Wilson v. Beard et al
Filing
9
SCREENING ORDER GRANTING Plaintiff LEAVE TO FILE AMENDED COMPLAINT or NOTIFY Court of Willingness to Proceed on Cognizable Claims; Thirty Day Deadline signed by Magistrate Judge Barbara A. McAuliffe on 11/29/2017. (Attachments: # 1 Amended Complaint Form)(Sant Agata, S)
Plaintiff’s Name____________________________
Inmate No.________________________________
Address __________________________________
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IN THE UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF CALIFORNIA
(Name of Plaintiff)
vs.
AMENDED CIVIL RIGHTS COMPLAINT UNDER:
42 U.S.C. 1983 (State Prisoner)
Bivens Action [403 U.S. 388 (1971)] (Federal Prisoner)
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(Names of all Defendants)
(Case Number)
I. Previous Lawsuits (list all other previous or pending lawsuits on additional page):
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, attach additional page to continue
outlining all lawsuits in same format.)
1. Parties to this previous lawsuit:
Plaintiff _______________________________________________________________________
Defendants ____________________________________________________________________
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2. Court (if Federal Court, give name of District; if State Court, give name of County)
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3. Docket Number _____________________ 4. Assigned Judge _________________________
5. Disposition (Was the case dismissed? Appealed? Is it still pending?)
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6. Filing Date (approx.) _________________ 7. Disposition Date (approx.) ________________
II. Exhaustion of Administrative Remedies
NOTICE: Pursuant to the Prison Litigation Reform Act of 1995, A[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). Prior to filing suit, inmates are required to exhaust
the available administrative remedy process, Jones v. Bock, 549 U.S. 199, 211, 127 S.Ct. 910, 918‐19 (2007); McKinney v. Carey, 311
F.3d 1198, 1999 (9th Cir. 2002), and neither futility nor the unavailability of money damages will excuse the failure to exhaust, Porter
v. Nussle, 534 U.S. 516, 524, 122 S.Ct. 983, 988 (2002). If the court determines that an inmate failed to exhaust prior to filing suit,
the unexhausted claims will be dismissed, without prejudice. Jones, 549 U.S. at 223‐24, 127 S.Ct. at 925‐26.
A. Is there an inmate appeal or administrative remedy process available at your institution?
Yes_______ No______
B. Have you filed an appeal or grievance concerning ALL of the facts contained in this complaint?
Yes______ No______
C. Is the process completed?
Yes______
If your answer is yes, briefly explain what happened at each level.
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No______
If your answer is no, explain why not.
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III. Defendants
List each defendant’s full name, official position, and place of employment and address in the spaces below. If you need additional
space please provide the same information for any additional defendants on separate sheet of paper.
A. Name _________________________________ is employed as ______________________________________________
Current Address/Place of Employment ___________________________________________________________________
B. Name _________________________________ is employed as _______________________________________________
Current Address/Place of Employment ___________________________________________________________________
C. Name _________________________________ is employed as _______________________________________________
Current Address/Place of Employment ___________________________________________________________________
D. Name ________________________________ is employed as ________________________________________________
Current Address/Place of Employment ___________________________________________________________________
E. Name ________________________________ is employed as ________________________________________________
Current Address/Place of Employment ___________________________________________________________________
IV. Causes of Action (You may attach additional pages alleging other causes of action and the facts supporting them if necessary.
Must be in same format outlined below.)
Claim 1: The following civil right has been violated (e.g. right to medical care, access to courts, due process, free speech, freedom of
religion, freedom of association, freedom from cruel and unusual punishment, etc.):
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Supporting Facts (Include all facts you consider important to Claim 1. State what happened clearly and in your own words. You need
not cite legal authority or argument. Be certain to describe exactly what each defendant, by name, did to violate the right alleged in
Claim 1.):
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Claim 2: The following civil right has been violated (e.g. right to medical care, access to courts, due process, free speech, freedom of
religion, freedom of association, freedom from cruel and unusual punishment, etc.):
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Supporting Facts (Include all facts you consider important to Claim 2. State what happened clearly and in your own words. You need
not cite legal authority or argument. Be certain to describe exactly what each defendant, by name, did to violate the right alleged in
Claim 2.):
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V. Relief
State briefly exactly what you want the court to do for you. Make no legal arguments. Cite no cases or statues.
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I declare under penalty of perjury that the foregoing is true and correct.
Date: ___________________ Signature of Plaintiff: _______________________________________________
(Revised 4/4/14)
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