IN T14E Im I-rED STATESDISTRICT COUR

FORTHE DISTRICTOF FILEDBY PC D.C.

DIVISION

(write//,coistrictandoivision, y'twy,ofthe MAt 212220

courtinwhich,/,ecomplaintjx./3/d(@? ctrRyuq),ljtv,

s.o.o!nrtx..Ml2&k

<

ttansc.-sop--pl..2-

Com plaintforViolation ofCivil

Rights - -

(Writethefulnameof (prisonercomplaint)

eachplaintffwhoishling

//?j.s'complaint. lfthenamesofaltheplaintlfv c

cann aseNo.

ot/3finthespaceabove,pleasewrï/:''see

,

.

attached''intheArpfzccandatachanadditional (tobehledinbytheClerk.%Ofhce)

pagewiththejl Iistofnames.)

JuryTrial: EEJYes EZINo

-against- (checkone)

' cat/div x2.)-S& zy,cp.y .g .

:l... ,1 - ( Case#

Jaus'c Mag %1r4V P- torkJ.. - R ,.f-t/.: -

votn Ifp /65 r-eepd$ o

Receipt#' .

(Writethejillnamet?feachdejkndantwhois

beingsued. /./'//7enamest#'cf#thelv?nllnB'

cannothtinthespaceabove,pleasewrite''see

attached''inthespaceandattachanadditional

pagewiththefullistofnames.Donotinclude

addresseshere)

NOTICE

FederalRulesofCivilProcedure5.2addressestheprivacy andsecurity concernsresultingfrom

aceessto electroniccou public

rtfiles.Underthisrule i , papersfiledwith thecourtshouldnotcontain:an

ndividual'sfullsocialsecuritynumberorfullbirthd

ate;thetkllnam eofapersonknownto beam inor;or

acom pletefinancialaccountnum ber. A filingmay includeonlyLthelastfourdigitsofasocial

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

, andthelastfourdigitsofafinancialaccount

number.

Exceptasnoted inthisform ,plaintiffneednotsendexhibits,affidavits,grievanceorwitnessstatem ents

anyotherm aterialstotheClerk'sOfficewiththiscompl , or aint.

lnorderforyourcom plainttobefiled, itm ustbeaccompaniedbythefilingfeeoranapplic

proceedinformapauperis. ationto

Case 1:20-cv-22121-UU Document 1 Entered on FLSD Docket 05/21/2020 Page 1 of 14
ThePartiestoThisCom plaint

A. ThePlaintiffts)

Providetheinformationbelow foreachplaintiffnam edinthecom plaint. Attach

additionalpagesifneeded.

Name 'So s'ts6o uk4-z.

Al1othernamesbywhichyouhavebeenknown:

ID Number l8P(q z.3qo

CurrentInstitution > + w .i...+ w c'e c

Address t3u p uw uttri-A .

v/cxt P& a4tH

B. TheDefendantts)

Providetheinformationbelow foreachdefendantnam edinthecomplaint, whether

thedefendantisanindividual,agovernmentagency,anorganization,ora

corporation.Makesurethatthedefendantls)listedbelow areidenticaltothose

containedintheabovecaption.Foran individualdefendant, includetheperson'sjob

ortitle(ifknown)andcheckwhetheryouarebringingthiscomplaintagainstthem in

theirindividualcapacityorofticialcapacity, orboth.Attach additionalpagesif

needed.

DefkndantNo.1

Nam e

JoborTitle

(ifknown)

ShieldNum ber

Employer

Address

lndividualcapacity

DefendantN0.2

N ame . .> '

Case 1:20-cv-22121-UU Document 1 Entered on FLSD Docket 05/21/2020 Page 2 of 14
JoborTitle

(ifknown)

ShieldNum ber

Employer

Address

lndividualcapacity Officialcapacity

DefendantNo.3

Nam e

JoborTitle

(if1.140- 1)

ShieldNum ber

Employer

Address

(Z1 lndividualcapacity EI Officialcapacity

DefendantNo.4

Nam e

JoborTitle

(ifknown)

ShieldNum ber

Employer

Address

lndividualcapacity EEI Ofticialcapacity

II. BasisforJurisdidion

Under42U.S.C.j1983,youmaysuestateorlocalofficialsfortheû'deprivationofanyrights,

privileges,orimmunitiessecuredbytheConstitutionandgfederallawsj.''UnderBivensv. Six

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

federalofficialsfortheviolationofcertain constitutionalrights.

Case 1:20-cv-22121-UU Document 1 Entered on FLSD Docket 05/21/2020 Page 3 of 14
Areyoubringingsuitagainst(checkaIthatapply):

E) Federalofticials(aBivensclaim)

Stateorlocalofficials(aj1983claim)

Section 1983allowsclaim sallegingtheSldeprivationofanyrights, privileges,or

immunitiessectlredbytheConstitutionand(federallawsl.''42U.S.C.j1983.lfyou

aresuingundersection1983,whatfederalconstitutionalorstatutoryrightts)doyou

claim is/arebeingviolatedbystateorlocalofficials?

i %'-c.? u. ,' '&-u 1 i- tt-s<l

j ' .j

B.

Plaintiffssuing underBivensmayonly recoverfortheviolationofcertain

constitutionalrights.lfyouaresuingunderBivens, whatconstitutionalrightts)doyou

claim is/arebeing violatedbylkderalofficials?

D . Section l983allowsdefendantstobefoundliableonlywhentheyhaveactedt'under

colorofanystatute,ordinance,regulation, custom ,orusage,ofanyStateorTerritory

ortheDistrictofColumbia.''42U.S.C.j1983.Ifyouaresuingundersection1983,

explainhow eachdefendantactedundercolorofstateorlocallaw. lfyouaresuing

tmderBivens,explainhow eachdefendantactedundercoloroffederallaw

. Attach

additionalpagesifneeded.

t '

( @ .- t .. xk (y (o k-

.-

oak.d-t - wfts t

111. PrisonerStatus

lndicatewhetheryouareaprisonerorotherconfinedpersonasfoll

ows(checkaIlthatapplyll

'

Pretrialdetainee

(D Civilly com mitteddetainee

lmm igrationdetainee

Case 1:20-cv-22121-UU Document 1 Entered on FLSD Docket 05/21/2020 Page 4 of 14
Convictedand sentenced'stateprisoner

Convictedandsentencedfederalprisoner

Other(explain)

lV. Statem entofClaim

Stateasbrietly aspossiblethefactsofyourcase.Describehow eachdefendantwas

personallyinvolvedintheallegedwrongfulaction,alongwiththedatesandlocationsofall

relevantevents.Youm aywishtoincludef'urtherdetailssuchasthenam esofotherpersons

involvedintheeventsgivingrisetoyourclaims.Donotciteanycasesorstatutes. lfm orv

thanoneclaim isasserted,numbereachclaim andwriteashortandplainstatem entofeach

claim inaseparateparagraph.Attachadditionalpagesifneeded.

lftheeventsgivingrisetoyourclaim aroseoutsideaninstitution,describewhereand

whentheyarose.

té rwc 4-.sovtk-.f5 ulva 11+2,lv u (q

lftheeventsgivingrisetoyourclaim aroseinan institution, describewhereandwhen

theyarose.

* . 3 p. l 1 q '--p w, %( kœh. &

e . t.

Whatdateandapproximatetimedidtheeventsgivingrisetoyourclaimts)occtlr?

. tq &,5wi'V.-'tq st1 ' '

Whatarethefactsunderlyingyourclaimts)?(Forexample:I'F/if/fhappenedtoyou?

Whodidwhat? I''W.çanyoneelseinvolved? Whoelseéww whathappened/)

,-

t gjuyy , s <x

15 ' t.11#- t

5

Case 1:20-cv-22121-UU Document 1 Entered on FLSD Docket 05/21/2020 Page 5 of 14
V lnjuries

lfyousustainedinjuriesrelatedtotheeventsalegedabove,describeyourinjuriesandstate

whatmedicaltreatment,ifany,yourequiredanddidordidnetreceive.

3zvea.z- çoma t 'a .- - tl?z.J

'

h. k ; '. ty

VI. Relief

Statebrietlywhatyouwantthecourttodoforyou.M akenolegalarguments.Donotciteany

casesorstatutes.Ifrequestingmoney damages,includetheamountsofany actualdam ages

and/orpunitivedamagesclaimedfortheactsalleged.Explainthebasisfortheseclaims.

($& ,t ' r'FTV-Y'X

Vll. Exhaustion ofAdministrativeRem ediesAdm inistrativeProcedures

ThePrisonLitigationReform Act($iPLRA''),42U.S.C.j1997e(a),requiresthat(ignjoadion

shallbebroughtwithrespecttoprisonconditionsundersection 1983ofthistitle,oranyother

Federallaw,byaprisonerconfinedinanyjail,prison,orothercorrectionalfacilityuntilsuch

administrativerem ediesasareavailableareexhausted.''

Adm inistrativeremediesarealsoltnown asgrievanceprocedures.Yourcasem aybe

dismissedifyouhavenotexhaustedyouradministrativerem edies.

6

Case 1:20-cv-22121-UU Document 1 Entered on FLSD Docket 05/21/2020 Page 6 of 14
A. Didyourclaimts)arisewhileyouwereconfinedinajail, prison,orothercorrectional

facility?

Yes

No

Ifyes,namethejail,prison,orothercorrectionalfacilitywhereyouwereconfinedat

thetimeoftheeventsgivingrisetoyourclaimts).

% lep u kftm h Qzm f. -

B. Doesthejail,prison,orothercorrectionalfacilitywhereyourclaimts)arosehavea

grievanceprocedure?

Yes

IZI N o

Donotknow

Doesthegrievanceprocedureatthejail,prison, orothercorrectionalfacilitywhere

yourclaimts)arosecoversomeoralofyourclaims?

E1 Yes

No

Do notknow

Ifyes,whichclaimts)?

Didyoufileagrievanceinthejail,prison,orothercorrectionalfacilitywhereyour

claimls)aroscconcerningthefactsrelatingtothiscomplaint?

ID Yes

N o

Case 1:20-cv-22121-UU Document 1 Entered on FLSD Docket 05/21/2020 Page 7 of 14
lfno,didyou fileagrievanceabouttheeventsdescribedinthiscom plaintatanyother

jail,prison,orothercorrectionalfacility?

(Z1 Yes

N o

E. lfyou didfileagrievance:

W heredidyoufilethegrievance?

W hatdidyou claim inyourgrievance?

W 'hatwastheresult,ifany?

W hatsteps,ifany,didyoutaketoappealthatdecision? Isthegrievance

processcompleted?Ifnot,explainwhynot.(DescribealIeffortstoappealto

thehighestlevelofthegrievanceprocess)

8

Case 1:20-cv-22121-UU Document 1 Entered on FLSD Docket 05/21/2020 Page 8 of 14
F. lfyoudidnotfileagrievance:

Ifthereareanyreasonswhyyoudidnotfileagrievance, statethem here:

n u ,c. (( . ,y s a ,Nyo

lfyoudidnottileagrievancebutyoudidinform officialsofyourclaim

, state

whoyouinformed,when andhow, andtheirresponse,ifany:

Z w. c ' .' N1

Pleasesetforthany additionalinform ationthatisrelevanttotheexha

ustionofyour

adm inistrativeremedies.

(Note.'Youmayatachasexhibitstothiscomplaintanydocumentsrelated tothe

exhaustionofyouradministrativeremedies.)

Vl1l. PreviousLawsuits

Thekçthreestrikesrule''barsaprisonerfrom bringingacivil

actionoranappealinfederal

courtwithoutpayingthefilingfeeifthatprisonerhasStonthreeor

i m oreprioroccasions, while

ncarceratedordetainedin anyfacility, broughtan action orappealinacourtoftheUnited

Statesthatwasdismissedonthegroundsthatitisfrivolous

, m alicious,orfailstostateaclaim

uponwhichreliefm aybtgranted, tmlesstheprisonerisunderimm inentdangerofserio

physicalinjuryv''28U .S.C. us j1915(g).

Tothebestofyourknowledge, havcyouhadacasedismissedbasedonthisidth

rul reestrikes e''?

lZl Yes

N o

Case 1:20-cv-22121-UU Document 1 Entered on FLSD Docket 05/21/2020 Page 9 of 14
Ifso,statewhich courtdism issedyourcase,whenthisoccurred,andattachacopyofthe

orderifpossible.

A Haveyoufiledotherlawsuitsinstateorfederalcourtdealingwiththesamefacts

involved inthisaction?

(71 Yes

No

B. lfyouranswertoA isyes,describeeachlawsuitbyansweringquestions1through 7

below.(Ifthereismorethanonelawsuit,describetheadditionallawsuitsonanother

page,usingthesameformat.)

Partiestothepreviouslawsuit

Plaintiffts)

Defendants)

Court(ffederalcourt,namethedistrict;fstatecourt,namethectplfa/yand

State)

Docketorindexnum ber

4. Nam eofJudgeassignedtoyourcase

Approxim atedateoffiling lawsuit

6. lsthecasestillpending?

EEI Yes

EZl No

Ifno,givetheapproxim atedateofdisposition.

10

Case 1:20-cv-22121-UU Document 1 Entered on FLSD Docket 05/21/2020 Page 10 of 14
W hatwastheresultofthecase? (Forexample:Wasthecasedismissed? I'I'JJ

judgmententeredinyourfavor? IF'J,Cthecaseappealed/)

Haveyoufiledotherlawsuitsinstateorfederalcourtotherwiserclatingtothe

conditionsofyourim prisonm ent?

E:1 Yes

No

D. Ifyouranswerto C isyes,describeeach lawsuitbyansweringquestions1through7

below.(Ifthere/,çmorethanonelawsuit,describetheadditionallawsuitsonanother

page,usingthesameformat)

Partiestothepreviouslawsuit

Plaintiffts)

Defendants)

Court(ffederalcourt,namethedistrict;fstatecourt,namethec/l/nl.yand

State)

3. Docketorindex number

4. N ameofJudgeassignedtoyourcase

5. Approxim atedateoffilinglawsuit

6. Isthecasestillpending?

IZI Yes

N o

11

Case 1:20-cv-22121-UU Document 1 Entered on FLSD Docket 05/21/2020 Page 11 of 14
lfno,givetheapproxim atedateofdisposition.

W hatwastheresultofthecase? (Forexample:Wasthecasedismissed? I'F'JA'

judgmententeredinyourjàvor? Wasthecaseappealed/)

lX. Certificationand Closing

UnderFederalRuleofCivilProcedure 11,by signingbelow,lcertifytothebestofmy

knowledge,information,andbeliefthatthiscomplaint:(1)isnotbeingpresentedforan

improperpurpose,such astoharass,causeurmecessal'ydelay,orneedlesslyincreasethecost

oflitigation;(2)issupportedbyexisting1aw orbyanonfrivolousargumentforextending,

modifying,orreversingexistinglaw;(3)thefactualcontentionshaveevidentiarysupportor,

ifspecificallysoidentified,willlikelyhaveevidentim'ysupportafterareasonableopportunity

forfurtherinvestigationordiscovery;and(4)thecomplaintothem isecomplieswiththe

requirem entsofRule11.

ForPartiesW ithoutan Attorney

IagreetoprovidetheClerk'sOfticewithanychangestomyaddresswherecaserelatedpapersm aybeserved.lunderstandthatm yfailuretokeepacurrentaddress

onfilewiththeClerk'sOfficemayresultinthedism issalofmycase,

B.

oateof-signing:n/ /$- ,20p..

SignatureofPlaintiff '- t

.

- '

PrintedNameofPlaintiff Y' kl4.'.'.r '

Prisonldentitication# t%ô io.1.â kj'b

PrisonAddress k) 5 ' ' (&h

X r'lL G uoràtzlq 93 t''Fç'

City State ZipCode

ForAttorneys

Dateofsigning', ,20 .

SignatureofAttorney

PrintedN ameofAttorney

BarNum ber

NameofLaw Firm

12

Case 1:20-cv-22121-UU Document 1 Entered on FLSD Docket 05/21/2020 Page 12 of 14
Address

TelephoneNum ber

E-mailAddress

13

Case 1:20-cv-22121-UU Document 1 Entered on FLSD Docket 05/21/2020 Page 13 of 14
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Case 1:20-cv-22121-UU Document 1 Entered on FLSD Docket 05/21/2020 Page 14 of 14