original. If you wish to have a conformed copy of your complaint returned to you,
you must send, in addition to the original, two extra copies and provide the court with
a self-addressed postage paid envelope

2.

Either a completed in forma pauperis application or the $350.00 filing fee.

NOTICE:

Leave to proceed in forma pauperis allows a case to proceed without pre-payment of the
filing fee. However, a prisoner who brings a civil action in forma pauperis shall
nevertheless be required to pay the full amount of the filing fee. The court shall collect the
filing fee through deductions from the prisoner’s trust account. Dismissal of the case does
not excuse payment of the full filing fee. See 28 U.S.C. § 1915.

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III. Complaint Form
Your complaint must be legibly handwritten or typewritten. You must sign the complaint
and declare under penalty of perjury that the facts stated in the complaint are correct. If you need
additional space to answer a question, you should attach an additional blank page. You are required
to state facts in support of each claim. The complaint should refer to the provision of the federal
constitution or federal law on which you are relying, but should not contain legal arguments or
citations.

IV. Venue
Your complaint should be filed in the Fresno Division of this court only if one or more of the
named defendants is located in the Fresno Division of the Eastern District of California, or if your
claim arose in the Fresno Division of this district. The Fresno Division of the Eastern District of
California is comprised of the following counties: Fresno, Calaveras, Inyo, Kern, Kings, Madera,
Mariposa, Merced, Stanislaus, Tulare, and Tuolumne.
Your complaint should be filed in the Sacramento Division of this court only if one or more
of the named defendants is located in the Sacramento Division of the Eastern District of California,
or if your claim arose in the Sacramento Division of this district. The Sacramento Division of the
Eastern District of California is comprised of the following counties: Alpine, Amador, Butte,
Colusa, El Dorado, Glenn, Lassen, Modoc, Mono, Nevada, Placer, Plumas, Sacramento, San
Joaquin, Shasta, Sierra, Siskiyou, Solano, Sutter, Tehama, Trinity, Yolo, and Yuba..

V. Mailing the Forms
When all of the forms described in part II are completed, if you are filing your case in the
Fresno Division, mail the original and copies to:
Clerk of the U.S. District Court
for the Eastern District of California
2500 Tulare Street, Suite 1501
Fresno, California 93721-2201
If you are filing your case in the Sacramento Division, mail the original and copies to:
Clerk of the U.S. District Court
for the Eastern District of California
501 “I” Street, Suite 4-200
Sacramento, California 95814
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VI. After the Complaint is Filed
Once the complaint is filed, the court will review it and decide whether to order service of
the complaint on the defendants. You will be sent a copy of any order the court issues. Because of
the large volume of cases filed by inmates pending in this court, the court WILL NOT ANSWER
INQUIRIES concerning the status of your complaint.
You must keep the Clerk of the Court informed of any change of address. If you fail
to do so, the Clerk cannot be responsible for your failure to receive Court orders.
This could result in the dismissal of your suit.
The Clerk of the Court cannot provide copies of documents to litigants, except at a charge
of fifty cents ($0.50) per page. This charge also applies to litigants proceeding in forma pauperis.
Therefore you must keep copies of all documents submitted to the court for your own records.

VII.

Submission of Original Paper Exhibits

The Eastern District of California converted to an electronic filing, service, and storage
system, effective January 3, 2005. Pro se litigants are exempt from the electronic filing requirement
and must submit all documents to the court in paper. Local Rule 5-133(b)(2). Paper documents
submitted by pro se litigants for filing will be scanned into the electronic court file by the Clerk’s
Office. After being scanned into the electronic court file, the paper documents will be retained in
the Clerk’s Office for a limited period of time and then discarded. Local Rule 39-138(d). For this
reason, pro se litigants are cautioned not to send original exhibits to the court. If pro se litigants
choose to submit exhibits to the court, the litigants shall retain their original exhibits and send
photocopies to the court.

(Revised 8/30/06)

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Plaintiff’s Name
Inmate No.
Address

IN THE UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF CALIFORNIA

(Name of Plaintiff)

(Case Number)

vs.

COMPLAINT

________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
(Names of all Defendants)

Civil Rights Act, 42 U.S.C. § 1983

I. Previous Lawsuits (list all other previous or pending lawsuits on back of this form):
A.

Have you brought any other lawsuits while a prisoner? Yes

No

B.

If your answer to A is yes, how many?
Describe previous or pending lawsuits in the space below.
(If more than one, use back of paper to continue outlining all lawsuits.)
1. Parties to this previous lawsuit:
Plaintiff
Defendants

2. Court (if Federal Court, give name of District; if State Court, give name of County)

3. Docket Number

4. Assigned Judge

5. Disposition (For example: W as the case dismissed? W as it appealed? Is it still pending?)

6. Filing date (approx.)

7. Disposition date (approx.)

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II.

Exhaustion of Administrative Remedies
A.
Yes
B.

Is there an inmate appeal or administrative remedy process available at your institution?
No

Have you filed an appeal or grievance concerning ALL of the facts contained in this complaint?
Yes

No

If your answer is no, explain why not

C.

Is the process completed?
Yes___

No

NOTICE:

If your answer is yes, briefly explain what happened at each level.

If your answer is no, explain why not.

Pursuant to the Prison Litigation Reform Act of 1995, “[n]o action shall be brought with respect to
prison conditions under [42 U.S.C. § 1983], or any other Federal law, by a prisoner confined in
any jail, prison, or other correctional facility until such administrative remedies as are available are
exhausted.” 42 U.S.C. § 1997e(a). If there is an inmate appeal or administrative remedy process
available at your institution, you may not file an action under Section 1983, or any other federal
law, until you have first completed (exhausted) the process available at your institution. You are
required to complete (exhaust) the inmate appeal or administrative remedy process before filing
suit, regardless of the relief offered by the process. Booth v. Churner, 532 U.S. 731, 741 (2001);
McKinney v. Carey, 311 F.3d 1198, 1999 (9th Cir. 2002). Even if you are seeking only money
damages and the inmate appeal or administrative remedy process does not provide money,
you must exhaust the process before filing suit. Booth, 532 U.S. at 734.

III. Defendants
(In Item A below, place the full name of the defendant in the first blank, his/her official position in the
second blank, and his/her place of employment in the third blank. Use item B for the names, positions and
places of employment of any additional defendants.)
A.

Defendant

is employed as
at

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B.

IV.

Additional defendants

Statement of Claim
(State here as briefly as possible the facts of your case. Describe how each defendant is involved,
including dates and places. Do not give any legal arguments or cite any cases or statutes. Attach extra
sheets if necessary.)

V. Relief.
(State briefly exactly what you want the court to do for you. Make no legal arguments. Cite no cases or
statutes.)

I declare under penalty of perjury that the foregoing is true and correct.

Date

Signature of Plaintiff

(revised 6/01/04)

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Name:___________________________________
CDC No:_________________________________
Address:_________________________________
_________________________________________

UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF CALIFORNIA
FRESNO DIVISION

CASE NUMBER:
Plaintiff,
vs.

APPLICATION TO PROCEED
IN FORMA PAUPERIS
BY A PRISONER
Defendants.
/

I,
, declare that I am the plaintiff in the above-entitled proceeding;
that, in support of my request to proceed without prepayment of fees under 28 U.S.C. section 1915, I declare
that I am unable to pay the fees for these proceedings or give security therefor and that I am entitled to the
relief sought in the complaint.
In support of this application, I answer the following questions under penalty of perjury:
1.

Are you currently incarcerated?

Yes

No (If “no” DO NOT USE THIS FORM)

State the place of your incarceration.
2.

Are you currently employed (includes prison employment)?

Yes

No

a.
b.

3.

If the answer is “yes” state the amount of your pay.
If the answer is “no” state the date of your last employment, the amount of your take-home
salary or wages and pay period, and the name and address of your last employer.

Have you received any money from the following sources over the last twelve months?
a.

Business, profession, or other self-employment:

Yes

No

b.

Rent payments, interest or dividends:

Yes

No

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c.

Pensions, annuities or life insurance payments:

Yes

No

d.

Disability or workers compensation payments:

Yes

No

e..

Gifts or inheritances:

Yes

No

f.

Any other sources:

Yes

No

If the answer to any of the above is “yes,” describe by that item each source of money. Also state
the amount received and what you expect you will continue to receive (attach an additional sheet if
necessary).

4.

Do you have cash (includes balance of checking or savings accounts)?

Yes

No

If “yes” state the total amount:
5.

Do you own any real estate, stocks, bonds, securities, other financial instruments, automobiles or
other valuable property?
Yes
No
If “yes” describe the property and state its value:

6.

Do you have any other assets?

Yes

No

If “yes,” list the asset(s) and state the value of each asset listed:

7.

List all persons dependent on you for support, stating your relationship to each person listed and
how much you contribute to their support.

IMPORTANT:

This form must be dated and signed below in order for the court to
consider your application.

I hereby authorize the agency having custody of me to collect from my trust account and forward
to the Clerk of the United States District Court payments in accordance with 28 U.S.C. section 1915(b)(2).

DATE

NOTE:

SIGNATURE OF APPLICANT

Within sixty days from the date of this application you must forward to the court a
certified copy of your prison trust account statement showing transactions for the
past six months.
(Revised 01/2008)

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