Jallow v. The City of New York

Filing 7

ORDER TO AMEND: The Clerk of Court is directed to detach the amended complaint (ECF No. 4-1) from the first motion to amend and docket it separately. Plaintiff's motions to amend (ECF Nos. 4 and 6) are denied for the reasons stated. The Clerk of Court is directed to terminate the two motions. Plaintiff is granted leave to file a second amended complaint that complies with the standards set forth above.6 Plaintiff must submit the second amended complaint to this Court's Pro Se Inta ke Unit within sixty days of the date of this order, caption the document as a "Second Amended Complaint," and label the document with docket number 20-CV-8629 (LLS). A Second Amended Complaint form is attached to this order. No summons wi ll issue at this time. If Plaintiff fails to comply within the time allowed, and he cannot show good cause to excuse such failure, the complaint will be dismissed for failure to state a claim upon which relief may be granted. Motions terminated: 6 MOTION to Amend/Correct 2 Complaint filed by Yaya Jallow; 4 MOTION to Amend/Correct 2 Complaint filed by Yaya Jallow. (Signed by Judge Louis L. Stanton on 1/5/2021) (sac)

Case 1:20-cv-08629-LLS Document 7 Filed 01/05/21 Page 1 of 21

UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF NEW YORK
YAYA JALLOW,
Plaintiff,
20-CV-8629 (LLS)
-againstORDER TO AMEND
CITY OF NEW YORK,
Defendant.
LOUIS L. STANTON, United States District Judge:
Plaintiff, appearing pro se, brings this action invoking the Court’s federal question and
diversity jurisdiction under 28 U.S.C. §§ 1331 and 1332. He alleges that members of the New
York City Police Department (NYPD) falsely arrested and detained him. By order dated
December 8, 2020, the Court granted Plaintiff’s request to proceed without prepayment of fees,
that is, in forma pauperis (IFP). For the reasons set forth below, the Court grants Plaintiff leave
to file a second amended complaint within sixty days of the date of this order.
STANDARD OF REVIEW
The Court must dismiss an IFP complaint, or any portion of the complaint, that is
frivolous or malicious, fails to state a claim on which relief may be granted, or seeks monetary
relief from a defendant who is immune from such relief. 28 U.S.C. § 1915(e)(2)(B); see
Livingston v. Adirondack Beverage Co., 141 F.3d 434, 437 (2d Cir. 1998). The Court must also
dismiss a complaint when the Court lacks subject matter jurisdiction. See Fed. R. Civ. P.
12(h)(3).
While the law mandates dismissal on any of these grounds, the Court is obliged to
construe pro se pleadings liberally, Harris v. Mills, 572 F.3d 66, 72 (2d Cir. 2009), and interpret
them to raise the “strongest [claims] that they suggest,” Triestman v. Fed. Bureau of Prisons, 470

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F.3d 471, 474 (2d Cir. 2006) (internal quotation marks and citations omitted) (emphasis in
original). But the “special solicitude” in pro se cases, id. at 475 (citation omitted), has its limits –
to state a claim, pro se pleadings still must comply with Rule 8 of the Federal Rules of Civil
Procedure, which requires a complaint to make a short and plain statement showing that the
pleader is entitled to relief.
The Supreme Court has held that under Rule 8, a complaint must include enough facts to
state a claim for relief “that is plausible on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544,
570 (2007). A claim is facially plausible if the plaintiff pleads enough factual detail to allow the
Court to draw the inference that the defendant is liable for the alleged misconduct. In reviewing
the complaint, the Court must accept all well-pleaded factual allegations as true. Ashcroft v.
Iqbal, 556 U.S. 662, 678-79 (2009). But it does not have to accept as true “[t]hreadbare recitals
of the elements of a cause of action,” which are essentially just legal conclusions. Twombly, 550
U.S. at 555. After separating legal conclusions from well-pleaded factual allegations, the Court
must determine whether those facts make it plausible – not merely possible – that the pleader is
entitled to relief. Id.
BACKGROUND
Plaintiff brings this action against the City of New York, claiming that police officers
from the NYPD violated his rights by arresting and detaining him on two occasions. He invokes
the Court’s federal question and diversity jurisdiction and brings causes of action under three
criminal statutes: (1) 18 U.S .C § 1038, which prohibits criminal hoaxes or terrorist threats; (2)
18 U.S .C § 1201, the federal kidnapping statute; and (3) N.Y . Penal Law § 135.10, New York’
s unlawful imprisonment statute. Plaintiff seeks money damages.
The following facts are taken from the amended complaint: On August 21, 2020, Plaintiff
received “discriminatory service” at a Chipotle and was attacked by one of the employees. (ECF
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No. 4-1, ¶ 18.) After he defended himself by fighting back, the police was called. When the
police arrived, Plaintiff told them what had occurred and cited to them statutes “that were
involved,” but “instead of doing the legal, proper, and morally right thing,” the police arrested
and detained him “against his will and consent and without legal or valid justification.” (Id.) The
police charged plaintiff with assault and while “other City personnel [did] everything in their
power to obstruct the Plaintiff’s justice and due process,” the police made “sure to provide the
aggressor and preparatory in this situation with the full protection of the law and their due
process.” (Id.)
Three weeks later, Plaintiff had another encounter with the police and was again arrested
and detained. On October 14, 2020, while Plaintiff was shopping at a Food Bazaar Supermarket
in Brooklyn, New York, he was “accosted by several employees there, a continuation of the
aforementioned discriminatory services, into a fight.” (Id. ¶ 19.) Although Plaintiff was not the
aggressor, he was again arrested and charged with disorderly conduct. The police “lack[ed]
authority or valid reason” to once again arrest and detain Plaintiff. (Id.)
DISCUSSION
A.

Plaintiff’s motions to amend the complaint
Four days after filing his initial pleading (ECF No. 2), Plaintiff submitted to the Court a

motion to amend his complaint, along with an amended complaint (ECF Nos. 4, 4-1). Under
Rule 15(a) of the Federal Rules of Civil Procedure, Plaintiff may amend his complaint once as of
right within a certain timeline. As Plaintiff’s filing of an amended complaint is permitted under
Rule 15(a), his first motion to amend (ECF No. 4) is denied as moot.
On December 9, 2020, Plaintiff submitted another motion to amend his complaint with a
proposed second amended complaint (ECF Nos.6, 6-1). In the proposed second amended
complaint, Plaintiff asserts that the City of New York discriminated against him based on his race
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and color after his arrest. But he fails to provide any facts in support of his claims, including the
information he provided in the amended complaint. For that reason the Court denies Plaintiff
leave to file the proposed second amended complaint.
Plaintiff, however, is granted leave to file a second amended complaint with all of his
claims as provided below.
B.

Plaintiff’s claims fall under 42 U.S.C. § 1983
Plaintiff brings this action asserting that the City of New York violated his federal rights

when NYPD officers falsely arrested and detained him. 1 As he brings this action against the City
of New York

a state actor the Court construes the amended complaint as asserting claims

under 42 U.S.C. § 1983. To state a claim under § 1983, a plaintiff must allege both that: (1) a
right secured by the Constitution or laws of the United States was violated, and (2) the right was
violated by a person acting under the color of state law, or a “state actor.” West v. Atkins, 487
U.S. 42, 48-49 (1988).
Plaintiff’s false arrest and imprisonment claims
Plaintiff asserts that the police falsely arrested and imprisoned him on two occasions. His
false-arrest and false-imprisonment claims are addressed together as they are synonymous
claims. 2 See Posr v. Doherty, 944 F.2d 91, 96 (2d Cir. 1991). For the elements of a § 1983 false-

1

Plaintiff also invokes the Court’s diversity jurisdiction, but he fails to allege facts
demonstrating that the Court has diversity jurisdiction over this action. To establish jurisdiction
under 28 U.S.C. § 1332, a plaintiff must first allege that the plaintiff and the defendants are
citizens of different states, Wis. Dep’t of Corr. v. Schacht, 524 U.S. 381, 388 (1998), and that the
claim is in excess of the sum or value of $75,000.00, the statutory jurisdictional amount, see 28
U.S.C. § 1332(a); Colavito v. N.Y. Organ Donor Network, Inc., 438 F.3d 214, 221 (2d Cir.
2006)). Plaintiff asserts that he is a resident of Brooklyn, New York, precluding complete
diversity of citizenship between him and the City of New York.
2

“False arrest is simply an unlawful detention or confinement brought about by means of
an arrest rather than in some other way and is in all other respects synonymous with false
imprisonment.” Evans v. City of New York, 308 F. Supp. 2d 316, 329 n.8 (S.D.N.Y. 2004)
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arrest claim, the Court first looks to state law. See Manuel v. City of Joliet, Ill., 137 S. Ct. 911,
925 (2017) (“[T]o flesh out the elements of this constitutional tort, we must look for ‘tort
analogies.’”); see also Lanning v. City of Glens Falls, 908 F.3d 19, 25 (2d Cir. 2018) (holding
that common law principles are meant simply to guide rather than to control the definition of
§ 1983 claims and courts should not “mechanically apply” the law of New York State).
To establish a false arrest claim under New York law, a plaintiff must show that: “(1) the
defendant intended to confine [the plaintiff], (2) the plaintiff was conscious of the confinement,
(3) the plaintiff did not consent to the confinement and (4) the confinement was not otherwise
privileged.” Liranzo v. United States, 690 F.3d 78, 95 (2d Cir. 2012). An arrest is privileged if it
is based on probable cause. Jenkins v. City of New York, 478 F.3d 76, 84 (2d Cir. 2007) (“The
existence of probable cause to arrest constitutes justification and is a complete defense to an
action for false arrest.” (quoting Weyant v. Okst, 101 F.3d 845, 852 (2d Cir. 1996)) (internal
quotation marks omitted)).
If “the facts known by the arresting officer at the time of the arrest objectively provided
probable cause to arrest,” the arrest is privileged, and the plaintiff cannot state a claim for false
arrest. Devenpeck v. Alford, 543 U.S. 146, 152 (2004). Officers have probable cause to arrest
when they have “knowledge or reasonably trustworthy information of facts and circumstances
that are sufficient to warrant a person of reasonable caution in the belief that the person to be
arrested has committed . . . a crime.” Jaegly v. Couch, 439 F.3d 149, 152 (2d Cir. 2006).
“Probable cause can exist even where it is based on mistaken information, so long as the
arresting officer acted reasonably and in good faith in relying on that information.” Bernard v.

(quoting Covington v. City of New York, 171 F.3d 117, 125 (2d Cir. 1999) (Glasser, J.,
dissenting)).

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United States, 25 F.3d 98, 102 (1994); Curley v. Vill. of Suffern, 268 F.3d 65, 70 (2d Cir. 2001)
(holding that a police officer is “not required to explore and eliminate every theoretically
plausible claim of innocence before making an arrest.”). Put another way, police officers may
have had probable cause to arrest if they have acted reasonably, even if they were mistaken.
Plaintiff has not pleaded facts indicating that any officer of the NYPD arrested him
without probable cause for assault on August 21, 2020, and for disorderly conduct on October
14, 2020. His assertions suggest instead that “the facts known by the arresting officer[s] at the
time of the arrest objectively provided probable cause to arrest.” Devenpeck v. Alford, 543 U.S.
146, 152 (2004). Plaintiff, who was charged with assault for the August 21, 2020 incident, asserts
that he defended himself against a Chipotle employee by fighting back. And he readily admits
that he was involved in a fight with employees of the Food Bazaar on October 14, 2020.
Plaintiff’s allegations indicate that the facts and circumstances would warrant a person of
reasonable caution to believe that he had committed a crime and that the police had probable
cause to arrest him. See Ricciuiti v. N.Y.C. Transit Auth., 124 F.3d 123, 128 (2d Cir. 1997) (“Once
a police officer has a reasonable basis for believing there is probable cause, he is not required to
explore and eliminate every theoretically plausible claim of innocence before making an
arrest.”).
Plaintiff proceeds in this matter without the benefit of an attorney. District courts
generally should grant a self-represented plaintiff an opportunity to amend a complaint to cure its
defects, unless amendment would be futile. See Hill v. Curcione, 657 F.3d 116, 123-24 (2d Cir.
2011); Salahuddin v. Cuomo, 861 F.2d 40, 42 (2d Cir. 1988). The Court therefore grants Plaintiff
leave to file a second amended complaint.

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If Plaintiff files a second amended complaint, he should allege any additional facts
suggesting that the NYPD officers lacked probable cause to arrest him for the two incidents.
Plaintiff must describe the circumstances of his arrest and state what the employees of Chipotle
and the Food Bazaar, eyewitnesses, and the police officers did or said. He should also provide
the status of his criminal proceedings for the assault and disorderly conduct charges.
Discrimination Claim
As noted, Plaintiff submitted a proposed second amended complaint in which he asserted
that he was subjected to discrimination based on his race and color. But because he failed to
provide any facts in the proposed second amended complaint, the Court is denying him leave to
file the proposed second amended complaint. Plaintiff may, however, assert facts in support of
his discrimination claim in the second amended complaint that he is granted leave to file.
Plaintiff’s assertions of discrimination could be read as arising under the Fourteenth
Amendment’s Equal Protection Clause, which prohibits the disparate treatment of similarly
situated individuals. See City of Cleburne v. Cleburne Living Center, 473 U.S. 432, 439 (1985);
Brown v. City of Syracuse, 673 F.3d 141, 151 (2d Cir. 2012). To state an equal protection claim, a
plaintiff must allege that he is a member of a suspect or quasi-suspect class of persons, see Giano
v. Senkowski, 54 F.3d 1050, 1057 (2d Cir. 1995); such classes include, but are not limited to,
classes identified by race, gender, alienage, or national origin, see Myers v. Cnty. of Orange, 157
F.3d 66, 75 (2d Cir. 1998). The plaintiff must also allege facts showing that the defendants have
purposefully discriminated against the plaintiff because of his membership in that class. See
Turkmen v. Hasty, 789 F.3d 218, 252 (2d Cir. 2015) (quoting Iqbal, 556 U.S. at 676, rev’d and
vacated in part on other grounds sub nom., Ziglar v. Abbasi, 137 S. Ct. 1843 (2017)); Giano, 54
F.3d at 1057. “[P]urposeful discrimination requires more than intent as volition or intent as

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awareness of consequences. It instead involves a decisionmaker’s undertaking a course of action
because of, not merely in spite of, [the action’s] adverse effects upon an identifiable group.”
Turkmen, 789 F.3d at 252 (quoting Iqbal, 556 U.S. at 676-77) (internal quotation marks and
citations omitted, alterations in original).
Plaintiff does not allege any facts suggesting that anyone treated him differently from
other similarly situated individuals or that any such treatment was based on an immutable
characteristic such as race

or any other improper factor. But Plaintiff may provide in the

second amended complaint any facts suggesting that individuals named as defendants treated
him differently because of his race or color.
Plaintiff’s claims against the City of New York
Plaintiff names the City of New York as the sole defendant. When a plaintiff sues a
municipality under § 1983, it is not enough for the plaintiff to allege that one of the
municipality’s employees or agents engaged in some wrongdoing. The plaintiff must show that
the municipality itself caused the violation of the plaintiff’s rights. See Connick v. Thompson,
563 U.S. 51, 60 (2011) (“A municipality or other local government may be liable under this
section [1983] if the governmental body itself ‘subjects’ a person to a deprivation of rights or
‘causes’ a person ‘to be subjected’ to such deprivation.”) (quoting Monell v. Dep’t of Soc. Servs.
of City of New York, 436 U.S. 658, 692 (1978)); Cash v. Cnty. of Erie, 654 F.3d 324, 333 (2d Cir.
2011). In other words, to state a § 1983 claim against a municipality, the plaintiff must allege
facts showing (1) the existence of a municipal policy, custom, or practice, and (2) that the policy,
custom, or practice caused the violation of the plaintiff’s constitutional rights. See Jones v. Town
of East Haven, 691 F.3d 72, 80 (2d Cir. 2012); Bd. of Cnty. Comm’rs of Bryan Cnty. v. Brown,
520 U.S. 397, 403 (1997) (internal citations omitted).

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Here, Plaintiff asserts that the City of New York violated his rights when the NYPD
police officers arrested and detained him. But he does not allege that a policy, custom, or practice
of the City of New York caused a deprivation of his federally protected rights. Plaintiff therefore
fails to state a claim against the City of New York on which relief may be granted. See 28 U.S.C.
§ 1915(e)(2)(B)(ii).
In light of Plaintiff’s pro se status, the Court grants him leave to state facts in the second
amended complaint suggesting that a City policy, custom, or practice caused the alleged
constitutional violations.
Personal Involvement
To state a claim under § 1983, a plaintiff must allege facts showing the defendants’ direct
and personal involvement in the alleged constitutional deprivation. See Spavone v. N.Y. State
Dep’t of Corr. Serv., 719 F.3d 127, 135 (2d Cir. 2013) (citing Colon v. Coughlin, 58 F.3d 865, 873
(2d Cir. 1995)). A defendant may not be held liable under § 1983 solely because that defendant
employs or supervises a person who violated the plaintiff’s rights. See Ashcroft v. Iqbal, 556 U.S.
662, 676 (2009) (“Government officials may not be held liable for the unconstitutional conduct
of their subordinates under a theory of respondeat superior.”). An individual defendant can be
personally involved in a § 1983 violation if:
(1) the defendant participated directly in the alleged constitutional violation,
(2) the defendant, after being informed of the violation through a report or appeal,
failed to remedy the wrong, (3) the defendant created a policy or custom under
which unconstitutional practices occurred, or allowed the continuance of such a
policy or custom, (4) the defendant was grossly negligent in supervising
subordinates who committed the wrongful acts, or (5) the defendant exhibited
deliberate indifference to the rights of [the plaintiff] by failing to act on
information indicating that unconstitutional acts were occurring.

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Colon, 58 F.3d at 873. 3
Here, Plaintiff alleges that NYPD police officers violated his rights, but he does not
identify these individuals or name them as defendants. The Court therefore grants Plaintiff leave
to name in the second amended complaint the individual-defendants who personally violated his
constitutional rights and state facts in support of his claim against each individual-defendant.
C.

Plaintiff cannot bring claims under criminal statutes
Plaintiff also purports to bring claims under three criminal statute 18 U.S.C. § 1038, 18

U.S .C § 1201, and N.Y . Penal Law § 135.10. But these criminal provisions cannot be the basis
for a civil action because such statutes do not provide private causes of action. See Cent. Bank of
Denver v. First Interstate Bank of Denver, 511 U.S. 164, 190 (1994) (refusing to infer a private
right of action from a “bare criminal statute”); Sheehy v. Brown, 335 F. App’x 102, 104 (2d Cir.
2009) (“federal criminal statutes do not provide private causes of action).
LEAVE TO AMEND
Plaintiff is granted leave to amend his complaint for the second time to detail his claims.
First, Plaintiff must name as the defendant(s) in the caption4 and in the statement of claim those
individuals who were allegedly involved in the deprivation of his federal rights. If Plaintiff does
not know the name of a defendant, he may refer to that individual as “John Doe” or “Jane Doe”

3

“Although the Supreme Court’s decision in [Ashcroft v. Iqbal, 556 U.S. 662 (2009)] may
have heightened the requirements for showing a supervisor’s personal involvement with respect
to certain constitutional violations,” the Second Circuit has not yet examined that issue. Grullon
v. City of New Haven, 720 F.3d 133, 139 (2d Cir. 2013).
4

The caption is located on the front page of the complaint. Each individual defendant
must be named in the caption. Plaintiff may attach additional pages if there is not enough space
to list all of the defendants in the caption. If Plaintiff needs to attach an additional page to list all
defendants, he should write “see attached list” on the first page of the second amended
complaint. Any defendants named in the caption must also be discussed in Plaintiff’s statement
of claim.

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in both the caption and the body of the second amended complaint. 5 The naming of John Doe
defendants, however, does not toll the three-year statute of limitations period governing this
action and Plaintiff shall be responsible for ascertaining the true identity of any “John Doe”
defendants and amending his complaint to include the identity of any “John Doe” defendants
before the statute of limitations period expires. Should Plaintiff seek to add a new claim or party
after the statute of limitations period has expired, he must meet the requirements of Rule 15(c) of
the Federal Rules of Civil Procedure.
In the statement of claim, Plaintiff must provide a short and plain statement of the
relevant facts supporting each claim against each defendant named in the second amended
complaint. Plaintiff is also directed to provide the addresses for any named defendants. To the
greatest extent possible, Plaintiff’s second amended complaint must:
a) give the names and titles of all relevant persons;
b) describe all relevant events, stating the facts that support Plaintiff’s case including
what each defendant did or failed to do;
c) give the dates and times of each relevant event or, if not known, the approximate date
and time of each relevant event;
d) give the location where each relevant event occurred;
e) describe how each defendant’s acts or omissions violated Plaintiff’s rights and
describe the injuries Plaintiff suffered; and
f) state what relief Plaintiff seeks from the Court, such as money damages, injunctive
relief, or declaratory relief.
Essentially, the body of Plaintiff’s second amended complaint must tell the Court: who
violated his federally protected rights; what facts show that his federally protected rights were
violated; when such violation occurred; where such violation occurred; and why Plaintiff is

5

For example, a defendant may be identified as: “NYPD Officer John Doe #1 on duty
August 21, 2020, during the 7-3 p.m. shift.”

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entitled to relief. Because Plaintiff’s second amended complaint will completely replace, not
supplement, the amended complaint, any facts or claims that Plaintiff wishes to maintain must be
included in the second amended complaint.
CONCLUSION
The Clerk of Court is directed to detach the amended complaint (ECF No. 4-1) from the
first motion to amend and docket it separately. Plaintiff’s motions to amend (ECF Nos. 4 and 6)
are denied for the reasons stated. The Clerk of Court is directed to terminate the two motions.
Plaintiff is granted leave to file a second amended complaint that complies with the
standards set forth above. 6 Plaintiff must submit the second amended complaint to this Court’s
Pro Se Intake Unit within sixty days of the date of this order, caption the document as a “Second
Amended Complaint,” and label the document with docket number 20-CV-8629 (LLS). A
Second Amended Complaint form is attached to this order. No summons will issue at this time. If
Plaintiff fails to comply within the time allowed, and he cannot show good cause to excuse such
failure, the complaint will be dismissed for failure to state a claim upon which relief may be
granted.
SO ORDERED.
Dated:

January 5, 2021
New York, New York
Louis L. Stanton
U.S.D.J.

6

Plaintiff has consented to electronic service. (ECF No. 3.)

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U NITED S TATES D ISTRICT C OURT
S OUTHERN D ISTRICT OF N EW Y ORK

_____CV_______________

Write the full name of each plaintiff.

(Include case number if one has been
assigned)

SECOND AMENDED

-against-

COMPLAINT
Do you want a jury trial?
Yes
No

Write the full name of each defendant. If you need more
space, please write “see attached” in the space above and
attach an additional sheet of paper with the full list of
names. The names listed above must be identical to those
contained in Section II.

NOTICE
The public can access electronic court files. For privacy and security reasons, papers filed
with the court should therefore not contain: an individual’s full social security number or full
birth date; the full name of a person known to be a minor; or a complete financial account
number. A filing may include only: the last four digits of a social security number; the year of
an individual’s birth; a minor’s initials; and the last four digits of a financial account number.
See Federal Rule of Civil Procedure 5.2.

Rev. 1/9/17

Case 1:20-cv-08629-LLS Document 7 Filed 01/05/21 Page 14 of 21

I.

BASIS FOR JURISDICTION

Federal courts are courts of limited jurisdiction (limited power). Generally, only two types of
cases can be heard in federal court: cases involving a federal question and cases involving
diversity of citizenship of the parties. Under 28 U.S.C. § 1331, a case arising under the United
States Constitution or federal laws or treaties is a federal question case. Under 28 U.S.C. § 1332,
a case in which a citizen of one State sues a citizen of another State or nation, and the amount
in controversy is more than $75,000, is a diversity case. In a diversity case, no defendant may
be a citizen of the same State as any plaintiff.
What is the basis for federal-court jurisdiction in your case?
Federal Question
Diversity of Citizenship

A. If you checked Federal Question
Which of your federal constitutional or federal statutory rights have been violated?

B. If you checked Diversity of Citizenship
1. Citizenship of the parties
Of what State is each party a citizen?
The plaintiff ,

, is a citizen of the State of
(Plaintiff’s name)

(State in which the person resides and intends to remain.)
or, if not lawfully admitted for permanent residence in the United States, a citizen or
subject of the foreign state of
.
If more than one plaintiff is named in the complaint, attach additional pages providing
information for each additional plaintiff.

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If the defendant is an individual:
The defendant,

, is a citizen of the State of
(Defendant’s name)

or, if not lawfully admitted for permanent residence in the United States, a citizen or
subject of the foreign state of
.

If the defendant is a corporation:
The defendant,

, is incorporated under the laws of

the State of
and has its principal place of business in the State of
or is incorporated under the laws of (foreign state)
and has its principal place of business in

.

If more than one defendant is named in the complaint, attach additional pages providing
information for each additional defendant.

II. PARTIES
A. Plaintiff Information
Provide the following information for each plaintiff named in the complaint. Attach additional
pages if needed.

First Name

Middle Initial

Last Name

Street Address

County, City

State

Telephone Number

Zip Code

Email Address (if available)

Page 3

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B. Defendant Information
To the best of your ability, provide addresses where each defendant may be served. If the
correct information is not provided, it could delay or prevent service of the complaint on the
defendant. Make sure that the defendants listed below are the same as those listed in the
caption. Attach additional pages if needed.
Defendant 1:

First Name

Last Name

Current Job Title (or other identifying information)
Current Work Address (or other address where defendant may be served)
County, City

State

Zip Code

Defendant 2:

First Name

Last Name

Current Job Title (or other identifying information)
Current Work Address (or other address where defendant may be served)
County, City

State

Zip Code

Defendant 3:
First Name

Last Name

Current Job Title (or other identifying information)
Current Work Address (or other address where defendant may be served)
County, City

State

Zip Code

Page 4

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Defendant 4:
First Name

Last Name

Current Job Title (or other identifying information)
Current Work Address (or other address where defendant may be served)
County, City

State

Zip Code

III. STATEMENT OF CLAIM
Place(s) of occurrence:

Date(s) of occurrence:

FACTS:

State here briefly the FACTS that support your case. Describe what happened, how you were
harmed, and what each defendant personally did or failed to do that harmed you. Attach
additional pages if needed.

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INJURIES:

If you were injured as a result of these actions, describe your injuries and what medical
treatment, if any, you required and received.

IV. RELIEF
State briefly what money damages or other relief you want the court to order.

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V. PLAINTIFF’S CERTIFICATION AND WARNINGS
By signing below, I certify to the best of my knowledge, information, and belief that: (1) the
complaint is not being presented for an improper purpose (such as to harass, cause
unnecessary delay, or needlessly increase the cost of litigation); (2) the claims are supported
by existing law or by a nonfrivolous argument to change existing law; (3) the factual
contentions have evidentiary support or, if specifically so identified, will likely have
evidentiary support after a reasonable opportunity for further investigation or discovery;
and (4) the complaint otherwise complies with the requirements of Federal Rule of Civil
Procedure 11.
I agree to notify the Clerk's Office in writing of any changes to my mailing address. I
understand that my failure to keep a current address on file with the Clerk's Office may
result in the dismissal of my case.
Each Plaintiff must sign and date the complaint. Attach additional pages if necessary. If seeking to
proceed without prepayment of fees, each plaintiff must also submit an IFP application.

Dated

Plaintiff’s Signature

First Name

Middle Initial

Last Name

Street Address
County, City
Telephone Number

State

Zip Code
Email Address (if available)

I have read the Pro Se (Nonprisoner) Consent to Receive Documents Electronically:
Yes

No

If you do consent to receive documents electronically, submit the completed form with your
complaint. If you do not consent, please do not attach the form.

Page 7

Case 1:20-cv-08629-LLS Document 7 Filed 01/05/21 Page 20 of 21

Pro Se (Nonprisoner) Consent to Receive Documents Electronically
Parties who are not represented by an attorney and are not currently incarcerated may
choose to receive documents in their cases electronically (by e-mail) instead of by regular
mail. Receiving documents by regular mail is still an option, but if you would rather receive
them only electronically, you must do the following:
1. Sign up for a PACER login and password by contacting PACER 1 at
www.pacer.uscourts.gov or 1-800-676-6856;
2. Complete and sign this form.
If you consent to receive documents electronically, you will receive a Notice of Electronic
Filing by e-mail each time a document is filed in your case. After receiving the notice, you
are permitted one “free look” at the document by clicking on the hyperlinked document
number in the e-mail. 2 Once you click the hyperlink and access the document, you may not
be able to access the document for free again. After 15 days, the hyperlink will no longer
provide free access. Any time that the hyperlink is accessed after the first “free look” or the
15 days, you will be asked for a PACER login and may be charged to view the document. For
this reason, you should print or save the document during the “free look” to avoid future
charges.

IMPORTANT NOTICE
Under Rule 5 of the Federal Rules of Civil Procedure, Local Civil Rule 5.2, and the Court’s
Electronic Case Filing Rules & Instructions, documents may be served by electronic means.
If you register for electronic service:
1. You will no longer receive documents in the mail;
2. If you do not view and download your documents during your “free look” and
within 15 days of when the court sends the e-mail notice, you will be charged for
looking at the documents;
3. This service does not allow you to electronically file your documents;
4. It will be your duty to regularly review the docket sheet of the case. 3
Public Access to Court Electronic Records (PACER) (www.pacer.uscourts.gov) is an electronic public access service that
allows users to obtain case and docket information from federal appellate, district, and bankruptcy courts, and the PACER
Case Locator over the internet.
1

You must review the Court’s actual order, decree, or judgment and not rely on the description in the email notice alone.
See ECF Rule 4.3

2

The docket sheet is the official record of all filings in a case. You can view the docket sheet, including images of
electronically filed documents, using PACER or you can use one of the public access computers available in the Clerk’s
Office at the Court.

3

rev. 2/9/15

Case 1:20-cv-08629-LLS Document 7 Filed 01/05/21 Page 21 of 21

CONSENT TO ELECTRONIC SERVICE
I hereby consent to receive electronic service of notices and documents in my case(s) listed below. I
affirm that:
1. I have regular access to my e-mail account and to the internet and will check regularly for
Notices of Electronic Filing;
2. I have established a PACER account;
3. I understand that electronic service is service under Rule 5 of the Federal Rules of Civil
Procedure and Rule 5.2 of the Local Civil Rules, and that I will no longer receive paper
copies of case filings, including motions, decisions, orders, and other documents;
4. I will promptly notify the Court if there is any change in my personal data, such as name,
address, or e-mail address, or if I wish to cancel this consent to electronic service;
5. I understand that I must regularly review the docket sheet of my case so that I do not miss a
filing; and
6. I understand that this consent applies only to the cases listed below and that if I file
additional cases in which I would like to receive electronic service of notices of documents, I
must file consent forms for those cases.
Civil case(s) filed in the Southern District of New York:
Note: This consent will apply to all cases that you have filed in this court, so please list all of
your pending and terminated cases. For each case, include the case name and docket number
(for example, John Doe v. New City, 10-CV-01234).

Name (Last, First, MI)

Address

City

State

Telephone Number

E-mail Address

Date

Signature

Return completed form to:
Pro Se Intake Unit (Room 200)
500 Pearl Street
New York, NY 10007

Zip Code