JS 44 (Rev. 06/17) CIVIL COVER SHEET 

The JS 44 civil cover sheet and the information contained herein neither replace nor supplement the filing and service of pleadings or other papers as required by law, except as 

provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is required for the use of the Clerk of Court for the 

purpose of initiating the civil docket sheet. (SEE INSTRUCTIONS ON NEXT PAGE OF THIS FORM.) 

I. (a) PLAINTIFFS 

Sheila M. Kampa 

(b) County of Residence of First Listed Plaintiff Kerr County 

(EXCEPT IN U.S. PLAINTIFF CASES) 

(c) Attorneys (Finn Name, Address, and Telephone Number) 

Dennis L. Richard, Law Offc. of Dennis L. Richard, 

14255 Blanco Road, San Antonio, Texas 78216 

(210) 308-6600 / Email: dennislrichardlaw@gmail.com 

DEFENDANTS 

Esperanza Health Systems, Ltd. d/b/a La Hacienda Treatment Center 

County of Residence of First Listed Defendant Kerr County 

(IN U.S. PLAINTIFF CASES ONLY) 

NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF 

THE TRACT OF LAND INVOLVED. 

Attorneys (If Known) 

Ramon D. Bissmeyer, Dykema Gossett PLLC, 

112 East Pecan, Suite 1800, San Antonio, Texas 78205 

(210) 554-5500 / Email: rbissmeyer@dykema.com 

II. BASIS OF JURISDICTION (Place an "X" in One Box Only) 

0 1 U.S. Government g 3 Federal Question 

Plaintiff (U.S. Government Not a Party) 

0 2 U.S. Government 0 4 Diversity 

Defendant (Indicate Citizenship of Parties in Item III) 

III. CITIZENSHIP OF PRINCIPAL PARTIES (Place an "X" in One Box for Plaintiff 

(For Diversity Cases Only) and One Box for Defendant) 

PTF DEF PTF DEF 

Citizen of This State 0 1 0 1 Incorporated or Principal Place 0 4 0 4 

of Business In This State 

Citizen of Another State 0 2 0 2 Incorporated and Principal Place 0 5 0 5 

of Business In Another State 

Citizen or Subject of a 

Foreign Country 

0 3 0 3 Foreign Nation 0 6 0 6 

IV. NATURE OF SUIT (Place an 'X" in One Box Only) 

CONTRACT TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES 

0 110 Insurance 

0 120 Marine 

0 130 Miller Act 

0 140 Negotiable Instrument 

0 150 Recovery of Overpayment 

& Enforcement of Judgment 

0 151 Medicare Act 

0 152 Recovery of Defaulted 

Student Loans 

(Excludes Veterans) 

0 153 Recovery of Overpayment 

of Veteran's Benefits 

0 160 Stockholders' Suits 

0 190 Other Contract 

0 195 Contract Product Liability 

0 196 Franchise 

PERSONAL INJURY 

0 310 Airplane 

0 315 Airplane Product 

Liability 

0 320 Assault, Libel & 

Slander 

0 330 Federal Employers' 

Liability 

0 340 Marine 

0 345 Marine Product 

Liability 

0 350 Motor Vehicle 

0 355 Motor Vehicle 

Product Liability 

0 360 Other Personal 

Injury 

0 362 Personal Injury - 

Medical Malpractice 

PERSONAL INJURY 

0 365 Personal Injury - 

Product Liability 

0 367 Health Care/ 

Pharmaceutical 

Personal Injury 

Product Liability 

0 368 Asbestos Personal 

Injury Product 

Liability 

PERSONAL PROPERTY 

0 370 Other Fraud 

0 371 Truth in Lending 

0 380 Other Personal 

Property Damage 

0 385 Property Damage 

Product Liability 

0 625 Drug Related Seizure 

of Property 21 USC 881 

0 690 Other 

0 422 Appeal 28 USC 158 

0 423 Withdrawal 

28 USC 157 

0 375 False Claims Act 

0 376 Qui Tam (31 USC 

3729(a)) 

0 400 State Reapportionment 

0 410 Antitrust 

0 430 Banks and Banking 

0 450 Commerce 

0 460 Deportation 

0 470 Racketeer Influenced and 

Corrupt Organizations 

0 480 Consumer Credit 

0 490 Cable/Sat TV 

0 850 Securities/Commodities/ 

Exchange 

0 890 Other Statutory Actions 

0 891 Agricultural Acts 

0 893 Environmental Matters 

0 895 Freedom of Information 

Act 

0 896 Arbitration 

0 899 Administrative Procedure 

Act/Review or Appeal of 

Agency Decision 

0 950 Constitutionality of 

State Statutes 

PROPERTY RIGHTS 

0 820 Copyrights 

0 830 Patent 

0 835 Patent - Abbreviated 

New Drug Application 

0 840 Trademark 

LABOR SOCIAL S CURTIN 

0 710 Fair Labor Standards 

Act 

0 720 Labor/Management 

Relations 

0 740 Railway Labor Act 

X 751 Family and Medical 

Leave Act 

0 790 Other Labor Litigation 

0 791 Employee Retirement 

Income Security Act 

0 861 HIA (1395ff) 

0 862 Black Lung (923) 

0 863 DIWC/DIWW (405(g)) 

0 864 SSID Title XVI 

0 865 RSI (405(g)) 

1 REAL PROPERTY CIVIL RIGHTS PRISONER PETITIONS FEDERAL TAX SUITS 

0 210 Land Condemnation 

0 220 Foreclosure 

0 230 Rent Lease & Ejectment 

0 240 Torts to Land 

0 245 Tort Product Liability 

0 290 All Other Real Property 

0 440 Other Civil Rights 

0 441 Voting 

0 442 Employment 

0 443 Housing/ 

Accommodations 

0 445 Amer. w/Disabilities - 

Employment 

0 446 Amer. w/Disabilities - 

Other 

0 448 Education 

Habeas Corpus: 

0 463 Alien Detainee 

0 510 Motions to Vacate 

Sentence 

0 530 General 

0 535 Death Penalty 

Other: 

0 540 Mandamus & Other 

0 550 Civil Rights 

0 555 Prison Condition 

0 560 Civil Detainee -

Conditions of 

Confinement 

0 870 Taxes (U.S. Plaintiff 

or Defendant) 

0 871 IRS—Third Party 

26 USC 7609 

IMMIGRATION 

0 462 Naturalization Application 

0 465 Other Immigration 

Actions 

V. ORIGIN (Place an "X" in One Box Only) 

Click here for: Nature of Suit Code Descriptions. 

1 Original 0 2 Removed from 

Proceeding State Court 

VI. CAUSE OF ACTION 

0 3 Remanded from 

Appellate Court 

0 4 Reinstated or 0 5 Transferred from 0 6 Multidistrict 0 8 Multidistrict 

Another District Litigation - Litigation - 

(sPeci.6) Transfer Direct File 

Cite the U.S. Civil Statute under which you are filing (Do not cite jurisdictional statutes unless diversity): 

Family and Medical Leave Act, 29 U.S.C. § 2601, et seq. 

Brief description of cause: 

Claims under the Family and Medical Leave Act 

VII. REQUESTED IN 

COMPLAINT: 

VIII. RELATED CASE(S) 

IF ANY 

Reopened 

CHECK IF THIS IS A CLASS ACTION DEMAND $ 

UNDER RULE 23, F.R.Cv.P. 

(See instructions): 

JUDGE 

CHECK YES only if demanded in complaint: 

999,999.00 JURY DEMAND: X Yes 0 No 

--DOCKET NUMBER 

DATE SIGNATURE OF ATIORNEY vi - RECORD 

FOR OFFICE USE ONLY 

RECEIPT it AMOUNT APPLYING IFP JUDGE MAG. JUDGE 

Case 5:20-cv-00132 Document 1-1 Filed 02/05/20 Page 1 of 2
JS 44 Reverse (Rev. 06/17) 

INSTRUCTIONS FOR ATTORNEYS COMPLETING CIVIL COVER SHEET FORM JS 44 

Authority For Civil Cover Sheet 

The JS 44 civil cover sheet and the information contained herein neither replaces nor supplements the filings and service of pleading or other papers as 

required by law, except as provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is 

required for the use of the Clerk of Court for the purpose of initiating the civil docket sheet. Consequently, a civil cover sheet is submitted to the Clerk of 

Court for each civil complaint filed. The attorney filing a case should complete the form as follows: 

I.(a) Plaintiffs-Defendants. Enter names (last, first, middle initial) of plaintiff and defendant. If the plaintiff or defendant is a government agency, use 

only the full name or standard abbreviations. If the plaintiff or defendant is an official within a government agency, identify first the agency and 

then the official, giving both name and title. 

(b) County of Residence. For each civil case filed, except U.S. plaintiff cases, enter the name of the county where the first listed plaintiff resides at the 

time of filing. In U.S. plaintiff cases, enter the name of the county in which the first listed defendant resides at the time of filing. (NOTE: In land 

condemnation cases, the county of residence of the "defendant" is the location of the tract of land involved.) 

(c) Attorneys. Enter the firm name, address, telephone number, and attorney of record. If there are several attorneys, list them on an attachment, noting 

in this section "(see attachment)". 

II. Jurisdiction. The basis of jurisdiction is set forth under Rule 8(a), F.R.Cv.P., which requires that jurisdictions be shown in pleadings. Place an "X" 

in one of the boxes. If there is more than one basis of jurisdiction, precedence is given in the order shown below. 

United States plaintiff. (1) Jurisdiction based on 28 U.S.C. 1345 and 1348. Suits by agencies and officers of the United States are included here. 

United States defendant. (2) When the plaintiff is suing the United States, its officers or agencies, place an "X" in this box. 

Federal question. (3) This refers to suits under 28 U.S.C. 1331, where jurisdiction arises under the Constitution of the United States, an amendment 

to the Constitution, an act of Congress or a treaty of the United States. In cases where the U.S. is a party, the U.S. plaintiff or defendant code takes 

precedence, and box 1 or 2 should be marked. 

Diversity of citizenship. (4) This refers to suits under 28 U.S.C. 1332, where parties are citizens of different states. When Box 4 is checked, the 

citizenship of the different parties must be checked. (See Section III below; NOTE: federal question actions take precedence over diversity 

cases.) 

III. Residence (citizenship) of Principal Parties. This section of the JS 44 is to be completed if diversity of citizenship was indicated above. Mark this 

section for each principal party. 

IV. Nature of Suit. Place an "X" in the appropriate box. If there are multiple nature of suit codes associated with the case, pick the nature of suit code 

that is most applicable. Click here for: Nature of Suit Code Descriptions. 

V. Origin. Place an "X" in one of the seven boxes. 

Original Proceedings. (1) Cases which originate in the United States district courts. 

Removed from State Court. (2) Proceedings initiated in state courts may be removed to the district courts under Title 28 U.S.C., Section 1441. 

When the petition for removal is granted, check this box. 

Remanded from Appellate Court. (3) Check this box for cases remanded to the district court for further action. Use the date of remand as the filing 

date. 

Reinstated or Reopened. (4) Check this box for cases reinstated or reopened in the district court. Use the reopening date as the filing date. 

Transferred from Another District. (5) For cases transferred under Title 28 U.S.C. Section 1404(a). Do not use this for within district transfers or 

multidistrict litigation transfers. 

Multidistrict Litigation — Transfer. (6) Check this box when a multidistrict case is transferred into the district under authority of Title 28 U.S.C. 

Section 1407. 

Multidistrict Litigation — Direct File. (8) Check this box when a multidistrict case is filed in the same district as the Master MDL docket. 

PLEASE NOTE THAT THERE IS NOT AN ORIGIN CODE 7. Origin Code 7 was used for historical records and is no longer relevant due to 

changes in statue. 

VI. Cause of Action. Report the civil statute directly related to the cause of action and give a brief description of the cause. Do not cite jurisdictional 

statutes unless diversity. Example: U.S. Civil Statute: 47 USC 553 Brief Description: Unauthorized reception of cable service 

VII. Requested in Complaint. Class Action. Place an "X" in this box if you are filing a class action under Rule 23, F.R.Cv.P. 

Demand. In this space enter the actual dollar amount being demanded or indicate other demand, such as a preliminary injunction. 

Jury Demand. Check the appropriate box to indicate whether or not a jury is being demanded. 

VIII. Related Cases. This section of the JS 44 is used to reference related pending cases, if any. If there are related pending cases, insert the docket 

numbers and the corresponding judge names for such cases. 

Date and Attorney Signature. Date and sign the civil cover sheet. 

Case 5:20-cv-00132 Document 1-1 Filed 02/05/20 Page 2 of 2