FILED BY D.C.

MAï152022

IN THE UN ITED STATES DISTRICT COURT sCt.rf7n.okç'JFltmwl.-7MjLA#Mi

FOR THE DISTRICT OF

DIVISION

(WritetheDistrictandDivision,fany,ofthe

courtinwhichthecomplaintishled)

a S J

Com plaintforViolationofCivil

Rights

(PrisonerComplaint)

(Writethefulnameofeachplaintffwhoishling

thiscomplaint.Y'//lcnamesofaltheplaintp caseNo.

cannothtinthespaceabove,pleasewritef'ycc (tobehledinbytheClerk,sO//cc)

attached''inthespaceandattachanadditional

pagewiththefullistofnames) Jul'yTrial: (ZIYes (7lNo

(checkone)

-againstV k'1) C/G

(Writethefullnameofeachdefendantwhois

beingsued..J/'//?t?namesofalthedefendants

Cannotfît

inthespaceabojle,pleasewrite''ATtl ccêJ:J'.V Y -

atached''inthespaceandattachanadditional C.cJ9j; - - ?

pagewiththefullistofnames.Donotinclude Judee. --Mag.-

ifp Feepd$ B- Jddresseshere.) MDtrl

Rqceipt# --

NOTICE

FederalRulesofCivilProcedure5.2addressestheprivacyandsecurityconcernsresultingfrom public

accesstoelectroniccourtfiles.Underthisrule,papersfiledwiththecourtshouldnotcontain:an

individual'sfullsocialsecuritynumberorfullbirthdate;thefullnameofapersonknowntobeaminor;or

acompletefinancialaccountnumber.A filingmay includeonlylthelastfourdigitsofasocialsecurity

num ber;theyearofan individual'sbirth;aminor'sinitials',andthelastfourdigitsofafinancialaccount

num ber.

Exceptasnotedinthisform ,plaintiffneednotsendexhibits,aftidavits,grievanceorwitnessstatements,or

anyotherm aterialstotheClerk'sOfficewiththiscomplaint.

lnorderforyourcomplainttobefiled,itmustbeaccom paniedbythefilingfeeoranapplicationto

proceedinformapauperis.

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Case 1:20-cv-22031-JEM Document 1 Entered on FLSD Docket 05/15/2020 Page 1 of 14
1. ThePartiestoThisCom plaint

A. ThePlaintiffts)

Providetheinformationbelow foreachplaintiffnamedinthecomplaint.Attach

additionalpagesifneeded.

Name r c x .

A1lothernamesbywhichyouhavebeenknown:

IDNumber t%'a(s-q:. (q

currentInstitution hllamm wlo : uekw.byy c'zaye c

Address t3t60 Hun qj* 1..

N rq,t#,P'L 35I-1%

B. TheDefendantts)

Providetheinfonnationbelow foreachdefendantnam edinthecom plaint,whether

thedefendantisanindividual,agovernmentagency,an organization,ora

corporation.M akesurethatthedefendantts)listedbelow areidenticaltothose

containedintheabovecaption.Foranindividualdefendant,includctheperson'sjob

ortitle(ifknown)andcheckwhetheryouarebringingthiscomplaintagainstthem in

theirindividualcapacity orofficialcapacity,orboth.Attachadditionalpagesif

needed.

DefendantNo.1

Name ('qrtos G.t&oc

?atkcê. aGjcgc

o'zo -2. â% .1 oo

<

*

A O

JoborTitle

(ifknown)

ShieldNumber

Employer

Address

Individualcapacity Officialcapacity

DefendantNo.2

Name 's'a uoo

2

Case 1:20-cv-22031-JEM Document 1 Entered on FLSD Docket 05/15/2020 Page 2 of 14
JoborTitle

(ifknown)

ShieldNumber

Employer

Address

lndividualcapacity Officialcapacity

kqttczroA'la c

O A o

h. h

' C>A

DefendantNo.3

Name

JoborTitle

(ifknown)

ShieldNumber

Em ployer

Address

Individualcapacity

$/.ug1u ;a.1-c'a.0

?ot/cz olfozr

d),2.(3 l ,a:?,e1- w+ &'gq

. A. !

Officialcapacity

DefendantNo.4

Name

JoborTitle

(ifknown)

ShieldNumber

Employer

Address

EZI Individualcapacity Officialcapacity

II. BasisforJurisdiction

Under42U.S.C.j1983,youmaysuestateorlocalofficialsforthetûdeprivationofanyrights,

privilegcs,orimmunitiessecuredbytheConstitutionand(federallawsl.''UnderBivensv.Six

UnknownNamedAgentsofFederalBureauofNarcotics,403U.S.388(1971),youmaysue

federalofticialsfortheviolationofcertain constitutionalrights.

3

Case 1:20-cv-22031-JEM Document 1 Entered on FLSD Docket 05/15/2020 Page 3 of 14
Areyoubringingsuitagainst(checkalthatapply):

IZI Federalofticials(aBivensclaim)

Stateorlocalofficials(aj1983claim)

Section l983allowsclaimsallegingtheûkdeprivationofanyrights,privileges,or

immunitiessecuredbytheConstitutionandFederallawsl.''42U.S.C.j1983.lfyou

aresuingundersection1983,whatfederalconstitutionalorstatutoryrightts)doyou

claim is/arebeingviolatedby stateorlocalofficials?

MMzx/ljw/-af ui-tyâr:l-paakf: jk-pkrto4,p .cdllw.cz;t.é+kz ùvs-kf'r--..T?>

- om 4' ' 4 :Y pgit<n j

t- z, dykw.z zo k 4Gzh plc)'

-7eN.oR5(j)f.5z- gvxpu jqw sya.w s)o yyua6j ,po

PlaintiffssuingunderBiven m ayonlyrecoverfortheviolationofcertain

constitutionalrights.lfyouaresuingunderBivens,whatconstitutionalrightts)doyou

claim is/arebeingviolatedbyfederalofticials?

B.

Section 1983allowsdefendantstobefoundliableonlywhentheyhaveactedCtunder

colorofanystatute,ordinance,regulation,custom ,orusage,ofany StateorTerritory

ortheDistrictofColumbia.''42U.S.C.j1983.Ifyouaresuingundersedion19:3,

explainhow eachdefendantactedundercolorofstateorlocallaw.Ifyouaresuing

underBivens,explainhow eachdefendantactedundercoloroffederallaw .Attach

additionalpagesifneeded.

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( a . y um ..y. k r g

111. PrisonerStatus

Indicatewhetheryouareaprisonerorotherconfinedpersonasfollows(checkalthatapplyll

' Pretrialdetainee

EEI Civillycomm itteddetainee

lmm igrationdetainee

4

Case 1:20-cv-22031-JEM Document 1 Entered on FLSD Docket 05/15/2020 Page 4 of 14
Convictedandsentencedstateprisoner

Convictedandsentencedfederalprisoner

Other(explain)

E)

ED

lV. Statem entofClaim

Stateasbrietlyaspossiblethefactsofyourcase.Describehow each defendantwas

personally involvedintheallegedwrongfulaction,alongwiththedatesandlocationsofal1

relevantevents.Youm aywishtoincludefurtherdetailssuchasthenmnesofotherpersons

involvedintheeventsgivingrisetoyourclaim s.Donotciteanycasesorstatutes.lfmore

thanoneclaim isasserted,num bereachclaim andwriteashol'tandplainstatementofeach

claim inaseparateparagraph.Attachadditionalpagesifneeded.

Iftheeventsgivingrisetoyourclaim aroseoutsideaninstitution,describewhereand

whenthey arose.

a Q I q ov e,.t .6'* (

(B).t> G5

$ o t-q t '4s-i : u c . c 3/w fo

Iftheeventsgivingrisetoyourclaim aroseinaninstitution,describewhereandwhen

theyarose.

B.

C. Whatdateandapproximatetimedidtheeventsgivingrisetoyourclaimts)occur?

D. Whatarethefactsunderlyingyourclaimts)? (Forexample:BJ/lt,happenedtoyou?

Whodidwhat? Wasanyoneelseinvolved? Whoelseswwwhathappened/)

.44 /m k . y B t ' koOG

x.

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x j.. v '- $yjgjz

thgst - .4. w = -?(#4'j

Case 1:20-cv-22031-JEM Document 1 Entered on FLSD Docket 05/15/2020 Page 5 of 14
V.

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c o . - o ' w a .b.e # q

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lnjuries

Ifyousustainedinjuriesrelatedtotheeventsallegedabove,describeyourinjuriesandstate

whatmedicaltreatm ent,ifany,yourequiredanddidordidnotreceive.

'r bt ' - x c t, /+vg.

.

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Vl. Relief

Statebrietly whatyouwantthecourttodoforyou.M akenolegalargum ents.Donotciteany

casesorstatutes.Ifrequestingmoneydamages,includetheamountsofanyactualdamages

and/orpunitivedam agesclaimedfortheactsalleged.Explainthebasisfortheseclaims.

1:'x-$t'Jn 'oks 'we o - ( - t

, s.y. ,

VIl. Exhaustion ofAdm inistrativeRem ediesAdministrativeProcedures

ThePrisonLitigationReform Act(tkPLItA''),42U.S.C.j1997e(a),requiresthatCûgnloadion

shallbebroughtwithrespecttoprisonconditionsundersection 1983ofthistitle,oranyother

Federallaw,byaprisonerconfinedinanyjail,prison,orothercorrectionalfacilityuntilsuch

administrativerem ediesasareavailableareexhausted.''

Administrativerem ediesarealsoknown asgrievanceprocedures.Yourcasemaybe

dismissedifyouhavenotexhaustedyouradm inistrativeremedies.

Case 1:20-cv-22031-JEM Document 1 Entered on FLSD Docket 05/15/2020 Page 6 of 14
Didyourclaimts)arisewhileyouwerecontinedinajail,prison,orothercorrectional

facility?

Yes

No

lfyes,namethejail,prison,orothercorrectionalfacilitywhereyouwerecontinedat

thetimeoftheeventsgivingrisetoyourclaimts).

B. Doesthejail,prison,orothercorrectionalfacilitywhereyourclaimls)arosehavea

grievanceprocedure?

Y es

(Z1 No

ED Donotknow

Doesthegrievanceprocedlzreatthejail,prison,orothercorrectionalfacilitywhere

yourclaimts)arosecoversomeora1lofyourclaims?

E1 Donotknow

lfyes,whichclaimts)?

Didyoufileagrievanceinthejail,prison,orothercorrectionalfacilitywhereyour

claimts)aroseconcemingthefactsrelatingtothiscomplaint?

Yes

Case 1:20-cv-22031-JEM Document 1 Entered on FLSD Docket 05/15/2020 Page 7 of 14
Ifno,didyoutileagrievanceabouttheeventsdescribedinthiscomplaintatanyother

jail,prison,orothercorrectionalfacility?

E. Ifyoudidfileagrievance:

W heredidyoufilethegrievance?

u/A

#

W hatdidyouclaim inyourgrievance?

W hatwastheresult,ifany?

4. W hatsteps,ifany,didyoutaketoappealthatdecision? lsthegrievance

processcompleted? lfnot,explainwhynot.(Describealleffortstoappealto

thehighestlevelofthegrievanceprocess.)

M/A

8

Case 1:20-cv-22031-JEM Document 1 Entered on FLSD Docket 05/15/2020 Page 8 of 14
lfyoudidnottileagrievance:

lfthereareanyreascmswhyyoudidnotfileagrievance,statethem here:

a ccjjvn)

. ' 'j' a-*' #

lfyoudidnotfileagrievancebutyoudidinfonu officialsofyourclaim ,state

whoyouinfonned,whenandhow,andtheirresponse,ifany:

N1/A

G. Pleasesetforthanyadditionalinform ationthatisrelevanttotheexhaustionofyour

adm inistrativeremedies.

(Note.'Youmayatachasexhibitstothiscomplaintanydocumentsrelatedtothe

exhaustionofyouradministrativeremedies.)

Vl11. PreviousLawsuits

TheGûthreestrikesrule''barsaprisonerfrom bringingacivilactionoranappealinfederal

courtwithoutpayingthetilingfeeifthatprisonerhasStonthreeorm oreprioroccasions,while

incarceratedordetainedinanyfacility,broughtanactionorappealinacourtoftheUnited

Statesthatwasdismissedonthegroundsthatitisfrivolous,m alicious,orfailstostateaclaim

uponwhichreliefmaybegranted,unlesstheprisonerisunderimminentdangerofserious

physicalinjuzy.''28U.S.C.j1915(g).

Tothebestofyourknowledge,haveyouhadacasedismissedbasedonthistûthreestrikes

nlle''?

EEI Yes

No

9

Case 1:20-cv-22031-JEM Document 1 Entered on FLSD Docket 05/15/2020 Page 9 of 14
lfso,statewhichcourtdism issedyourcase,whenthisoccurred,andattachacopyofthe

orderifpossible.

Haveyoutiledotherlawsuitsinstateorfederalcourtdealingwiththesamefacts

involvedinthisaction?

Y es

1r No

B. lfyouranswertoA isyes,describeeach lawsuitby answeringquestions1through 7

below.(Ifthereismorethanonelawsuit,describetheadditionallawsuitsonanother

page,usingthesameformat)

Partiestothepreviouslawsuit

Plaintiffts)

Defendantts)

Court(ffederalcourt,namethedistrict;fstatecourt,namethectaz/n/yand

State)

3. Docketorindexnumber

Nam eofJudgeassignedtoyourcase

Approxim atedateoftilinglawsuit

6. lsthecasestillpending?

EEI Yes

EE1 No

lfno,givetheapproximatedateofdisposition.

10

Case 1:20-cv-22031-JEM Document 1 Entered on FLSD Docket 05/15/2020 Page 10 of 14
W hatwastheresultofthecase? (Forexample:Wasthecasedismissed? Was

judgmententeredinyourfavor? Wasthecaseappealed/)

Haveyoutiledotherlawsuitsinstateorfederalcourtotherwiserelatingtothe

conditionsofyourimprisonment?

IZI Yes

N o

D. lfyouranswertoC isyes,describeeachlawsuitbyansweringquestions1through7

below.(IfthereismorethanoneIawsuit,describetheadditionallawsuitsonanother

page,usingthesameformat)

Partiestothepreviouslawsuit

Plaintiffts)

Defendants)

Court(Iffederalcourt,namethedistrict;Ifstatecourt,namethecoz/z?f.pand

State)

2.

Docketorindexnumber

Nam eofJudgeassignedtoyourcase

Approximatedateoffilinglawsuit

6. lsthecasestillpending?

EEI Yes

11

Case 1:20-cv-22031-JEM Document 1 Entered on FLSD Docket 05/15/2020 Page 11 of 14
lfno,givetheapproxim atedateofdisposition.

W hatwastheresultofthecase? (Forexample: Wasthecasedismissed? Was

judgmententeredinyourfavor? Wasthecaseappealed?)

lX. Certification and Closing

UnderFederalRuleofCivilProcedure 1l,bysigningbelow,1certifytothebestofmy

knowledge,infonnation,andbeliefthatthiscomplaint:(1)isnotbeingpresentedforan

improperpup ose,suchastoharass,causeunnecessarydelay,orneedlessly increasethecost

oflitigation',(2)issupportedbyexistinglaw orbyanonfrivolousargumentforextending,

modifying,orreversingexistinglaw;(3)thefactualcontentionshaveevidentiarysupportor,

ifspecificallysoidentified,willlikelyhaveevidentiarysupportafterareasonableopportunity

forfurtherinvestigationordiscovery;and(4)thecomplaintotherwisecomplieswiththe

requirem entsofRule11.

A. ForPartiesW ithoutanAttorney

IagreetoprovidetheClerk'sOfficewithanychangestomyaddresswherecaserelatedpapersm aybeselved.1understandthatmyfailuretokeep acurrentaddress

onfilewiththeClerk'sOfficem ayresultinthedismissalofmycase.

Dateofsigning: ' /' ,20-zo

.- , > .-

SignatureofPlaintiff . ,

PrintedNameofPlaintif A/'fzl-rty?eI ..'.'-.v.sf./?-5-/.

Prisonldentification# t8ö$..$kpl9-iV - -

PrisonAddress + osà t3 # 5 M v.ul V(%* sl

#

T7öCAL P& '3#?T'ï

City State Zip Code

ForAttorneys

Dateofsigning: ,20 .

SignatureofAttorney

PrintedNam eofAttorney

BarNumber

N ameofLaw Firm

B.

12

Case 1:20-cv-22031-JEM Document 1 Entered on FLSD Docket 05/15/2020 Page 12 of 14
Address

TelephoneNumber

E-mailAddress

13

Case 1:20-cv-22031-JEM Document 1 Entered on FLSD Docket 05/15/2020 Page 13 of 14
Case 1:20-cv-22031-JEM Document 1 Entered on FLSD Docket 05/15/2020 Page 14 of 14