Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_13-cv-01186/USCOURTS-azd-2_13-cv-01186-0/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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MDR 

WO 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Cedric R. Jordan, 

Plaintiff, 

vs. 

Joseph M. Arpaio, et al., 

Defendants. 

No. CV 13-1186-PHX-DGC (MEA) 

ORDER 

On June 12, 2013, Plaintiff Cedric R. Jordan, who is confined in the Maricopa 

County Fourth Avenue Jail, filed a pro se civil rights Complaint pursuant to 42 U.S.C. 

§ 1983 and an Application to Proceed In Forma Pauperis (Doc. 2). On August 5, 2013, 

he filed a Notice for Status (Doc. 5). On August 13, 2013, he filed a Motion to Expedite 

Service (Doc. 6). On September 23, 2013, he filed a First Amended Complaint (Doc. 7). 

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. 28 U.S.C. § 1915(b)(1). The 

statutory fee will be collected monthly in payments of 20% of the previous month’s 

income 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). The 

Court should not, however, advise the litigant how to cure the defects. This type of 

advice “would undermine district judges’ role as impartial decisionmakers.” Pliler v. 

Ford, 542 U.S. 225, 231 (2004); see also Lopez, 203 F.3d at 1131 n.13 (declining to 

decide whether the court was required to inform a litigant of deficiencies). The Court 

will dismiss Plaintiff’s Complaint for failure to state a claim, but because the Complaint 

may possibly be saved by amendment, will dismiss the Complaint with leave to amend. 

III. First Amended Complaint 

 In his three-count First Amended Complaint, Plaintiff sues the following 

Defendants: Maricopa County Sheriff Joseph M. Arpaio, the Phoenix Police Department, 

Phoenix Police Chief Daniel V. Garcia and Homicide Detective Jan Butcher, St. Joseph’s 

Hospital, Community Bridges, Correctional Health Services, Maricopa County, the 

Arizona Department of Corrections, Arizona Governor Jan Brewer, and the United States 

of America. 

 In Count One, Plaintiff alleges that his Eighth Amendment rights have been 

violated. Plaintiff asserts that the “New World Order Crime Syndicate” has placed a 

“contract” or “hit” on Plaintiff’s life “because of the Plaintiff’s knowledge of ‘their’ 

illegal operations in Arizona.”1

 Plaintiff asserts that the New World Order Crime 

Syndicate consists of, among others, Defendants Butcher, Garcia, and the Phoenix Police 

Department; a group of doctors, nurses, and other professionals at Defendant St. Joseph’s 

Hospital; other professionals all over “the State of Arizona and beyond”; and Defendant 

Community Bridges. Plaintiff contends that Defendants Butcher, Garcia, Phoenix Police 

Department, St. Joseph’s Hospital, and Community Bridges conspired to have Plaintiff 

 

1

 Plaintiff contends that the New World Order is involved in, among other things, manufacturing counterfeit currency, kidnaping, prostitution, murder, drug trafficking, identity theft, fraud, extorting businesses and professional athletes, and producing pornography by controlling “young pretty females” by injecting them with heroin and methamphetamine so they become “sex-slaves.” 

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murdered in Maricopa County by placing a contract on Plaintiff’s life in February 2013 

because he had infiltrated many of their illegal business. 

 Plaintiff states that he was arrested on April 18, 2013, and is housed in the 

Maricopa County Fourth Avenue Jail. Plaintiff asserts that he informed a classification 

specialist at the jail that he needed to be “‘housed’ in the double door[]s for safety 

reasons” because there was a contract on his life, but the classification specialist failed to 

house Plaintiff in a safe environment. Plaintiff claims he was “assaulted because of that 

negligence.” Plaintiff claims he was housed for weeks “‘in harms way’ with other 

inmate[]s who wanted to ‘kill’ the Plaintiff . . . so [they] could collect the money for the 

contract (‘hit’),” and that Plaintiff submitted several “tank order[]s” to Defendant Arpaio 

so that he would be aware of a threat to Plaintiff’s safety. Plaintiff asserts that he faced 

imminent danger because he was housed with known members of the Aryan 

Brotherhood, a prison gang that is “‘close associates’ with the New World Order.” 

 Plaintiff also claims that a jail commander, a sergeant, two floor officers, and a 

tower officer conspired to have Plaintiff killed by the Aryan Brotherhood on “[razor] 

night.” Plaintiff asserts that on the night closed-custody inmates are permitted to shave 

with a razor while locked in their cell, the tower officer opened Plaintiff’s cell door and 

the cell door of a member of the Aryan Brotherhood. Plaintiff asserts that he was “almost 

‘killed’” but managed to escape from the attack. Plaintiff claims that four days later, he 

contacted his attorney, “informed him of the murder attempt,” and his attorney contacted 

the jail and had Plaintiff “moved to the safer double-door[]s.” Plaintiff contends that 

Defendant Arpaio “failed to prevent his [rogue] jail official[]s from collaborating with the 

[New World Order]” and that Plaintiff was “nearly ‘killed’” by the Aryan Brotherhood. 

 In Count Two, Plaintiff alleges a violation of the Eighth Amendment prohibition 

against cruel and unusual punishment. He claims it was cruel and unusual for Defendant 

Brewer to subject him to an organized crime syndicate that includes officials and 

employees of the State, County, and City. Plaintiff asserts that Defendant Brewer has 

knowledge of the crime syndicate, condoned its existence, and condoned criminal 

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enterprises at Defendant St. Joseph’s Hospital, Defendant Community Bridges, 

Defendant Arizona Department of Corrections, urgent care, and other State agencies. 

Plaintiff asserts that Defendant Arizona Department of Corrections is a named defendant 

because it “is in correlation with prison gang[]s that are under the [New World Order].” 

Plaintiff asserts that the “Maricopa County Board of Director[]s” also knew about and 

condoned the New World Order and that Defendant United States of America is “using 

the Plaintiff as bait to catch [all] the fish.” 

 In Count Three, Plaintiff contends that his Eighth Amendment rights were 

violated. He claims Defendant Correctional Health Services has failed to provide him 

with adequate health care. Plaintiff asserts that a doctor examined Plaintiff and 

diagnosed him as having a ruptured eardrum, informing Plaintiff that it appeared that 

someone had stuck something down Plaintiff’s ear. Plaintiff contends that Defendant 

Correctional Health Services failed to provide a surgery for the ear drum and that this 

was “deliberate indifference.” Plaintiff also claims that during a surgery in September 

2012 at Defendant St. Joseph’s Hospital, a doctor maliciously and sadistically jammed an 

object in Plaintiff’s ear. 

 In his Request for Relief, Plaintiff seeks injunctive relief, 16 million dollars to 

“create safe havens for (sex-slaves) across the country,” and for the case to be “under 

seal.” 

IV. Failure to State a Claim

 Although pro se pleadings are liberally construed, Haines v. Kerner, 404 U.S. 519, 

520-21 (1972), conclusory and vague allegations will not support a cause of action. Ivey 

v. Board of Regents of the University of Alaska, 673 F.2d 266, 268 (9th Cir. 1982). 

Further, a liberal interpretation of a civil rights complaint may not supply essential 

elements of the claim that were not initially pled. Id. 

. . . . 

. . . . 

. . . . 

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A. Defendants Phoenix Police Department, Garcia, Butcher, St. Joseph’s 

Hospital, and Community Bridges 

Plaintiff’s allegations regarding the New World Order Crime Syndicate against 

Defendants Phoenix Police Department, Garcia, Butcher, St. Joseph’s Hospital, and 

Community Bridges are implausible and frivolous. See Iqbal; O’Loughlin v. John Doe,

920 F.2d 614, 617 (9th Cir. 1990) (“An in forma pauperis complaint is frivolous if it has 

no arguable basis in fact or law.”) (citation and internal quotation marks omitted)). The 

Court will therefore dismiss Plaintiff’s claims in Counts One and Two against these 

Defendants. 

 In Count Three, Plaintiff alleges that a doctor performed a surgery at Defendant 

St. Joseph’s Hospital. This is insufficient to state a claim against Defendant St. Joseph’s 

Hospital. To state a valid claim under § 1983, plaintiffs must allege that they suffered a 

specific injury as a result of specific conduct of a defendant and show an affirmative link 

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

371-72, 377 (1976). There is no respondeat superior liability under § 1983, and 

therefore, a defendant’s position as the supervisor of persons who allegedly violated 

Plaintiff’s constitutional rights does not impose liability. Monell v. New York City Dep’t 

of Soc. Servs., 436 U.S. 658, 691-92 (1978); Hamilton v. Endell, 981 F.2d 1062, 1067 

(9th Cir. 1992); Taylor v. List, 880 F.2d 1040, 1045 (9th Cir. 1989). Defendant St. 

Joseph’s Hospital is not liable simply because a doctor performed a surgery at the 

hospital. Thus, the Court will dismiss Plaintiff’s claim in Count Three against Defendant 

St. Joseph’s Hospital. 

B. Defendant Arpaio

 Plaintiff alleges that he submitted “tank order[]s” to Defendant Arpaio so 

Defendant Arpaio would be aware of a threat to Plaintiff’s safety by inmates who wanted 

to kill Plaintiff and collect on the New World Order Crime Syndicate’s alleged “contract” 

on his life, and that Defendant Arpaio failed to prevent his employees from collaborating 

with the New World Order Crime Syndicate. Plaintiff’s allegations regarding the New 

World Order Crime Syndicate are implausible and frivolous and his claim against 

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Defendant Arpaio is too vague and conclusory to rise to the level of deliberate 

indifference. See Farmer v. Brennan, 511 U.S. 825, 834-37 (1994). 

C. Defendants Correctional Health Services

 Defendant Correctional Health Services is an improper Defendant. Municipalities 

and other local governing bodies are included among those “persons” who may be sued 

under § 1983. Monell, 436 U.S. at 690-91. Because Correctional Health Services is an 

administrative subdivision of Maricopa County and not a municipal corporation, a local 

governing body or a private corporation, it is not a “person” amenable to suit under 

§ 1983. Maricopa County is responsible for providing medical care to county jail 

inmates. See Ariz. Rev. Stat. § 11-291(A). Any actions concerning a county policy must 

be brought against the county itself and not against an administrative subdivision of the 

county. Thus, Defendant Correctional Health Services is an improper defendant and will 

be dismissed from this action. 

D. Maricopa County

 The Court will dismiss as implausible and frivolous Plaintiff’s allegation in Count 

Two that Defendant Maricopa County or the “Maricopa County Board of Director[]s” 

knew about and condoned the New World Order Crime Syndicate. 

 In Count Three, Plaintiff alleges that Defendant Correctional Health Services was 

deliberately indifferent because it failed to provide a surgery for Plaintiff’s ruptured 

eardrum. To the extent this allegation can be construed as a claim against Defendant 

Maricopa County, Plaintiff has failed to state a claim. 

 A municipality cannot be held liable unless its “policy or custom caused the 

constitutional injury.” See Leatherman v. Tarrant County Narcotics Intelligence and 

Coordination Unit, 507 U.S. 163, 166 (1993). Thus, a municipality may not be sued 

solely because an injury was inflicted by one of its employees or agents. Long v. County 

of Los Angeles, 442 F.3d 1178, 1185 (9th Cir. 2006). Rather, the municipality is liable 

only when the execution of its policy or custom inflicts the constitutional injury. Id. 

Thus, a § 1983 claim against a municipal defendant “cannot succeed as a matter of law” 

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unless the 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. See Sadoski v. Mosley, 435 F.3d 1076, 1080 (9th 

Cir. 2006) (affirming dismissal of a municipal defendant pursuant to Fed. R. Civ. P. 

12(b)(6)). Plaintiff’s claim fails because he has not alleged that the failure to provide him 

with a surgery was a result of an official policy or custom of Defendant Maricopa 

County. Thus, the Court will dismiss without prejudice Defendant Maricopa County. 

 E. Defendant Arizona Department of Corrections

The Arizona Department of Corrections is not a proper Defendant. Under the 

Eleventh Amendment to the Constitution of the United States, a state or state agency may 

not be sued in federal court without its consent. Pennhurst State Sch. & Hosp. v. 

Halderman, 465 U.S. 89, 100 (1984); Taylor, 880 F.2d at 1045. Furthermore, “a state is 

not a ‘person’ for purposes of section 1983. Likewise ‘arms of the State’ such as the 

Arizona Department of Corrections are not ‘persons’ under section 1983.” Gilbreath v. 

Cutter Biological, Inc., 931 F.2d 1320, 1327 (9th Cir. 1991) (citation omitted). 

Therefore, the Court will dismiss Defendant Arizona Department of Corrections. 

F. Defendant Brewer

 Plaintiff alleges that Defendant Brewer has knowledge of the New World Order 

Crime Syndicate, condoned its existence, and condoned criminal enterprises at Defendant 

St. Joseph’s Hospital, Defendant Community Bridges, Defendant Arizona Department of 

Corrections, urgent care, and other State agencies. Plaintiff’s claim is implausible and 

frivolous and, therefore, the Court will dismiss it. 

G. Defendant United States of America 

 The United States, its agencies, and its employees acting within their official 

capacities, are immune from suit unless the United States waives its sovereign immunity. 

FDIC v. Meyer, 510 U.S. 471, 475 (1994); Hodge v. Dalton, 107 F.3d 705, 707 (9th Cir. 

1997). “Any waiver of immunity must be ‘unequivocally expressed,’ and any limitations 

and conditions upon the waiver ‘must be strictly observed and exceptions thereto are not 

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to be implied.’” Hodge, 107 F.3d at 707 (quoting Lehman v. Nakshian, 453 U.S. 156, 

160-61 (1981)). Plaintiff has the burden of asserting specific provisions that 

unequivocally waive sovereign immunity. Holloman v. Watt, 708 F.2d 1399, 1401 (9th 

Cir. 1983). Plaintiff has not asserted any basis for a waiver of sovereign immunity. 

Thus, the Court will dismiss Defendant United States of America. 

V. Leave to Amend 

 Plaintiff’s First Amended Complaint will be dismissed for failure to state a claim 

upon which relief may be granted. Counts 1 and 2 are dismissed with prejudice because 

they are frivolous; Plaintiff is not granted leave to amend them. Within 30 days, Plaintiff 

may submit a second amended complaint to cure the deficiencies outlined above in 

Count 3. The Clerk of Court will mail Plaintiff a court-approved form to use for filing a 

second amended complaint. If Plaintiff fails to use the court-approved form, the Court 

may strike the second 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 “Second 

Amended Complaint.” The second 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 or First Amended Complaint by reference. Plaintiff may include only one 

claim per count. 

 A second amended complaint supersedes the original Complaint and First 

Amended 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 the original Complaint and First Amended Complaint as 

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

original Complaint or First Amended complaint is waived if it is not raised in a second 

amended complaint. King v. Atiyeh, 814 F.2d 565, 567 (9th Cir. 1987). 

/ / / 

/ / / 

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VI. Notice for Status

 In his Notice for Status, Plaintiff “moves with notice for status.” To the extent 

Plaintiff is seeking information regarding the status of his case, this Order provides 

Plaintiff with the status of his case. To the extent Plaintiff is making allegations against 

the Maricopa County Sheriff’s Office Inmate Legal Services (ILS) and an ILS staff 

member and alleging that there is a conspiracy between ILS, the staff member, and 

Defendant Phoenix Police Department, the Court will not grant any relief regarding these 

allegations. 

VII. Motion to Expedite Service

 Plaintiff’s Motion to Expedite Service is premature. Plaintiff’s First Amended 

Complaint has been dismissed. If he files a second amended complaint, the Court will 

screen it pursuant to 28 U.S.C. § 1915A. If the Court determines that an answer is 

required, the Court will direct the Clerk of Court to send Plaintiff a service packet 

containing summonses and request for waiver forms for Plaintiff to complete and return 

to the Court. The United States Marshal will effect service if Plaintiff timely completes 

the service packet and returns it to the Court. 

VIII. 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 

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. 

/ / / 

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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 First Amended Complaint has been dismissed for failure to state a 

claim, if Plaintiff fails to file a second 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. 

 (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 First Amended Complaint (Doc. 7) 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 on Count 3 in compliance with this Order. 

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 (4) If Plaintiff fails to file a second 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) Plaintiff’s Notice of Status (Doc. 5) is granted in part, to the extent this 

Order provides Plaintiff with the status of his case, and is denied in part as to any other 

relief Plaintiff may be requesting. 

 (6) Plaintiff’s Motion to Expedite Service (Doc. 6) is denied as premature. 

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

civil rights complaint by a prisoner. 

Dated this 16th day of October, 2013. 

Case 2:13-cv-01186-DGC--MEA Document 8 Filed 10/16/13 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 2:13-cv-01186-DGC--MEA Document 8 Filed 10/16/13 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.

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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 2:13-cv-01186-DGC--MEA Document 8 Filed 10/16/13 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 2:13-cv-01186-DGC--MEA Document 8 Filed 10/16/13 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 2:13-cv-01186-DGC--MEA Document 8 Filed 10/16/13 Page 18 of 22
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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. 

.

Case 2:13-cv-01186-DGC--MEA Document 8 Filed 10/16/13 Page 19 of 22
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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. 

.

Case 2:13-cv-01186-DGC--MEA Document 8 Filed 10/16/13 Page 20 of 22
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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.

Case 2:13-cv-01186-DGC--MEA Document 8 Filed 10/16/13 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 2:13-cv-01186-DGC--MEA Document 8 Filed 10/16/13 Page 22 of 22