Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_19-cv-05285/USCOURTS-azd-2_19-cv-05285-0/pdf.json

Nature of Suit Code: 555
Nature of Suit: Prisoner - Prison Condition
Cause of Action: 42:1983 Prisoner Civil Rights

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WO MH

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Reginald D. Trotter,

Plaintiff, 

v. 

Joseph M. Arpaio, et al.,

Defendants.

No. CV 19-05285-PHX-MTL (JZB)

ORDER

On September 26, 2019, Plaintiff Reginald D. Trotter, who is confined in a 

Maricopa County Jail, filed a pro se civil rights Complaint and an Application to Proceed 

In Forma Pauperis. On October 16, 2019, Plaintiff filed a First Amended Complaint. In a 

December 23, 2019 Order, the Court granted the Application to Proceed and dismissed the 

First Amended Complaint because Plaintiff had failed to state a claim. The Court gave 

Plaintiff 30 days to file a second amended complaint that cured the deficiencies identified 

in the Order. 

On January 9, 2020, Plaintiff filed a Second Amended Complaint (Doc. 10). The 

Court will dismiss the Second Amended Complaint with leave to amend.

I. Statutory Screening of Prisoner Complaints

The Court is required to screen complaints brought by prisoners seeking relief 

against a governmental entity or an officer or an employee of a governmental entity. 2 8 

U.S.C. § 1915A(a). The Court must dismiss a complaint or portion thereof if a plaintiff 

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has raised claims that are legally frivolous or malicious, that fail to state a claim upon which 

relief may be granted, or that seek monetary relief from a defendant who is immune from 

such relief. 28 U.S.C. § 1915A(b)(1)–(2). 

A pleading must contain a “short and plain statement of the claim showing that the 

pleader is entitled to relief.” Fed. R. Civ. P. 8(a)(2) (emphasis added). While Rule 8 does 

not demand detailed factual allegations, “it demands more than an unadorned, the -

defendant-unlawfully-harmed-me accusation.” Ashcroft v. Iqbal, 556 U.S. 662, 678 

(2009). “Threadbare recitals of the elements of a cause of action, supported by mere 

conclusory statements, do not suffice.” Id.

“[A] complaint must contain sufficient factual matter, accepted as true, to ‘state a 

claim to relief that is plausible on its face.’” Id. (quoting Bell Atlantic Corp. v. Twombly, 

550 U.S. 544, 570 (2007)). A claim is plausible “when the plaintiff pleads factual content 

that allows the court to draw the reasonable inference that the defendant is liable for the 

misconduct alleged.” Id. “Determining whether a complaint states a plausible claim for 

relief [is] . . . a context-specific task that requires the reviewing court to draw on its judicial 

experience and common sense.” Id. at 679. Thus, although a plaintiff’s specific factual 

allegations may be consistent with a constitutional claim, a court must assess whether there 

are other “more likely explanations” for a defendant’s conduct. Id. at 681.

But as the United States Court of Appeals for the Ninth Circuit has instructed, courts 

must “continue to construe pro se filings liberally.” Hebbe v. Pliler, 627 F.3d 338, 342 

(9th Cir. 2010). A “complaint [filed by a pro se prisoner] ‘must be held to less stringent 

standards than formal pleadings drafted by lawyers.’” Id.(quoting Erickson v. Pardus, 551 

U.S. 89, 94 (2007) (per curiam)). 

If the Court determines that a pleading could be cured by the allegation of other 

facts, a pro se litigant is entitled to an opportunity to amend a complaint before dismissal 

of the action. See Lopez v. Smith, 203 F.3d 1122, 1127-29 (9th Cir. 2000) (en banc). 

Plaintiff’s Second Amended Complaint will be dismissed for failure to state a claim, but 

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because it may possibly be amended to state a claim, the Court will dismiss it with leave 

to amend.

II. Second Amended Complaint

In each count of his Second Amended Complaint, Plaintiff asserts a threat-to-safety 

claim and a claim for inadequate medical care. He names as Defendants Towers Jail,1

Lower Buckeye Jail, the Maricopa County Sheriff’s Office (MCSO), Correctional Health 

Services (CHS), “CHS Staff,” and “MCSO Staff.” Plaintiff seeks $5 million in damages.

In Count One, Plaintiff claims that his cellmate punched him in the face five times 

on December 4, 2019, then took Plaintiff to the ground and proceeded to bang Plaintiff’s 

head against the floor. As a result, Plaintiff allegedly suffered a concussion; a seizure;

knots on his head; bruises on his ribs, back, and right eye; and “mental issues,” including

fear, distress, post-traumatic stress disorder, and difficulty sleeping or relaxing. (Doc. 10 

at 3.)2 According to Plaintiff, when detention officers “finally” arrived, they sent Plaintiff 

to the medical department, where he was given an ice pack. Plaintiff was then sent to the 

“hole.” (Id.) Once there, Plaintiff advised the detention officers and “medical” that he 

needed to be examined again because “something was wrong with [him].” (Id.) Plaintiff’s 

cellmate awakened Plaintiff because Plaintiff was shaking “real bad.” (Id.) When Plaintiff 

awoke, he vomited everywhere. (Id.) A nurse examined Plaintiff and sent him to the 

hospital because he was unresponsive. Plaintiff was told by the doctor that he had a 

concussion, bruised ribs, and a bruised back. During the two months prior to the assault, 

Plaintiff had allegedly submitted grievances and request forms “asking to be remove[d] 

because the brothers meaning the black people were threatening [him], ganging up on 

[him], trying to roll [him] out, bullying [him], and making fun of [him].” (Id.) Detention 

officers had “told [him] to go fight the inmates that were trying to bully [him].” (Id.)

1 This Defendant is identified as “Tower Jail.” However, Plaintiff appears to be 

referring to Maricopa County’s Towers Jail.

2 The citation refers to the document and page number generated by the Court’s 

Case Management/Electronic Case Filing system.

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In Count Two, Plaintiff claims that he was “jump[ed]” at Towers Jail on December 

12, 2019. (Id. at 4.) Plaintiff claims that he went to the medical department and told “them” 

he was “seeing double, seeing stars, [that the] room was spinning and [his] hea d was 

pounding plus [he] was throwing up blood and couldn’t swallow.” (Id.) The detention 

officers and “Medical” allegedly told Plaintiff that he was “ok.” (Id.) The sergeant placed 

Plaintiff in a holding tank, where he remained for four to five hours. Plaintiff vomited 

continuously and ultimately lost consciousness. He could “barely talk or breath,” and 

“bang[ed] on the cell” until a detention officer came and told Plaintiff that he was securing 

a bed for Plaintiff. Plaintiff told the officer that he could barely see, was vomiting and 

passing out, and needed assistance and medical attention. The officer told Plaintiff, “I got 

you,” then “shipped [him] off to [Lower Buckeye Jail]” after obtaining his signature on a

form documenting Plaintiff’s refusal of protective custody. (Id.) Plaintiff did not see a 

doctor until the following day. He then spent seven days in the hospital. According to 

Plaintiff, the doctor said, “this could [have] been wors[e] the longer [Plaintiff] waited.” 

(Id.) Plaintiff claims that as a result of the assault, he suffered a concussion, seizures, a 

“broke[n]” voice box, “something with [his] eye,” a headache, and “mental issues,” 

including worsened post-traumatic stress disorder and problems sleeping or relaxing. (Id.) 

He also alleges that he had advised detention officers before the assault occurred that he 

was not supposed to be in the pod because inmates there had threatened him previously. 

He states that he is afraid of the detention officers and that they treat inmates like “animals/

----.”

In Count Three, Plaintiff claims that on December 13, 2019, after he had arrived at 

Lower Buckeye Jail, he requested assistance from Detention Officer Bae Boza, stating that 

he needed help because he had “been seeing double, room spinning, head pounding, [he 

could] barely talk or swallow, and [he] pass[es] out.” (Id. at 5.) Boza allegedly told 

Plaintiff to “shut up” and said, “I don’t care[,] die.” Boza then left Plaintiff in a holding 

tank for hours. Eventually, another detention officer escorted Plaintiff to “level 3,” where

he continued to tell detention officers that he felt bad and requested their assistance while 

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crying. According to Plaintiff, the officers acted as though they had not seen Plaintiff and 

ignored him for hours while he threw up and passed out. Eventually, two sergeants who 

Plaintiff had spoken to contacted the medical department. “[M]edical” came several hours 

later and told Plaintiff he was “fine” and that there was “nothing wrong with him.” (Id.) 

Plaintiff “beg[ged] her[,] crying told her something ain’t right.” He was told to “quit acting 

like a girl” and was “sent . . . on [his] way. (Id.) Plaintiff spent the next several hours 

vomiting and spitting up blood. A detention officer allegedly told Plaintiff that he was 

going to “get help,” but he came back with a sergeant who was disrespectful, treated 

Plaintiff poorly, and did nothing to help him. Approximately one hour later, a different 

detention officer saw Plaintiff and took him to the medical department because he did not 

“look good.” (Id.) At that point, “medical” sent Plaintiff to the hospital. As a result of 

this alleged misconduct, Plaintiff claims that he suffered a concussion, seizures, a 

“broke[n]” voice box, “something with [his] right eye,” a headache, and “mental issues,” 

including fear, worsened post-traumatic stress disorder and problems sleeping or relaxing. 

In addition, Plaintiff allegedly required surgery.

III. Failure to State a Claim

To prevail in a § 1983 claim,3 a plaintiff must show that (1) acts by the defendants 

(2) under color of state law (3) deprived him of federal rights, privileges or immunities and 

(4) caused him damage. Thornton v. City of St. Helens, 425 F.3d 1158, 1163-64 (9th Cir. 

2005) (quoting Shoshone-Bannock Tribes v. Idaho Fish & Game Comm’n, 42 F.3d 1278, 

1284 (9th Cir. 1994)). In addition, a plaintiff must allege that he suffered a specific injury 

as a result of the conduct of a particular defendant and he must a llege an affirmative link 

between the injury and the conduct of that defendant. Rizzo v. Goode, 423 U.S. 362, 371-

72, 377 (1976).

. . . .

. . . .

3 Although Plaintiff has not identified a jurisdictional basis for his lawsuit, the Court 

construe his claims as having been brought pursuant to 42 U.S.C. § 1983 because they arise 

from the conduct of individuals who were allegedly acting under color of state law. 

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A. Towers and Lower Buckeye Jails

Section 1983 imposes liability on any “person” who violates an individual’s federal 

rights while acting under color of state law. Congress intended municipalities and other 

local government units to be included among those persons to whom § 1983 applies. 

Monell v. Dept. of Soc. Serv. of N.Y., 436 U.S. 658, 689-90 (1978). However, Towers and 

Lower Buckeye Jails are buildings or collections of buildings, not persons or legally 

created entities capable of being sued. Thus, the Court will dismiss Defendants Towers 

and Lower Buckeye Jails.

B. MCSO and CHS

The Maricopa County Sheriff’s Office is not a proper defendant because it is a “nonjural entity.” Melendres v. Arpaio, 784 F.3d 1254, 1260 (9th Cir. 2015) (citing Braillard 

v. Maricopa County, 232 P.3d 1263, 1269 (Ariz. Ct. App. 2010)). In Arizona, the 

responsibility of operating jails and caring for prisoners is placed by law upon the sheriff. 

See Ariz. Rev. Stat. §§ 11-441(A)(5), 31-101. The sheriff’s office is simply an 

administrative creation of the county sheriff to allow him to carry out his statutory duties 

and is not a “person” amenable to suit pursuant to § 1983. MCSO will therefore be 

dismissed.

Nor is CHS a “person” amenable to suit under § 1983. While Maricopa County is 

responsible, by law, for providing medical care to county jail inmates, see Ariz. Rev. Stat. 

§ 11–291(A), any actions against a county must be brought against the county itself, not an 

administrative subdivision of the county. CHS will be dismissed accordingly.

To the extent Plaintiff is attempting to sue Maricopa County, he has failed to allege 

any facts to show that Maricopa County maintained a policy, practice, or custom that 

resulted in a violation of Plaintiff’s federal constitutional rights. See Sadoski v. Mosley, 

435 F.3d 1076, 1080 (9th Cir. 2006) (section 1983 claim against a municipal defendant 

“cannot succeed as a matter of law” unless a plaintiff: (1) contends that the municipal 

defendant maintains a policy or custom pertinent to the plaintiff’ s alleged injury; and 

(2) explains how such policy or custom caused the plaintiff’ s injury). 

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C. “CHS Staff” and “MCSO Staff”

Plaintiff has failed to state a claim against Defendants CHS Staff and MCSO Staff. 

To the extent Plaintiff’s claims against these Defendants are premised on undifferentiated

allegations against a group of individuals, such allegations are not sufficient to state a 

claim. See Marcilis v. Township of Redford, 693 F.3d 589, 596 (6th Cir. 2012) (upholding 

dismissal of Bivens complaint that referred to all defendants “generally and categorically” 

because the plaintiff had failed to “‘allege, with particularity, facts that demonstrate what 

each defendant did to violate the asserted constitutional right.’” (quoting Lanman v. 

Hinson, 529 F.3d 673, 684 (6th Cir. 2008))); Robbins v. Oklahoma, 519 F.3d 1242, 1250 

(10th Cir. 2008) (“Given the complaint’s use of either the collective term ‘Defendants’ or 

a list of the defendants named individually but with no distinction as to what acts are 

attributable to whom, it is impossible for any of these individuals to a scertain what 

particular unconstitutional acts they are alleged to have committed.”); Gauvin v. 

Trombatore, 682 F. Supp. 1067, 1071 (N.D. Cal. 1988) (section 1983 allegation that 

“lumped [defendants] together in a single, broad allegation” did not satisfy Federal Rule of 

Civil Procedure 8(a)(2)). Insofar as Plaintiff’s claims against CSH Staff and MCSO Staff

are premised upon the conduct of individual members of these staffs, Plaintiff must name 

each individual staff member as a Defendant and make it clear which allegations refer to 

him or her. The Court cannot impose liability on an entire staff based on the conduct of

only some of its members. Accordingly, Defendants CHS Staff and MCSO Staff will be 

dismissed.

IV. Leave to Amend

For the foregoing reasons, Plaintiff’s Second Amended Complaint will be dismissed 

for failure to state a claim upon which relief may be granted. Within 30 days, Pl aintiff may 

submit a third amended complaint to cure the deficiencies outlined above. The Clerk of 

Court will mail Plaintiff a court-approved form to use for filing a third amended complaint. 

If Plaintiff fails to use the court-approved form, the Court may strike the third amended 

complaint and dismiss this action without further notice to Plaintiff.

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Plaintiff must clearly designate on the face of the document that it is the “Third

Amended Complaint.” The third amended complaint must be retyped or rewritten in its 

entirety on the court-approved form and may not incorporate any part of the original 

Complaint, First Amended Complaint, or Second Amended Complaints by reference. 

Plaintiff may include only one claim per count. 

A third amended complaint supersedes the prior pleadings. Ferdik v. Bonzelet, 963 

F.2d 1258, 1262 (9th Cir. 1992); Hal Roach Studios v. Richard Feiner & Co., 896 F.2d 

1542, 1546 (9th Cir. 1990). After amendment, the Court will treat the original Complaint, 

the First Amended Complaint, and the Second Amended Complaint as nonexistent. Ferdik, 

963 F.2d at 1262. Any cause of action that was raised those pleadings and was voluntarily 

dismissed or was dismissed without prejudice is waived if it is not alleged in a third

amended complaint. Lacey v. Maricopa County, 693 F.3d 896, 928 (9th Cir. 2012) (en 

banc).

If Plaintiff files an amended complaint, Plaintiff must write short, plain statements 

telling the Court: (1) the constitutional right Plaintiff believes was violated; (2) the name 

of the Defendant who violated the right; (3) exactly what that Defendant did or failed to 

do; (4) how the action or inaction of that Defendant is connected to the violation of 

Plaintiff’s constitutional right; and (5) what specific injury Plaintiff suffered because of 

that Defendant’s conduct. See Rizzo, 423 U.S. at 371-72, 377.

Plaintiff must repeat this process for each person he names as a Defendant. If 

Plaintiff fails to affirmatively link the conduct of each named Defendant with the specific 

injury suffered by Plaintiff, the allegations against that Defendant will be dismissed for 

failure to state a claim. Conclusory allegations that a Defendant or group of 

Defendants has violated a constitutional right are not acceptable and will be 

dismissed. If Plaintiff does not know the names of individual Defendants, he may identify 

them as Defendant John (or Jane) Doe 1, John Doe 2, and so on in the caption of his 

amended complaint and, in the body of the amended complaint, allege facts to support how 

each particular Doe Defendant violated his rights. 

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Plaintiff should be aware that a pretrial detainee has a right under the Due Process 

Clause of the Fourteenth Amendment to be free from punishment prior to an adjudication 

of guilt. Bell v. Wolfish, 441 U.S. 520, 535 (1979). “Pretrial detainees are entitled to 

‘adequate food, clothing, shelter, sanitation, medical care, and personal safety.’” AlvarezMachain v. United States, 107 F.3d 696, 701 (9th Cir. 1996) (quoting Hoptowit v. Ray, 682 

F.2d 1237, 1246 (9th Cir. 1982)). To state a claim of unconstitutional conditions of 

confinement or inadequate medical care against an individual defendant, a pretrial detainee 

must allege facts that show: 

(i) the defendant made an intentional decision with respect to 

the conditions under which the plaintiff was confined; 

(ii) those conditions put the plaintiff at substantial risk of 

suffering serious harm; (iii) the defendant did not take 

reasonable available measures to abate that risk, even though a 

reasonable official in the circumstances would have 

appreciated the high degree of risk involved—making the 

consequences of the defendant’s conduct obvious; and (iv) by 

not taking such measures, the defendant caused the plaintiff’s 

injuries.

Gordon v. County of Orange, 888 F.3d 1118, 1125 (9th Cir. 2018).

V. Warnings

A. Release

If Plaintiff is released while this case remains pending, and the filing fee has not 

been paid in full, Plaintiff must, within 30 days of his release, either (1) notify the Court 

that he intends to pay the unpaid balance of his filing fee within 120 days of his release or 

(2) file a non-prisoner application to proceed in forma pauperis. Failure to comply may 

result in dismissal of this action.

B. Address Changes

Plaintiff must file and serve a notice of a change of address in accordance with Rule 

83.3(d) of the Local Rules of Civil Procedure. Plaintiff must not include a motion for other 

relief with a notice of change of address. Failure to comply may result in dismissal of this 

action.

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C. Possible “Strike”

Because the Second Amended Complaint has been dismissed for failure to state a 

claim, if Plaintiff fails to file a third amended complaint correcting the deficiencies 

identified in this Order, the dismissal may count as a “strike” under the “3 -strikes” 

provision of 28 U.S.C. § 1915(g). Under the 3-strikes provision, a prisoner may not bring 

a civil action or appeal a civil judgment in forma pauperis under 28 U.S.C. § 1915 “if the 

prisoner has, on 3 or more prior occasions, while incarcerated or detained in any facility, 

brought an action or appeal in a court of the United States that was dismissed on the 

grounds that it is frivolous, malicious, or fails to state a claim upon which relief may be 

granted, unless the prisoner is under imminent danger of serious physical injury.” 28 

U.S.C. § 1915(g). 

D. Possible Dismissal

If Plaintiff fails to timely comply with every provision of this Order, including these 

warnings, the Court may dismiss this action without further notice. See Ferdik, 963 F.2d 

at 1260-61 (a district court may dismiss an action for failure to comply with any order of 

the Court).

IT IS ORDERED: 

(1) The Second Amended Complaint (Doc. 10 ) is dismissed for failure to state 

a claim. Plaintiff has 30 days from the date this Order is filed to file a third amended 

complaint in compliance with this Order.

(2) If Plaintiff fails to file a third amended complaint within 30 days, the Clerk 

of Court must, without further notice, enter a judgment of dismissal of this action with 

prejudice that states that the dismissal may count as a “strike” under 28 U.S.C. § 1915(g) 

and deny any pending unrelated motions as moot.

. . . .

. . . .

. . . .

. . . .

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(3) The Clerk of Court must mail Plaintiff a court-approved form for filing a 

civil rights complaint by a prisoner. 

Dated this 1st day of April, 2020.

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Revised 3/11/16 1

Instructions for a Prisoner Filing a Civil Rights Complaint 

in the United States District Court for the District of Arizona

1. Who May Use This Form. The civil rights complaint form is designed to help incarcerated 

persons prepare a complaint seeking relief for a violation of their federal civil rights. These 

complaints typically concern, but are not limited to, conditions of confinement. This form

should not be used to challenge your conviction or sentence. If you want to challenge a state 

conviction or sentence, you should file a petition under 28 U.S.C. ' 2254 for a writ of habeas 

corpus by a person in state custody. If you want to challenge a federal conviction or sentence, you 

should file a motion under 28 U.S.C. § 2255 to vacate sentence in the federal court that entered the 

judgment. 

2. The Form. Local Rule of Civil Procedure (LRCiv) 3.4(a) provides that complaints by 

incarcerated persons must be filed on the court-approved form. The form must be typed or 

neatly handwritten. The form must be completely filled in to the extent applicable. All questions 

must be answered clearly and concisely in the appropriate space on the form. If needed, you may 

attach additional pages, but no more than fifteen additional pages, of standard letter-sized 

paper. You must identify which part of the complaint is being continued and number all pages. If 

you do not fill out the form properly, you will be asked to submit additional or corrected 

information, which may delay the processing of your action. You do not need to cite law. 

3. Your Signature. You must tell the truth and sign the form. If you make a false statement of a 

material fact, you may be prosecuted for perjury.

4. The Filing and Administrative Fees. The total fees for this action are $400.00 ($350.00 filing 

fee plus $50.00 administrative fee). If you are unable to immediately pay the fees, you may 

request leave to proceed in forma pauperis. Please review the “Information for Prisoners Seeking 

Leave to Proceed with a (Non-Habeas) Civil Action in Federal Court In Forma Pauperis Pursuant 

to 28 U.S.C. ' 1915” for additional instructions.

5. Original and Judge=s Copy. You must send an original plus one copy of your complaint and 

of any other documents submitted to the Court. You must send one additional copy to the Court if 

you wish to have a file-stamped copy of the document returned to you. All copies must be 

identical to the original. Copies may be legibly handwritten. This section does not apply to 

inmates housed at an Arizona Department of Corrections facility that participates in 

electronic filing.

6. Where to File. You should file your complaint in the division where you were confined 

when your rights were allegedly violated. See LRCiv 5.1(a) and 77.1(a). If you were confined 

in Maricopa, Pinal, Yuma, La Paz, or Gila County, file in the Phoenix Division. If you were 

confined in Apache, Navajo, Coconino, Mohave, or Yavapai County, file in the Prescott Division. 

If you were confined in Pima, Cochise, Santa Cruz, Graham, or Greenlee County, file in the 

Tucson Division. Mail the original and one copy of the complaint with the $400 filing and 

administrative fees or the application to proceed in forma pauperis to:

Case 2:19-cv-05285-MTL--JZB Document 11 Filed 04/01/20 Page 12 of 21
2

Phoenix & Prescott Divisions: OR Tucson Division:

U.S. District Court Clerk U.S. District Court Clerk

U.S. Courthouse, Suite 130 U.S. Courthouse, Suite 1500

401 West Washington Street, SPC 10 405 West Congress Street

Phoenix, Arizona 85003-2119 Tucson, Arizona 85701-5010

7. Change of Address. You must immediately notify the Court and the defendants in writing of 

any change in your mailing address. Failure to notify the Court of any change in your mailing 

address may result in the dismissal of your case.

8. Certificate of Service. You must furnish the defendants with a copy of any document you 

submit to the Court (except the initial complaint and application to proceed in forma pauperis). 

Each original document (except the initial complaint and application to proceed in forma pauperis) 

must include a certificate of service on the last page of the document stating the date a copy of the 

document was mailed to the defendants and the address to which it was mailed. See Fed. R. Civ. 

P. 5(a), (d). Any document received by the Court that does not include a certificate of service 

may be stricken. This section does not apply to inmates housed at an Arizona Department of 

Corrections facility that participates in electronic filing.

A certificate of service should be in the following form:

I hereby certify that a copy of the foregoing document was mailed

this (month, day, year) to:

Name: 

Address: 

 Attorney for Defendant(s)

 

(Signature)

9. Amended Complaint. If you need to change any of the information in the initial complaint, 

you must file an amended complaint. The amended complaint must be written on the 

court-approved civil rights complaint form. You may file one amended complaint without leave 

(permission) of Court within 21 days after serving it or within 21 days after any defendant has filed 

an answer, whichever is earlier. See Fed. R. Civ. P. 15(a). Thereafter, you must file a motion for 

leave to amend and lodge (submit) a proposed amended complaint. LRCiv 15.1. In addition, an 

amended complaint may not incorporate by reference any part of your prior complaint. LRCiv 

15.1(a)(2). Any allegations or defendants not included in the amended complaint are 

considered dismissed. All amended complaints are subject to screening under the Prison 

Litigation Reform Act; screening your amendment will take additional processing time.

10. Exhibits. You should not submit exhibits with the complaint or amended complaint. 

Instead, the relevant information should be paraphrased. You should keep the exhibits to use to 

support or oppose a motion to dismiss, a motion for summary judgment, or at trial.

11. Letters and Motions. It is generally inappropriate to write a letter to any judge or the staff of 

any judge. The only appropriate way to communicate with the Court is by filing a written 

pleading or motion.

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3

12. Completing the Civil Rights Complaint Form.

HEADING:

1. Your Name. Print your name, prison or inmate number, and institutional mailing 

address on the lines provided.

2. Defendants. If there are four or fewer defendants, print the name of each. If you 

name more than four defendants, print the name of the first defendant on the first line, 

write the words “and others” on the second line, and attach an additional page listing the 

names of all of the defendants. Insert the additional page after page 1 and number it 

“1-A” at the bottom.

3. Jury Demand. If you want a jury trial, you must write “JURY TRIAL DEMANDED”

in the space below “CIVIL RIGHTS COMPLAINT BY A PRISONER.” Failure to do so 

may result in the loss of the right to a jury trial. A jury trial is not available if you are 

seeking only injunctive relief.

Part A. JURISDICTION:

1. Nature of Suit. Mark whether you are filing the complaint pursuant to 42 U.S.C. ' 1983 

for state, county, or city defendants; “Bivens v. Six Unknown Federal Narcotics Agents”

for federal defendants; or “other.” If you mark “other,” identify the source of that 

authority. 

2. Location. Identify the institution and city where the alleged violation of your rights 

occurred. 

3. Defendants. Print all of the requested information about each of the defendants in the 

spaces provided. If you are naming more than four defendants, you must provide the 

necessary information about each additional defendant on separate pages labeled “2-A,”

“2-B,” etc., at the bottom. Insert the additional page(s) immediately behind page 2.

Part B. PREVIOUS LAWSUITS:

You must identify any other lawsuit you have filed in either state or federal court while you 

were a prisoner. Print all of the requested information about each lawsuit in the spaces provided. 

If you have filed more than three lawsuits, you must provide the necessary information about each 

additional lawsuit on a separate page. Label the page(s) as “2-A,” “2-B,” etc., at the bottom of the 

page and insert the additional page(s) immediately behind page 2.

Part C. CAUSE OF ACTION:

You must identify what rights each defendant violated. The form provides space to allege 

three separate counts (one violation per count). If you are alleging more than three counts, you 

must provide the necessary information about each additional count on a separate page. Number 

the additional pages “5-A,” “5-B,” etc., and insert them immediately behind page 5. Remember 

that you are limited to a total of fifteen additional pages.

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1. Counts. You must identify which civil right was violated. You may allege the 

violation of only one civil right per count.

2. Issue Involved. Check the box that most closely identifies the issue involved in your 

claim. You may check only one box per count. If you check the box marked “Other,”

you must identify the specific issue involved.

3. Supporting Facts. After you have identified which civil right was violated, you must 

state the supporting facts. Be as specific as possible. You must state what each 

individual defendant did to violate your rights. If there is more than one defendant, you 

must identify which defendant did what act. You also should state the date(s) on which 

the act(s) occurred, if possible.

4. Injury. State precisely how you were injured by the alleged violation of your rights. 

5. Administrative Remedies. You must exhaust any available administrative remedies 

before you file a civil rights complaint. See 42 U.S.C. § 1997e. Consequently, you 

should disclose whether you have exhausted the inmate grievance procedures or 

administrative appeals for each count in your complaint. If the grievance procedures were 

not available for any of your counts, fully explain why on the lines provided.

Part D. REQUEST FOR RELIEF:

Print the relief you are seeking in the space provided. 

SIGNATURE:

You must sign your name and print the date you signed the complaint. Failure to sign the 

complaint will delay the processing of your action. Unless you are an attorney, you may not bring 

an action on behalf of anyone but yourself.

FINAL NOTE

You should follow these instructions carefully. Failure to do so may result in your 

complaint being stricken or dismissed. All questions must be answered concisely in the proper 

space on the form. If you need more space, you may attach no more than fifteen additional pages. 

But the form must be completely filled in to the extent applicable. If you attach additional pages, 

be sure to identify which section of the complaint is being continued and number the pages.

Case 2:19-cv-05285-MTL--JZB Document 11 Filed 04/01/20 Page 15 of 21
Revised 3/11/16 1 550/555

___________________________________________

Name and Prisoner/Booking Number

___________________________________________ Place of Confinement

___________________________________________

Mailing Address

___________________________________________

City, State, Zip Code

(Failure to notify the Court of your change of address may result in dismissal of this action.)

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

_________________________________________ ,

(Full Name of Plaintiff)

)

Plaintiff,

v. 

(1) _______________________________________ , (Full Name of Defendant)

(2) _______________________________________ ,

(3) _______________________________________ ,

(4) _______________________________________ ,

Defendant(s).

G Check if there are additional Defendants and attach page 1-A listing them.

CASE NO. __________________________________ 

(To be supplied by the Clerk)

CIVIL RIGHTS COMPLAINT

BY A PRISONER

G Original Complaint

G First Amended Complaint

G Second Amended Complaint

A. JURISDICTION

1. This Court has jurisdiction over this action pursuant to:

G 28 U.S.C. § 1343(a); 42 U.S.C. § 1983

G 28 U.S.C. § 1331; Bivens v. Six Unknown Federal Narcotics Agents, 403 U.S. 388 (1971).

G Other: .

2. Institution/city where violation occurred: .

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2

B. DEFENDANTS

1. Name of first Defendant: . The first Defendant is employed 

as: ______________________________________________ at_______________________________________. (Position and Title) (Institution)

2. Name of second Defendant: . The second Defendant is employed as:

as: ______________________________________________ at_______________________________________. (Position and Title) (Institution)

3. Name of third Defendant: . The third Defendant is employed 

as: ______________________________________________ at_______________________________________. (Position and Title) (Institution)

4. Name of fourth Defendant: . The fourth Defendant is employed 

as: ______________________________________________ at_______________________________________. (Position and Title) (Institution)

If you name more than four Defendants, answer the questions listed above for each additional Defendant on a separate page.

C. PREVIOUS LAWSUITS

1. Have you filed any other lawsuits while you were a prisoner? G Yes G No

2. If yes, how many lawsuits have you filed? . Describe the previous lawsuits:

a. First prior lawsuit:

1. Parties: v. 

2. Court and case number: .

3. Result: (Was the case dismissed? Was it appealed? Is it still pending?)

.

b. Second prior lawsuit:

1. Parties: v. 

2. Court and case number: .

3. Result: (Was the case dismissed? Was it appealed? Is it still pending?)

.

c. Third prior lawsuit:

1. Parties: v. 

2. Court and case number: .

3. Result: (Was the case dismissed? Was it appealed? Is it still pending?)

.

If you filed more than three lawsuits, answer the questions listed above for each additional lawsuit on a separate page.

Case 2:19-cv-05285-MTL--JZB Document 11 Filed 04/01/20 Page 17 of 21
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D. CAUSE OF ACTION

COUNT I

1. State the constitutional or other federal civil right that was violated: 

.

2. Count I. Identify the issue involved. Check only one. State additional issues in separate counts.

G Basic necessities G Mail G Access to the court G Medical care 

G Disciplinary proceedings G Property G Exercise of religion G Retaliation

G Excessive force by an officer G Threat to safety G Other: .

3. Supporting Facts. State as briefly as possible the FACTS supporting Count I. Describe exactly what 

each Defendant did or did not do that violated your rights. State the facts clearly in your own words without 

citing legal authority or arguments.

.

4. Injury. State how you were injured by the actions or inactions of the Defendant(s).

.

5. Administrative Remedies:

a. Are there any administrative remedies (grievance procedures or administrative appeals) available at 

your institution? G Yes G No

b. Did you submit a request for administrative relief on Count I? G Yes G No

c. Did you appeal your request for relief on Count I to the highest level? G Yes G No

d. If you did not submit or appeal a request for administrative relief at any level, briefly explain why you 

did not. 

.

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COUNT II

1. State the constitutional or other federal civil right that was violated: 

.

2. Count II. Identify the issue involved. Check only one. State additional issues in separate counts.

G Basic necessities G Mail G Access to the court G Medical care 

G Disciplinary proceedings G Property G Exercise of religion G Retaliation

G Excessive force by an officer G Threat to safety G Other: .

3. Supporting Facts. State as briefly as possible the FACTS supporting Count II. Describe exactly what 

each Defendant did or did not do that violated your rights. State the facts clearly in your own words without 

citing legal authority or arguments.

.

4. Injury. State how you were injured by the actions or inactions of the Defendant(s).

.

5. Administrative Remedies.

a. Are there any administrative remedies (grievance procedures or administrative appeals) available at 

your institution? G Yes G No

b. Did you submit a request for administrative relief on Count II? G Yes G No

c. Did you appeal your request for relief on Count II to the highest level? G Yes G No

d. If you did not submit or appeal a request for administrative relief at any level, briefly explain why you 

did not. 

.

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COUNT III

1. State the constitutional or other federal civil right that was violated: 

.

2. Count III. Identify the issue involved. Check only one. State additional issues in separate counts.

G Basic necessities G Mail G Access to the court G Medical care 

G Disciplinary proceedings G Property G Exercise of religion G Retaliation

G Excessive force by an officer G Threat to safety G Other: .

3. Supporting Facts. State as briefly as possible the FACTS supporting Count III. Describe exactly what 

each Defendant did or did not do that violated your rights. State the facts clearly in your own words without 

citing legal authority or arguments.

.

4. Injury. State how you were injured by the actions or inactions of the Defendant(s).

.

5. Administrative Remedies.

a. Are there any administrative remedies (grievance procedures or administrative appeals) available at 

your institution? G Yes G No

b. Did you submit a request for administrative relief on Count III? G Yes G No

c. Did you appeal your request for relief on Count III to the highest level? G Yes G No

d. If you did not submit or appeal a request for administrative relief at any level, briefly explain why you 

did not. 

.

If you assert more than three Counts, answer the questions listed above for each additional Count on a separate page.

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E. REQUEST FOR RELIEF

State the relief you are seeking:

.

I declare under penalty of perjury that the foregoing is true and correct.

Executed on 

DATE SIGNATURE OF PLAINTIFF

___________________________________________

(Name and title of paralegal, legal assistant, or

other person who helped prepare this complaint)

___________________________________________

(Signature of attorney, if any)

___________________________________________

(Attorney=s address & telephone number)

ADDITIONAL PAGES

All questions must be answered concisely in the proper space on the form. If you need more space, you may 

attach no more than fifteen additional pages. But the form must be completely filled in to the extent applicable. 

If you attach additional pages, be sure to identify which section of the complaint is being continued and number 

all pages.

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