Williams v. Pavese et al

Filing 9

OPINION AND ORDER: DIRECTING the clerk to place this cause number on a blank Prisoner Complaint form and send it to the Plaintiff; GRANTING Plaintiff to/including 6/26/2017 to file an amended complaint; DENYING 8 motion to proceed in forma pauperis; CAUTIONING Plaintiff that if he does not respond by the deadline this case will be dismissed without further notice. Signed by Judge Jon E DeGuilio on 5/30/17. (Attachments: # 1 Blank Amended Complaint form)(Copy sent to pro se party)(jld)

Download PDF
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 , 3:16cv851 [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.] AMENDED 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.]

Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.

Why Is My Information Online?