Williams v. Pavese et al

Filing 6

OPINION AND ORDER: The Court DIRECTS the clerk to place this cause number on a blank Prisoner Complaint form and send it to Michael Jerome Williams; GRANTS Michael Jerome Williams to and including March 27, 2017, to file an amended complaint; and CAU TIONS him that if he does not respond by the deadline, this case will be dismissed pursuant to 28 U.S.C. § 1915A because the current complaint does not state a claim for which relief can be granted. Signed by Judge Jon E DeGuilio on 2/28/2017. (Attachments: # 1 Prisoner Complaint forms)(Copy mailed to pro se party)(rmc)

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page 1 (INND Rev. 8/16) UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF INDIANA [This form is for prisoners to sue for civil rights violations. NEATLY print in ink (or type) your answers.] , [You are the PLAINTIFF, print your full name on this line.] v. Case Number , 3:16-cv-851 [For a new case in this court, leave blank. The court will assign a case number.] [The DEFENDANT is who you are suing. Put ONE name on this line. List ALL defendants below, including this one.] [The top of this page is the caption. Everything you file in this case must have the same caption. Once you know your case number, it is VERY IMPORTANT that you include it on everything you send to the court for this case. DO NOT send more than one copy of anything to the court.] PRISONER COMPLAINT # Defendant’s Name and Job Title 1 [Put the defendant named in the caption in this box.] Work Address 2 [Put the names of any other defendants in these boxes.] 3 [If you are suing more defendants, attach an additional page. Number each defendant. Put the name, job title, and work address of each defendant in a separate box as shown here.] 1. How many defendants are you suing? _________ 2. What is the name and address of your prison or jail? _________________________________ 3. Did the event you are suing about happen there? ⃝ Yes. ⃝ No, it happened at: _________ 4. On what date did this event occur? _______________________________________________ [DO NOT write in the margins or on the back of any pages. Attach additional pages if necessary.] page 2 (INND Rev. 8/16) CLAIMS and FACTS DO: Write a short and plain statement telling what each defendant did wrong. DO: Use simple English words and sentences. DO NOT: Quote from cases or statutes, use legal terms, or make legal arguments. DO: Explain when, where, why, and how each defendant violated your rights. DO: Include every fact necessary to explain your case and describe your injuries or damages. DO: Number any documents you attach and refer to them by number in your complaint. DO NOT: Include social security numbers, dates of birth, or the names of minors. DO: Use each defendant’s name every time you refer to that defendant. DO: Number your paragraphs. [The first paragraph has been numbered for you.] 1. ____________________________________________________________________________ [DO NOT write in the margins or on the back of any pages. Attach additional pages if necessary.] (INND Rev. 8/16) Claims and Facts (continued) [DO NOT write in the margins or on the back of any pages. Attach additional pages if necessary.] page 3 page 4 (INND Rev. 8/16) 5. When did this event happen? ⃝ Before I was confined. ⃝ While I was confined awaiting trial. ⃝ After I was convicted while confined serving the sentence. ⃝ Other: _______________________________________________________________ 6. Have you ever sued anyone for this exact same event? ⃝ No. ⃝ Yes, attached is a copy of the final judgment OR an additional sheet listing the court, case number, file date, judgment date, and result of the previous case(s). 7. Could you have used a prison grievance system to complain about this event? ⃝ No, this event did not happen in a prison or jail. ⃝ No, this event is not grievable at the prison or jail where it occurred. ⃝ Yes, I filed a grievance and attached is a copy of the response from the final step. ⃝ Yes, this event was grievable, but I did not file a grievance because _______________ 8. If you win this case, what do you want the court to order the defendant(s) to do? [NOTE: A case filed on this form will not overturn your conviction or change your release date.] [Initial Each Statement] _____ _____ _____ _____ I will pre-pay the filing fee OR file a prisoner motion to proceed in forma pauperis. I will keep a copy of this complaint for my records. I will promptly notify the court of any change of address. I declare under penalty of perjury that the statements in this complaint are true. I placed this complaint in the prison mail system on ____/____/20____ at _______ am/pm. [Do not fill in this date and time until you give the complaint to prison officials to send to the court.] Signature Prisoner Number [DO NOT write in the margins or on the back of any pages. Attach additional pages if necessary.] USM-285 is a 5-part form. Fill out the form and print 5 copies. Sign as needed and route as specified below. U.S. Department of Justice United States Marshals Service PROCESS RECEIPT AND RETURN See "Instructions for Service of Process by U.S. Marshal" PLAINTIFF COURT CASE NUMBER YOUR NAME DEFENDANT TYPE OF PROCESS FIRST NAMED DEFENDANT NAME OF INDIVIDUAL, COMPANY, CORPORATION. ETC. TO SERVE OR DESCRIPTION OF PROPERTY TO SEIZE OR CONDEMN { SERVE AT NAME OF DEFENDANT BEING SERVED ADDRESS (Street or RFD, Apartment No., City, State and ZIP Code) ADDRESS OF DEFENDANT BEING SERVED SEND NOTICE OF SERVICE COPY TO REQUESTER AT NAME AND ADDRESS BELOW YOUR NAME AND ADDRESS Number of process to be served with this Form 285 Number of parties to be served in this case Check for service on U.S.A. SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE (Include Business and Alternate Addresses, All Telephone Numbers, and Estimated Times Available for Service): Fold Fold ANY SPECIAL INSTRUCTIONS FOR THE MARSHAL Signature of Attorney other Originator requesting service on behalf of: sign form here PLAINTIFF DEFENDANT TELEPHONE NUMBER phone # DATE SPACE BELOW FOR USE OF U.S. MARSHAL ONLY-- DO NOT WRITE BELOW THIS LINE I acknowledge receipt for the total number of process indicated. (Sign only for USM 285 if more than one USM 285 is submitted) Total Process District of Origin District to Serve No. No. Signature of Authorized USMS Deputy or Clerk Date I hereby certify and return that I have personally served , have legal evidence of service, have executed as shown in "Remarks", the process described on the individual , company, corporation, etc., at the address shown above on the on the individual , company, corporation, etc. shown at the address inserted below. I hereby certify and return that I am unable to locate the individual, company, corporation, etc. named above (See remarks below) Name and title of individual served (if not shown above) A person of suitable age and discretion then residing in defendant's usual place of abode Address (complete only different than shown above) Date Time am pm Signature of U.S. Marshal or Deputy Service Fee Total Mileage Charges Forwarding Fee including endeavors) Total Charges Advance Deposits Amount owed to U.S. Marshal* or (Amount of Refund*) $0.00 REMARKS: PRINT 5 COPIES: 1. CLERK OF THE COURT 2. USMS RECORD 3. NOTICE OF SERVICE 4. BILLING STATEMENT*: To be returned to the U.S. Marshal with payment, if any amount is owed. Please remit promptly payable to U.S. Marshal. 5. ACKNOWLEDGMENT OF RECEIPT PRIOR EDITIONS MAY BE USED Form USM-285 Rev. 12/80 U.S. Department of Justice United States Marshals Service PROCESS RECEIPT AND RETURN See "Instructions for Service of Process by U.S. Marshal" PLAINTIFF COURT CASE NUMBER DEFENDANT TYPE OF PROCESS 3:16-cv-851 { NAME OF INDIVIDUAL, COMPANY, CORPORATION. ETC. TO SERVE OR DESCRIPTION OF PROPERTY TO SEIZE OR CONDEMN SERVE AT ADDRESS (Street or RFD, Apartment No., City, State and ZIP Code) SEND NOTICE OF SERVICE COPY TO REQUESTER AT NAME AND ADDRESS BELOW Number of process to be served with this Form 285 Number of parties to be served in this case Check for service on U.S.A. SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE (Include Business and Alternate Addresses, All Telephone Numbers, and Estimated Times Available for Service): Fold Fold Signature of Attorney other Originator requesting service on behalf of: PLAINTIFF TELEPHONE NUMBER DATE DEFENDANT SPACE BELOW FOR USE OF U.S. MARSHAL ONLY-- DO NOT WRITE BELOW THIS LINE I acknowledge receipt for the total number of process indicated. (Sign only for USM 285 if more than one USM 285 is submitted) Total Process District of Origin District to Serve No. No. Signature of Authorized USMS Deputy or Clerk Date I hereby certify and return that I have personally served , have legal evidence of service, have executed as shown in "Remarks", the process described on the individual , company, corporation, etc., at the address shown above on the on the individual , company, corporation, etc. shown at the address inserted below. I hereby certify and return that I am unable to locate the individual, company, corporation, etc. named above (See remarks below) Name and title of individual served (if not shown above) A person of suitable age and discretion then residing in defendant's usual place of abode Address (complete only different than shown above) Date Time am pm Signature of U.S. Marshal or Deputy Service Fee Total Mileage Charges Forwarding Fee including endeavors) Total Charges Advance Deposits Amount owed to U.S. Marshal* or (Amount of Refund*) REMARKS: DISTRIBUTE TO: 1. CLERK OF THE COURT 2. USMS RECORD 3. NOTICE OF SERVICE 4. BILLING STATEMENT*: To be returned to the U.S. Marshal with payment, if any amount is owed. Please remit promptly payable to U.S. Marshal. 5. ACKNOWLEDGMENT OF RECEIPT PRIOR EDITIONS MAY BE USED Form USM-285 Rev. 11/13 AO 440 (Rev. 12/09) Summons in a Civil Action UNITED STATES DISTRICT COURT for the Northern District of Indiana __________ District of __________ YOUR NAME HERE Plaintiff v. NAME OF FIRST DEFENDANT Defendant ) ) ) ) ) ) ) PROVIDE 2 PER DEFENDANT Civil Action No. SUMMONS IN A CIVIL ACTION To: (Defendant’s name and address) DEFENDANT'S NAME AND ADDRESS A lawsuit has been filed against you. Within 21 days after service of this summons on you (not counting the day you received it) — or 60 days if you are the United States or a United States agency, or an officer or employee of the United States described in Fed. R. Civ. P. 12 (a)(2) or (3) — you must serve on the plaintiff an answer to the attached complaint or a motion under Rule 12 of the Federal Rules of Civil Procedure. The answer or motion must be served on the plaintiff or plaintiff’s attorney, whose name and address are: YOUR NAME AND ADDRESS If you fail to respond, judgment by default will be entered against you for the relief demanded in the complaint. You also must file your answer or motion with the court. CLERK OF COURT Date: Signature of Clerk or Deputy Clerk AO 440 (Rev. 12/09) Summons in a Civil Action (Page 2) Civil Action No. PROOF OF SERVICE (This section should not be filed with the court unless required by Fed. R. Civ. P. 4 (l)) This summons for (name of individual and title, if any) was received by me on (date) . ’ I personally served the summons on the individual at (place) on (date) ; or ’ I left the summons at the individual’s residence or usual place of abode with (name) , a person of suitable age and discretion who resides there, on (date) , and mailed a copy to the individual’s last known address; or ’ I served the summons on (name of individual) , who is designated by law to accept service of process on behalf of (name of organization) on (date) ; or ’ I returned the summons unexecuted because ; or ’ Other (specify): . My fees are $ for travel and $ for services, for a total of $ I declare under penalty of perjury that this information is true. Date: Server’s signature Printed name and title Server’s address Additional information regarding attempted service, etc: 0.00 . AO 440 (Rev. 06/12) Summons in a Civil Action UNITED STATES DISTRICT COURT for the Northern District of Indiana ) ) ) ) ) ) ) ) ) ) ) ) Plaintiff(s) v. Defendant(s) Civil Action No. 3:16-cv-851 SUMMONS IN A CIVIL ACTION To: (Defendant’s name and address) A lawsuit has been filed against you. Within 21 days after service of this summons on you (not counting the day you received it) — or 60 days if you are the United States or a United States agency, or an officer or employee of the United States described in Fed. R. Civ. P. 12 (a)(2) or (3) — you must serve on the plaintiff an answer to the attached complaint or a motion under Rule 12 of the Federal Rules of Civil Procedure. The answer or motion must be served on the plaintiff or plaintiff’s attorney, whose name and address are: If you fail to respond, judgment by default will be entered against you for the relief demanded in the complaint. You also must file your answer or motion with the court. ROBERT TRGOVICH, CLERK OF COURT Date: Signature of Clerk or Deputy Clerk AO 440 (Rev. 06/12) Summons in a Civil Action (Page 2) Civil Action No. PROOF OF SERVICE (This section should not be filed with the court unless required by Fed. R. Civ. P. 4 (l)) This summons for (name of individual and title, if any) was received by me on (date) . ’ I personally served the summons on the individual at (place) on (date) ; or ’ I left the summons at the individual’s residence or usual place of abode with (name) , a person of suitable age and discretion who resides there, on (date) , and mailed a copy to the individual’s last known address; or ’ I served the summons on (name of individual) , who is designated by law to accept service of process on behalf of (name of organization) on (date) ; or ’ I returned the summons unexecuted because ; or ’ Other (specify): . My fees are $ for travel and $ for services, for a total of $ I declare under penalty of perjury that this information is true. Date: Server’s signature Printed name and title Server’s address Additional information regarding attempted service, etc: .

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