Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-3_14-cv-08141/USCOURTS-azd-3_14-cv-08141-0/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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SKC 

WO 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Anthony L. Rodrigues, 

Plaintiff, 

vs. 

Charles L. Ryan, et al., 

Defendants. 

No. CV 14-8141-PCT-DGC (MEA) 

ORDER 

Plaintiff Anthony L. Rodrigues, who is confined in the Arizona State Prison 

Complex-Kingman in Kingman, Arizona, has filed a pro se civil rights Complaint 

pursuant to 42 U.S.C. § 1983 (Doc. 1) and an Application to Proceed In Forma Pauperis

(Doc. 2). The Court will dismiss the Complaint with leave to amend. 

I. Application to Proceed In Forma Pauperis and Filing Fee

 Plaintiff’s Application to Proceed In Forma Pauperis will be granted. 28 U.S.C. 

§ 1915(a). Plaintiff must pay the statutory filing fee of $350.00. 28 U.S.C. § 1915(b)(1). 

The Court will not assess an initial partial filing fee. Id. The statutory filing fee will be 

collected monthly in payments of 20% of the previous month’s income credited to 

Plaintiff’s trust account each time the amount in the account exceeds $10.00. 28 U.S.C. 

§ 1915(b)(2). The Court will enter a separate Order requiring the appropriate government 

agency to collect and forward the fees according to the statutory formula. 

. . . . 

. . . . 

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II. 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. 28 

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

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, thedefendant-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)). 

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 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 Complaint will be dismissed for failure to state a claim, but because it may 

possibly be amended to state a claim, the Court will dismiss it with leave to amend. 

III. Complaint 

 Plaintiff alleges seven counts against Defendants Charles L. Ryan, Director of the 

Arizona Department of Corrections (“ADOC”); R. Scott Marquardt, President and CEO 

of Management Training Corporation (“MTC”); Tara R. Diaz, Director of Contract Beds 

Bureau-Arizona Department of Corrections; and P. Rider, Warden of the Arizona State 

Prison Complex-Kingman. 

 In Count One, Plaintiff asserts a claim against Defendant Ryan in his individual 

and official capacity for a violation of Plaintiff’s rights under the Fifth, Eighth, and 

Fourteenth Amendments, and the Americans with Disabilities Act (“ADA”). Plaintiff 

alleges that Ryan was aware that MTC and ADOC personnel had adopted a written 

policy imposing disciplinary sanctions “not otherwise inclusive of ADOC earned 

incentive program (EIP) phase level privileges subject to non-discretionary loss or 

forfeiture for alleged [ADOC policy] violation[s].” While not entirely clear, Plaintiff 

appears to assert that the alleged policy took away certain of his “state created liberties” – 

including participation in federally subsidized education programs and earned release 

credits – without notice or an opportunity to be heard. Plaintiff alleges that Ryan showed 

deliberate indifference to significant hardships that Plaintiff endured as a result of this 

policy, including loss of educational opportunities and reassignment to housing that 

exposed Plaintiff to conditions that aggravated his pre-existing chronic medical 

condition. Plaintiff alleges that he suffered “emotional trauma, mental anguish, medical 

complications involving hospitalization, loss of physical and emotional wellness and the 

enjoyment of quality life/free of discrimination.” 

. . . . 

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 In Count Two, Plaintiff asserts a second claim against Defendant Ryan in his 

individual and official capacity for violation of Plaintiff’s rights under the Fifth, Eighth, 

and Fourteenth Amendments, and the ADA. Plaintiff alleges that Ryan knew that 

Plaintiff suffered from a chronic medical condition that qualified as a disability under the 

ADA yet denied Plaintiff’s request for alternative housing and reasonable 

accommodation, thus exposing Plaintiff to elevated levels of stress, airborne 

contaminants, overcrowding, extreme fluctuations in temperature, and second-hand 

smoke. Plaintiff further alleges that Ryan’s failure to enforce ADOC policies and 

compliance with the ADA deprived Plaintiff of participation in federally subsidized 

education programs. Plaintiff appears to allege that he suffered these losses as a 

disciplinary response to conduct he claims was the result of medications he used to treat 

his disability. Plaintiff alleges that he suffered a variety of physical and emotional 

injuries, including medical complications that required hospitalization. 

 In Count Three, Plaintiff asserts a claim against Defendant R. Scott Marquardt in 

his individual and official capacity for violation of Plaintiff’s rights under the Fifth, 

Eighth, and Fourteenth Amendments, and the ADA. Plaintiff alleges nearly identical 

facts in Count Three against Marquardt to those alleged in Count One against Ryan, 

namely that Marquardt was aware that MTC personnel had adopted a written policy 

imposing “non-discretionary disciplinary sanctions” that deprived Plaintiff of certain 

alleged “liberty interests” in educational programs, leave credits, and assigned housing, 

the last of which resulted in his exposure to preventable environmental stresses and 

contaminants – all without notice or a hearing. Plaintiff alleges that Marquardt failed to 

monitor, supervise, or ensure the proper training of MTC staff to prevent these losses. 

Plaintiff alleges that he suffered emotional trauma and mental and physical 

complications, including hospitalization. 

 In Counts Four and Five, Plaintiff asserts claims against Defendant Tara Diaz in 

her individual and official capacity for violation of Plaintiff’s rights under the Fifth, 

Eighth, and Fourteenth Amendments, and the ADA. Plaintiff makes nearly identical 

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allegations against Diaz to those made in Counts One and Two against Ryan. In Count 

Four, Plaintiff alleges that Diaz was aware that MTC staff had a written policy leading to 

the loss of Plaintiff’s “liberty interests” in educational programs, leave credits, and 

housing without notice or a hearing, but she failed “to take corrective action and monitor, 

supervise[,] and ensure the proper training” of these individuals. In Count Five, Plaintiff 

alleges that Diaz knew or should have known that Plaintiff suffered from a chronic 

medical condition recognized by the ADA, yet she denied his request for alternative 

housing and reasonable accommodation. In both counts, Plaintiff re-alleges that he 

suffered emotional trauma and mental and physical complications, including 

hospitalization. 

 In Counts Six and Seven, Plaintiff asserts claims against Defendant P. Rider in her 

individual and official capacity for violation of Plaintiff’s rights under the Fifth, Eighth, 

and Fourteenth Amendments, and the ADA. Again, Plaintiff asserts nearly identical 

allegations with respect to Rider as to those made in Counts One and Two against Ryan. 

In Count Six, Plaintiff alleges that MTC personnel enforced a written policy leading to 

the loss of Plaintiff’s alleged “liberty interests” in educational programs, leave credits, 

and housing without notice or a hearing, but Rider failed “to monitor, supervise or take 

corrective action to ensure the proper training” of these individuals. In Count Seven, 

Plaintiff alleges that Rider knew that Plaintiff suffered from a chronic medical condition 

recognized by the ADA yet denied his request for alternative housing and reasonable 

accommodation. In both counts, Plaintiff re-alleges that he suffered emotional trauma 

and mental and physical complications, including hospitalization. 

 Plaintiff seeks declaratory relief as to all Defendants, finding that they jointly and 

severally violated his right to due process and equal protection and his right to be free 

from cruel and unusual punishment, specifically by denying his requests for reasonable 

accommodation pursuant to the ADA. Plaintiff also seeks injunctive relief requiring 

Defendants to discontinue current policy, compensatory damages in an amount to be 

determined, punitive damages of $4,000,000, and attorney fees and costs. 

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IV. Failure to State a Claim under § 1983 

 To prevail in a § 1983 claim, 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 allege an 

affirmative link between the injury and the conduct of that defendant. Rizzo v. Goode, 

423 U.S. 362, 371-72, 377 (1976). 

A. Defendant Ryan 

 Plaintiff fails to state a § 1983 claim against Defendant Ryan. “A plaintiff must 

allege facts, not simply conclusions, that show that an individual was personally involved 

in the deprivation of his civil rights.” Barren v. Harrington, 152 F.3d 1193, 1194 (9th 

Cir. 1998). For an individual to be liable in his official capacity, a plaintiff must allege 

injuries resulting from a policy, practice, or custom of the agency over which that 

individual has final policy-making authority. See Cortez v. County of Los Angeles, 294 

F.3d 1186, 1188 (9th Cir. 2002). Further, there is no respondeat superior liability under 

§ 1983, so a defendant’s position as the supervisor of someone who allegedly violated a 

plaintiff’s constitutional rights does not make him liable. Monell v. N.Y. Dep’t of Soc. 

Servs., 436 U.S. 658, 691 (1978); Taylor v. List, 880 F.2d 1040, 1045 (9th Cir. 1989) 

(citation omitted). A supervisor in his individual capacity “is only liable for 

constitutional violations of his subordinates if the supervisor participated in or directed 

the violations, or knew of the violations and failed to act to prevent them.” Taylor, 880 

F.2d at 1045. 

 To the extent that Plaintiff seeks to sue Ryan in his official capacity as Director of 

ADOC, Plaintiff must allege facts showing that ADOC’s policy or custom lead to the 

alleged violations. See Hafer v. Melo, 502 U.S. 21, 25 (1991). Plaintiff alleges that 

ADOC and MTC personnel adopted a “written policy” that lead to deprivations of his 

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alleged liberty interests. More specifically, Plaintiff appears to allege that he suffered 

disciplinary sanctions pursuant to “ADOC policy 809.” Plaintiff’s statements about the 

substance of this alleged policy, however, are vague and largely incomprehensible. 

Moreover, Plaintiff fails to allege any facts showing in short, plain terms what happened. 

Absent further factual detail, Plaintiff’s mere statements that he was deprived of certain 

liberty interests as a result of an ADOC policy are insufficient to state a claim. See Iqbal, 

556 U.S. at 678 (“Threadbare recitals of the elements of a cause of action, supported by 

mere conclusory statements, do not suffice.”). Accordingly, Plaintiff’s § 1983 claims 

against Ryan in his official capacity will be dismissed. 

 To the extent that Plaintiff attempts to sue Ryan in his personal capacity, Plaintiff 

also fails to state a claim. Plaintiff does not allege that Ryan participated in or directed 

the alleged violations, or that he knew of the violations and failed to act to prevent them. 

Accordingly, Plaintiff’s § 1983 claims against Ryan in his personal capacity will be 

dismissed. 

B. Other Defendants 

 For the same reasons discussed above with respect to Defendant Ryan, Plaintiff 

fails to state a claim against Defendants Marquardt, Diaz, or Rider, either in their official 

or personal capacities. 

 To the extent that Plaintiff attempts to sue Defendant Marquardt in his official 

capacity as President and CEO of MTC, Plaintiff alleges that Marquardt knew MTC 

personnel had adopted a “written policy” that led to the deprivation of certain of 

Plaintiff’s alleged liberty interests. Plaintiff once again fails to provide an intelligible 

description of this policy, however, or to allege any facts showing in short, plain terms 

what occurred to deprive him of his rights. 

 To the extent that Plaintiff attempts to sue Defendant Marquardt in his personal 

capacity, Plaintiff alleges that Marquardt failed “to monitor, supervise[,] and ensure the 

proper training of MTC staff responsible for the management and enforcement of ADOC 

Policy.” Plaintiff fails, however, to allege any facts showing that Marquardt “knew of the 

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violations [against Plaintiff] and failed to act to prevent them.” Taylor, 880 F.2d at 1045. 

Accordingly, Plaintiff’s § 1983 claims against Marquardt in his personal capacity will be 

dismissed. 

 As to Defendants Diaz and Rider, Plaintiff fails to allege any additional facts 

regarding the alleged ADOC and MTC policy that would cure the deficiencies noted 

above. Additionally, although Plaintiff alleges generally that he was deprived of his 

ability to participate in federally funded educational programs; he lost “release credits”; 

and he was reassigned to less-desirable housing – all without notice or a hearing – he fails 

to allege specific actions on the parts of either Defendant or to allege any facts showing 

that either Defendant was made aware of these alleged violations and failed to act to 

prevent them. Accordingly Plaintiff has failed to state claims against Diaz and Rider in 

either their official or individual capacities. Plaintiff’s § 1983 claims against these 

Defendants will be dismissed. 

V. Failure to State a Claim under the ADA 

 Plaintiff asserts violation of the ADA against all Defendants. Under Title II of the 

ADA, “no qualified individual with a disability shall, by reason of such disability, be 

excluded from participation in or be denied the benefits of the services, programs, or 

activities of a public entity, or be subjected to discrimination by any such entity.” 42 

U.S.C. § 12132. A “public entity” is “any State or local government; [or] (B) any 

department, agency, special purpose district, or other instrumentality of a State or States 

or local government. . . .” 42 U.S.C. § 12131. Individuals, however, may only be sued 

under the ADA in their official, rather than, their individual capacities. Vinson v. 

Thomas, 288 F.3d 1145, 1156 (9th Cir. 2002) (plaintiff cannot sue state officials in their 

individual capacities to vindicate rights created by Title II of the ADA). To state an 

ADA claim, a plaintiff must allege facts to support that he: “(1) is a handicapped person; 

(2) that he is otherwise qualified; and that [prison officials’] actions either (3) excluded 

his participation in or denied him the benefits of a service, program, or activity; or 

(4) otherwise subjected him to discrimination on the basis of his physical handicap.” 

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Duffy v. Riveland, 98 F.3d 447, 455 (9th Cir. 1996). The term “qualified individual with 

a disability” includes “an individual with a disability who, with or without . . . the 

provision of auxiliary aids and services, meets the essential eligibility requirements for 

the receipt of services or participation in programs or activities provided by a public 

entity.” 42 U.S.C. § 12131(2). 

A. Defendant Ryan 

 Plaintiff fails to state a claim under the ADA as to Defendant Ryan. Plaintiff 

alleges in Count Two that Ryan “knew Plaintiff suffered from a chronic medical 

condition recognized by ADOC Policy as a qualifying disability subject to [the ADA] 

and denied Plaintiff’s request for alternative housing reassignment and reasonable 

accommodation.” He further alleges that Ryan based this denial on the absence of 

medical necessity rather than disability. Plaintiff appears to allege that Ryan applied the 

wrong standard for responding to a request for reasonable accommodation under the 

ADA. Nowhere, however, does Plaintiff allege facts showing that he has a qualifying 

disability under the ADA. Neither does Plaintiff allege facts showing that he was 

excluded from a program or denied services based on disability. Plaintiff alleges that he 

was deprived of benefits – including his preferred housing assignment and participation 

in educational programs – and that these losses were due to conduct related to the 

medications he took for his disability. But Plaintiff fails to provide any facts about his 

conduct and how it resulted in his alleged deprivations or to show any connection 

between his conduct, the medications, and his disability. Absent additional facts showing 

that Plaintiff had a disability and was otherwise qualified for the benefits he allegedly 

lost, Plaintiff fails to state a claim under the ADA. Accordingly, Plaintiff’s ADA claim 

against Ryan will be dismissed. 

B. Remaining Defendants 

 For the same reasons cited above, Plaintiff fails to state a claim under the ADA as 

to Defendants Marquardt, Diaz, and Rider. Plaintiff alleges similar facts in Counts Five 

and Seven against Diaz and Rider as to those alleged against Ryan in Count Two. But 

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Plaintiff fails to allege additional facts anywhere in his Complaint showing that he has a 

disability or showing that he was denied services for which he was otherwise qualified 

simply because of that disability. Accordingly, Plaintiff fails to state a claim under the 

ADA as to any Defendant, and his ADA claims against Marquardt, Diaz, and Rider will 

be dismissed. 

VI. Leave to Amend 

 For the foregoing reasons, Plaintiff’s Complaint will be dismissed for failure to 

state a claim upon which relief may be granted. Within 30 days, Plaintiff may submit a 

first amended complaint to cure the deficiencies outlined above. The Clerk of Court will 

mail Plaintiff a court-approved form to use for filing a first amended complaint. If 

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

complaint and dismiss this action without further notice to Plaintiff. 

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

Amended Complaint.” The first 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 by reference. Plaintiff may include only one claim per count. 

 A first amended complaint supersedes the original complaint. 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 an original 

complaint as nonexistent. Ferdik, 963 F.2d at 1262. Any cause of action that was raised 

in the original complaint and that was voluntarily dismissed or was dismissed without 

prejudice is waived if it is not alleged in a first amended complaint. Lacey v. Maricopa 

County, 693 F.3d 896, 928 (9th Cir. 2012) (en banc). 

VII. Warnings

A. Release

 Plaintiff must pay the unpaid balance of the filing fee within 120 days of his 

release. Also, within 30 days of his release, he must either (1) notify the Court that he 

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intends to pay the balance or (2) show good cause, in writing, why he cannot. 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. 

C. Copies

 Plaintiff must submit an additional copy of every filing for use by the Court. See

LRCiv 5.4. Failure to comply may result in the filing being stricken without further 

notice to Plaintiff. 

 D. Possible “Strike”

 Because the Complaint has been dismissed for failure to state a claim, if Plaintiff 

fails to file an 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). 

E. 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) Plaintiff’s Application to Proceed In Forma Pauperis (Doc. 2) is granted. 

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 (2) As required by the accompanying Order to the appropriate government 

agency, Plaintiff must pay the $350.00 filing fee and is not assessed an initial partial 

filing fee. 

(3) The Complaint (Doc. 1) is dismissed for failure to state a claim. Plaintiff 

has 30 days from the date this Order is filed to file a first amended complaint in 

compliance with this Order. 

 (4) If Plaintiff fails to file an 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). 

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

civil rights complaint by a prisoner. 

Dated this 17th day of November, 2014. 

Case 3:14-cv-08141-DGC Document 7 Filed 11/17/14 Page 12 of 22
Revised 5/1/2013 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.

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 3:14-cv-08141-DGC Document 7 Filed 11/17/14 Page 13 of 22
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. 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 before any defendant has answered your original complaint. See Fed. R. Civ. P. 15(a). After

any defendant has filed an answer, 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.

Case 3:14-cv-08141-DGC Document 7 Filed 11/17/14 Page 14 of 22
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.

Case 3:14-cv-08141-DGC Document 7 Filed 11/17/14 Page 15 of 22
4

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 3:14-cv-08141-DGC Document 7 Filed 11/17/14 Page 16 of 22
Revised 5/1/2013 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, )

)

 vs. ) CASE NO. 

) (To be supplied by the Clerk)

(1) , )

(Full Name of Defendant) )

(2) , )

) CIVIL RIGHTS COMPLAINT

(3) ,) BY A PRISONER

)

(4) , ) G Original Complaint

Defendant(s). ) G First Amended Complaint

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

Case 3:14-cv-08141-DGC Document 7 Filed 11/17/14 Page 17 of 22
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:

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 3:14-cv-08141-DGC Document 7 Filed 11/17/14 Page 18 of 22
3

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. 

.

Case 3:14-cv-08141-DGC Document 7 Filed 11/17/14 Page 19 of 22
4

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. 

.

Case 3:14-cv-08141-DGC Document 7 Filed 11/17/14 Page 20 of 22
5

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.

Case 3:14-cv-08141-DGC Document 7 Filed 11/17/14 Page 21 of 22
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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.

Case 3:14-cv-08141-DGC Document 7 Filed 11/17/14 Page 22 of 22