Rowland v. Unknown
ORDER signed by Magistrate Judge Kendall J. Newman on 4/2/2014 ORDERING 1 Plaintiff's 3/21/2014 request is DENIED without prejudice; plaintiff is GRANTED 30 days from the date of service of this order to file a complaint that complies with the requirements of the Civil Rights Act, the FRCP and the Local Rules of Practice; the Clerk of the Court is directed to send plaintiff the court's form for filing a civil rights action, and the application to proceed ifp by a prisoner. (Attachments: # 1 Prisoner Civil Rights Form)(Reader, L)
INSTRUCTIONS FOR FILING A COMPLAINT BY A PRISONER
UNDER THE 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 only be raised through a
petition for a 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.
One copy of a complaint form is attached to this instruction sheet. In addition,
included in the packet are an information sheet for prisoners seeking leave to proceed in forma
pauperis (without prepayment of filing fees) and one copy of an application to proceed in forma
pauperis. To start an action, the following items must be included:
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.
Either a completed in forma pauperis application or pay the $400.00 filing fee.
III. Complaint Form
Your complaint must be legibly handwritten or typewritten. You must sign each copy of
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.
Your complaint should be brought 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
“instruct” Revised 2/05
Your complaint should be brought 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.
V. Mailing the Forms
When all of the forms described in part II are completed, if you are bringing 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, Room 4-200
Sacramento, California 95814
If you are bringing 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
Fresno, California 93721
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's Office will provide copies of documents and of the docket sheet at $0.50 per
page. Checks in the exact amount are made payable to "Clerk, USDC." Please Note:
In Forma Paperis status does not include the cost of copies. Copies of documents in cases
may also be obtained by printing from the public terminals at the Clerk's Office or by
contacting Cal Legal Support Group at: 3104 "O" Street, Suite 291, Sacramento, CA 95816,
phone 916-441-4396, fax 916-400-4948.
IN THE UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF CALIFORNIA
(Name of Plaintiff)
(Address of Plaintiff)
(Names of Defendants)
I. Previous Lawsuits:
A. Have you brought any other lawsuits while a prisoner:
B. If your answer to A is yes, how many?:
Describe the lawsuit in the space
below. (If there is more than one lawsuit, describe the additional lawsuits on another piece of paper
using the same outline.)
1. Parties to this previous lawsuit:
FORM TO BE USED BY A PRISONER IN FILING A COMPLAINT
UNDER THE CIVIL RIGHTS ACT, 42 U.S.C. § 1983
2. Court (if Federal Court, give name of District; if State Court, give name of County)
3. Docket Number
4. Name of judge to whom case was assigned
(For example: W as the case dismissed? W as it appealed? Is it still pending?)
6. Approximate date of filing lawsuit
7. Approximate date of disposition
II. Exhaustion of Administrative Remedies
A. Is there a grievance procedure available at your institution?
B. Have you filed a grievance concerning the facts relating to this complaint?
If your answer is no, explain why not
C. Is the grievance process completed?
(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.)
is employed as
B. 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.)
(State briefly exactly what you want the court to do for you. Make no legal arguments. Cite
no cases or statutes.)
(Signature of Plaintiff)
I declare under penalty of perjury that the foregoing is true and correct.
(Signature of Plaintiff)
INFORMATION TO PRISONERS SEEKING LEAVE TO
PROCEED WITH A CIVIL ACTION IN FEDERAL COURT
IN FORMA PAUPERIS PURSUANT TO 28 U.S.C. § 1915
In accordance with 1996 amendments to the in forma pauperis (IFP) statute, as a prisoner you
will be obligated to pay the filing fee of $350.00 for a civil action. If you later file an appeal, the
filing fee for the appeal is $455.00.
If you have the money to pay the filing fee, you should send a cashier’s check or money order
to the court with your complaint, petition, or notice of appeal and, if appropriate, your IFP
If you do not have enough money to pay the full filing fee when your action is filed, you can
file the action without prepaying the filing fee. However, the court will assess an initial partial filing
fee at the time your action is filed. The initial partial filing fee will be equal to 20 percent of the
average monthly deposits to your prison or jail account for the six months immediately preceding the
filing of the lawsuit, or 20 percent of the average monthly balance in your prison or jail account for
that same six month period, whichever is greater. The court will order the agency that has custody of
you to take that initial partial filing fee out of your prison or jail account as soon as funds are
available and to forward the money to the court.
After the initial partial filing fee has been paid, you will owe the balance of the filing fee.
Until the amount of the filing fee is paid in full, each month you will owe 20 percent of your
preceding month’s income toward the balance. The agency that has custody of you will collect that
money and send payments to the court any time the amount in the account exceeds $10.00. The
balance of the filing fee may be collected even if the action is later dismissed, summary judgment is
granted against you or you fail to prevail at trial.
In order to proceed with an action in forma pauperis you must complete the attached form
and return it to the court with your complaint. You must have a prison or jail official complete the
Certification section on the back of the form and attach to the form a certified copy of your prison or
jail account statement for the last six months. If you submit an incomplete form or do not submit a
prison or jail account statement with the form, your request to proceed in forma pauperis will be
Regardless of whether some or all of the filing fee has been paid, the court is required to
screen your complaint and to dismiss the complaint if (1) your allegation of poverty is untrue; (2) the
action is frivolous or malicious; (3) your complaint does not state a claim on which relief can be
granted; or (4) you sue a defendant for money damages and that defendant is immune from liability
for money damages.
If you file more than three actions or appeals while you are a prisoner which are dismissed as
frivolous or malicious or for failure to state a claim on which relief can be granted, then you will be
prohibited from bringing any other actions in forma pauperis unless you are in imminent danger of
serious physical injury.
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF CALIFORNIA
APPLICATION TO PROCEED
IN FORMA PAUPERIS
BY A PRISONER
, 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. § 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:
9 No (If “No” DO NOT USE THIS FORM)
If “Yes” state the place of your incarceration.
Have the institution fill out the Certificate portion of this application and attach a certified
copy of your prison trust account statement showing transactions for the past six months.
2. Are you currently employed?
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.
3. In the past twelve months have you received any money from any of the following sources?
a. Business, profession or other self-employment
b. Rent payments, interest or dividends
c. Pensions, annuities or life insurance payments
d. Disability or workers compensation payments
e. Gifts or inheritances
f. Any other sources
If the answer to any of the above is “Yes” describe by that item each source of money and state the amount
received and what you expect you will continue to receive. Please attach an additional sheet if necessary.
IFPFORM Revised 5/99
4. Do you have cash or checking or savings accounts?
If “Yes” state the total amount:
5. Do you own any real estate, stocks, bonds, securities, other financial instruments, automobiles or other
If “Yes” describe the property and state its value.
6. Do you have any other assets?
If “Yes” list the asset(s) and state the value of each asset listed.
7. List the persons who are dependent on you for support, state your relationship to each person and indicate
how much you contribute to their support.
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. § 1915(b)(2).
I declare under penalty of perjury that the above information is true and correct.
SIGNATURE OF APPLICANT
(To be completed by the institution of incarceration)
I certify that the applicant named herein has the sum of $
on account to his/her credit at
(name of institution). I further certify that during the past six months
the applicant's average monthly balance was $
. I further certify that during the past six months the
average of monthly deposits to the applicant's account was $
(Please attach a certified copy of the applicant's trust account statement showing transactions for the past six
SIGNATURE OF AUTHORIZED OFFICER
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