I. (a) PLAINTIFFS 

(b) County of Residence of First Listed Plaintiff 

(EXCEPT IN U.S. PLAINTIFF CASES) 

(C) Attorneys (Firm Name, Address, and Telephone Number) 

DEFENDANTS 

County of Residence of First Listed Defendant 

(IN U.S. PLAINTIFF CASES ONLI9 

NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF 

THE TRACT OF LAND INVOLVED. 

Attorneys (If Known) 

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

0 1 U.S. Government 0 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 HI) 

HI. 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 0 3 0 3 Foreign Nation 

Foreign Country 

0 6 0 6 

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.) 

IV. NATURE OF SUIT (Place an "X" in One Box Only) Click here for: Nature of Suit Code Descriptions. 

CONTRACT . TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES 

II 110 Insurance 

II 120 Marine 

II 130 Miller Act 

II 140 Negotiable Instrument 

11 150 Recovery of Overpayment 

& Enforcement of Judgment 

II 151 Medicare Act 

II 152 Recovery of Defaulted 

Student Loans 

(Excludes Veterans) 

II 153 Recovery of Overpayment 

of Veteran's Benefits 

II 160 Stockholders' Suits 

II 190 Other Contract 

11 195 Contract Product Liability 

II 196 Franchise 

PERSONAL INJURY PERSONAL INJURY 

II 310 Airplane 11 365 Personal Injury - 

II 315 Airplane Product Product Liability 

Liability CI 367 Health Care/ 

11 320 Assault, Libel & Pharmaceutical 

Slander Personal Injury 

CI 330 Federal Employers' Product Liability 

Liability 11 368 Asbestos Personal 

II 340 Marine Injury Product 

II 345 Marine Product Liability 

Liability PERSONAL PROPERTY 

11 350 Motor Vehicle CI 370 Other Fraud 

11 355 Motor Vehicle II 371 Truth in Lending 

Product Liability 11 380 Other Personal 

11 360 Other Personal Property Damage 

Injury 11 385 Property Damage 

II 362 Personal Injury - Product Liability 

Medical Malpractice 

II 625 Drug Related Seizure 

of Property 21 USC 881 

11 690 Other 

LABOR 

II 422 Appeal 28 USC 158 

CI 423 Withdrawal 

28 USC 157 

II 375 False Claims Act 

II 376 Qui Tam (31 USC 

3729(a)) 

11 400 State Reapportionment 

II 410 Antitrust 

II 430 Banks and Banking 

II 450 Commerce 

11 460 Deportation 

CI 470 Racketeer Influenced and 

Corrupt Organizations 

II 480 Consumer Credit 

II 490 Cable/Sat TV 

CI 850 Securities/Commodities/ 

Exchange 

11 890 Other Statutory Actions 

II 891 Agricultural Acts 

11 893 Environmental Matters 

CI 895 Freedom of Information 

Act 

11 896 Arbitration 

CI 899 Administrative Procedure 

Act/Review or Appeal of 

Agency Decision 

11 950 Constitutionality of 

State Statutes 

1.140PERTY RIGHTS 

II 820 Copyrights 

II 830 Patent 

11 835 Patent - Abbreviated 

New Drug Application 

II 840 Trademark 

II 710 Fair Labor Standards 

Act 

II 720 Labor/Management 

Relations 

11 740 Railway Labor Act 

II 751 Family and Medical 

Leave Act 

11 790 Other Labor Litigation 

II 791 Employee Retirement 

Income Security Act 

II 861 FHA (1395f0 

II 862 Black Lung (923) 

CI 863 DIWC/DIWW (405(g)) 

II 864 SSID Title XVI 

CI 865 RSI (405(g)) 

REAL PROPERTY ICIVIL RIGHTS PRISONER PETITIONS FEDERAL TAX SUITS 1 

II 210 Land Condemnation 

II 220 Foreclosure 

11 230 Rent Lease & Ejectment 

II 240 Torts to Land 

0 245 Tort Product Liability 

II 290 All Other Real Property 

II 440 Other Civil Rights 

II 441 Voting 

II 442 Employment 

II 443 Housing/ 

Accommodations 

II 445 Amer. w/Disabilities - 

Employment 

II 446 Amer. w/Disabilities - 

Other 

II 448 Education 

Habeas Corpus: 

II 463 Alien Detainee 

II 510 Motions to Vacate 

Sentence 

CI 530 General 

0 535 Death Penalty 

Other: 

CI 540 Mandamus & Other 

CI 550 Civil Rights 

II 555 Prison Condition 

CI 560 Civil Detainee - 

Conditions of 

Confinement 

CI 870 Taxes (U.S. Plaintiff 

or Defendant) 

II 871 IRS—Third Party 

26 USC 7609 

IMMIGRATION 

II 462 Naturalization Application 

CI 465 Other Immigration 

Actions 

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

D 1 Original D 2 Removed from D 3 Remanded from D 4 Reinstated or D 5 Transferred from D 6 Multidistrict D 8 Multidistrict 

Proceeding State Court Appellate Court Reopened Another District Litigation - Litigation - 

(specify) Transfer Direct File 

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

VI. CAUSE OF ACTION Brief description of cause: 

VII. REQUESTED IN 0 CHECK IF THIS IS A CLASS ACTION 

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

DEMAND $ CHECK YES only if demanded in complaint: 

JURY DEMAND: D Yes 0No 

VIII. RELATED CASE(S) 

(See instructions): IF ANY JUDGE DOCKET NUMBER 

DATE SIGNATURE OF ATTORNEY OF RECORD 

FOR OFFICE USE ONLY 

RECEIPT # AMOUNT APPLYING IFP JUDGE MAG. JUDGE 

I. (a) PLAINTIFFS 

(b) County of Residence of First Listed Plaintiff 

(EXCEPT IN U.S. PLAINTIFF CASES) 

(C) Attorneys (Firm Name, Address, and Telephone Number) 

DEFENDANTS 

County of Residence of First Listed Defendant 

(IN U.S. PLAINTIFF CASES ONLI9 

NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF 

THE TRACT OF LAND INVOLVED. 

Attorneys (If Known) 

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

0 1 U.S. Government 0 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 HI) 

HI. 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 0 3 0 3 Foreign Nation 

Foreign Country 

0 6 0 6 

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.) 

IV. NATURE OF SUIT (Place an "X" in One Box Only) Click here for: Nature of Suit Code Descriptions. 

CONTRACT . TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES 

II 110 Insurance 

II 120 Marine 

II 130 Miller Act 

II 140 Negotiable Instrument 

11 150 Recovery of Overpayment 

& Enforcement of Judgment 

II 151 Medicare Act 

II 152 Recovery of Defaulted 

Student Loans 

(Excludes Veterans) 

II 153 Recovery of Overpayment 

of Veteran's Benefits 

II 160 Stockholders' Suits 

II 190 Other Contract 

11 195 Contract Product Liability 

II 196 Franchise 

PERSONAL INJURY PERSONAL INJURY 

II 310 Airplane 11 365 Personal Injury - 

II 315 Airplane Product Product Liability 

Liability CI 367 Health Care/ 

11 320 Assault, Libel & Pharmaceutical 

Slander Personal Injury 

CI 330 Federal Employers' Product Liability 

Liability 11 368 Asbestos Personal 

II 340 Marine Injury Product 

II 345 Marine Product Liability 

Liability PERSONAL PROPERTY 

11 350 Motor Vehicle CI 370 Other Fraud 

11 355 Motor Vehicle II 371 Truth in Lending 

Product Liability 11 380 Other Personal 

11 360 Other Personal Property Damage 

Injury 11 385 Property Damage 

II 362 Personal Injury - Product Liability 

Medical Malpractice 

II 625 Drug Related Seizure 

of Property 21 USC 881 

11 690 Other 

LABOR 

II 422 Appeal 28 USC 158 

CI 423 Withdrawal 

28 USC 157 

II 375 False Claims Act 

II 376 Qui Tam (31 USC 

3729(a)) 

11 400 State Reapportionment 

II 410 Antitrust 

II 430 Banks and Banking 

II 450 Commerce 

11 460 Deportation 

CI 470 Racketeer Influenced and 

Corrupt Organizations 

II 480 Consumer Credit 

II 490 Cable/Sat TV 

CI 850 Securities/Commodities/ 

Exchange 

11 890 Other Statutory Actions 

II 891 Agricultural Acts 

11 893 Environmental Matters 

CI 895 Freedom of Information 

Act 

11 896 Arbitration 

CI 899 Administrative Procedure 

Act/Review or Appeal of 

Agency Decision 

11 950 Constitutionality of 

State Statutes 

1.140PERTY RIGHTS 

II 820 Copyrights 

II 830 Patent 

11 835 Patent - Abbreviated 

New Drug Application 

II 840 Trademark 

II 710 Fair Labor Standards 

Act 

II 720 Labor/Management 

Relations 

11 740 Railway Labor Act 

II 751 Family and Medical 

Leave Act 

11 790 Other Labor Litigation 

II 791 Employee Retirement 

Income Security Act 

II 861 FHA (1395f0 

II 862 Black Lung (923) 

CI 863 DIWC/DIWW (405(g)) 

II 864 SSID Title XVI 

CI 865 RSI (405(g)) 

REAL PROPERTY ICIVIL RIGHTS PRISONER PETITIONS FEDERAL TAX SUITS 1 

II 210 Land Condemnation 

II 220 Foreclosure 

11 230 Rent Lease & Ejectment 

II 240 Torts to Land 

0 245 Tort Product Liability 

II 290 All Other Real Property 

II 440 Other Civil Rights 

II 441 Voting 

II 442 Employment 

II 443 Housing/ 

Accommodations 

II 445 Amer. w/Disabilities - 

Employment 

II 446 Amer. w/Disabilities - 

Other 

II 448 Education 

Habeas Corpus: 

II 463 Alien Detainee 

II 510 Motions to Vacate 

Sentence 

CI 530 General 

0 535 Death Penalty 

Other: 

CI 540 Mandamus & Other 

CI 550 Civil Rights 

II 555 Prison Condition 

CI 560 Civil Detainee - 

Conditions of 

Confinement 

CI 870 Taxes (U.S. Plaintiff 

or Defendant) 

II 871 IRS—Third Party 

26 USC 7609 

IMMIGRATION 

II 462 Naturalization Application 

CI 465 Other Immigration 

Actions 

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

D 1 Original D 2 Removed from D 3 Remanded from D 4 Reinstated or D 5 Transferred from D 6 Multidistrict D 8 Multidistrict 

Proceeding State Court Appellate Court Reopened Another District Litigation - Litigation - 

(specify) Transfer Direct File 

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

VI. CAUSE OF ACTION Brief description of cause: 

VII. REQUESTED IN 0 CHECK IF THIS IS A CLASS ACTION 

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

DEMAND $ CHECK YES only if demanded in complaint: 

JURY DEMAND: D Yes 0No 

VIII. RELATED CASE(S) 

(See instructions): IF ANY JUDGE DOCKET NUMBER 

DATE SIGNATURE OF ATTORNEY OF RECORD 

FOR OFFICE USE ONLY 

RECEIPT # AMOUNT APPLYING IFP JUDGE MAG. JUDGE 

I. (a) PLAINTIFFS 

(b) County of Residence of First Listed Plaintiff 

(EXCEPT IN U.S. PLAINTIFF CASES) 

(C) Attorneys (Firm Name, Address, and Telephone Number) 

DEFENDANTS 

County of Residence of First Listed Defendant 

(IN U.S. PLAINTIFF CASES ONLI9 

NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF 

THE TRACT OF LAND INVOLVED. 

Attorneys (If Known) 

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

0 1 U.S. Government 0 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 HI) 

HI. 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 0 3 0 3 Foreign Nation 

Foreign Country 

0 6 0 6 

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.) 

IV. NATURE OF SUIT (Place an "X" in One Box Only) Click here for: Nature of Suit Code Descriptions. 

CONTRACT . TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES 

II 110 Insurance 

II 120 Marine 

II 130 Miller Act 

II 140 Negotiable Instrument 

11 150 Recovery of Overpayment 

& Enforcement of Judgment 

II 151 Medicare Act 

II 152 Recovery of Defaulted 

Student Loans 

(Excludes Veterans) 

II 153 Recovery of Overpayment 

of Veteran's Benefits 

II 160 Stockholders' Suits 

II 190 Other Contract 

11 195 Contract Product Liability 

II 196 Franchise 

PERSONAL INJURY PERSONAL INJURY 

II 310 Airplane 11 365 Personal Injury - 

II 315 Airplane Product Product Liability 

Liability CI 367 Health Care/ 

11 320 Assault, Libel & Pharmaceutical 

Slander Personal Injury 

CI 330 Federal Employers' Product Liability 

Liability 11 368 Asbestos Personal 

II 340 Marine Injury Product 

II 345 Marine Product Liability 

Liability PERSONAL PROPERTY 

11 350 Motor Vehicle CI 370 Other Fraud 

11 355 Motor Vehicle II 371 Truth in Lending 

Product Liability 11 380 Other Personal 

11 360 Other Personal Property Damage 

Injury 11 385 Property Damage 

II 362 Personal Injury - Product Liability 

Medical Malpractice 

II 625 Drug Related Seizure 

of Property 21 USC 881 

11 690 Other 

LABOR 

II 422 Appeal 28 USC 158 

CI 423 Withdrawal 

28 USC 157 

II 375 False Claims Act 

II 376 Qui Tam (31 USC 

3729(a)) 

11 400 State Reapportionment 

II 410 Antitrust 

II 430 Banks and Banking 

II 450 Commerce 

11 460 Deportation 

CI 470 Racketeer Influenced and 

Corrupt Organizations 

II 480 Consumer Credit 

II 490 Cable/Sat TV 

CI 850 Securities/Commodities/ 

Exchange 

11 890 Other Statutory Actions 

II 891 Agricultural Acts 

11 893 Environmental Matters 

CI 895 Freedom of Information 

Act 

11 896 Arbitration 

CI 899 Administrative Procedure 

Act/Review or Appeal of 

Agency Decision 

11 950 Constitutionality of 

State Statutes 

1.140PERTY RIGHTS 

II 820 Copyrights 

II 830 Patent 

11 835 Patent - Abbreviated 

New Drug Application 

II 840 Trademark 

II 710 Fair Labor Standards 

Act 

II 720 Labor/Management 

Relations 

11 740 Railway Labor Act 

II 751 Family and Medical 

Leave Act 

11 790 Other Labor Litigation 

II 791 Employee Retirement 

Income Security Act 

II 861 FHA (1395f0 

II 862 Black Lung (923) 

CI 863 DIWC/DIWW (405(g)) 

II 864 SSID Title XVI 

CI 865 RSI (405(g)) 

REAL PROPERTY ICIVIL RIGHTS PRISONER PETITIONS FEDERAL TAX SUITS 1 

II 210 Land Condemnation 

II 220 Foreclosure 

11 230 Rent Lease & Ejectment 

II 240 Torts to Land 

0 245 Tort Product Liability 

II 290 All Other Real Property 

II 440 Other Civil Rights 

II 441 Voting 

II 442 Employment 

II 443 Housing/ 

Accommodations 

II 445 Amer. w/Disabilities - 

Employment 

II 446 Amer. w/Disabilities - 

Other 

II 448 Education 

Habeas Corpus: 

II 463 Alien Detainee 

II 510 Motions to Vacate 

Sentence 

CI 530 General 

0 535 Death Penalty 

Other: 

CI 540 Mandamus & Other 

CI 550 Civil Rights 

II 555 Prison Condition 

CI 560 Civil Detainee - 

Conditions of 

Confinement 

CI 870 Taxes (U.S. Plaintiff 

or Defendant) 

II 871 IRS—Third Party 

26 USC 7609 

IMMIGRATION 

II 462 Naturalization Application 

CI 465 Other Immigration 

Actions 

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

D 1 Original D 2 Removed from D 3 Remanded from D 4 Reinstated or D 5 Transferred from D 6 Multidistrict D 8 Multidistrict 

Proceeding State Court Appellate Court Reopened Another District Litigation - Litigation - 

(specify) Transfer Direct File 

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

VI. CAUSE OF ACTION Brief description of cause: 

VII. REQUESTED IN 0 CHECK IF THIS IS A CLASS ACTION 

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

DEMAND $ CHECK YES only if demanded in complaint: 

JURY DEMAND: D Yes 0No 

VIII. RELATED CASE(S) 

(See instructions): IF ANY JUDGE DOCKET NUMBER 

DATE SIGNATURE OF ATTORNEY OF RECORD 

FOR OFFICE USE ONLY 

RECEIPT # AMOUNT APPLYING IFP JUDGE MAG. JUDGE 

I. (a) PLAINTIFFS 

(b) County of Residence of First Listed Plaintiff 

(EXCEPT IN U.S. PLAINTIFF CASES) 

(C) Attorneys (Firm Name, Address, and Telephone Number) 

DEFENDANTS 

County of Residence of First Listed Defendant 

(IN U.S. PLAINTIFF CASES ONLI9 

NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF 

THE TRACT OF LAND INVOLVED. 

Attorneys (If Known) 

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

0 1 U.S. Government 0 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 HI) 

HI. 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 0 3 0 3 Foreign Nation 

Foreign Country 

0 6 0 6 

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.) 

IV. NATURE OF SUIT (Place an "X" in One Box Only) Click here for: Nature of Suit Code Descriptions. 

CONTRACT . TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES 

II 110 Insurance 

II 120 Marine 

II 130 Miller Act 

II 140 Negotiable Instrument 

11 150 Recovery of Overpayment 

& Enforcement of Judgment 

II 151 Medicare Act 

II 152 Recovery of Defaulted 

Student Loans 

(Excludes Veterans) 

II 153 Recovery of Overpayment 

of Veteran's Benefits 

II 160 Stockholders' Suits 

II 190 Other Contract 

11 195 Contract Product Liability 

II 196 Franchise 

PERSONAL INJURY PERSONAL INJURY 

II 310 Airplane 11 365 Personal Injury - 

II 315 Airplane Product Product Liability 

Liability CI 367 Health Care/ 

11 320 Assault, Libel & Pharmaceutical 

Slander Personal Injury 

CI 330 Federal Employers' Product Liability 

Liability 11 368 Asbestos Personal 

II 340 Marine Injury Product 

II 345 Marine Product Liability 

Liability PERSONAL PROPERTY 

11 350 Motor Vehicle CI 370 Other Fraud 

11 355 Motor Vehicle II 371 Truth in Lending 

Product Liability 11 380 Other Personal 

11 360 Other Personal Property Damage 

Injury 11 385 Property Damage 

II 362 Personal Injury - Product Liability 

Medical Malpractice 

II 625 Drug Related Seizure 

of Property 21 USC 881 

11 690 Other 

LABOR 

II 422 Appeal 28 USC 158 

CI 423 Withdrawal 

28 USC 157 

II 375 False Claims Act 

II 376 Qui Tam (31 USC 

3729(a)) 

11 400 State Reapportionment 

II 410 Antitrust 

II 430 Banks and Banking 

II 450 Commerce 

11 460 Deportation 

CI 470 Racketeer Influenced and 

Corrupt Organizations 

II 480 Consumer Credit 

II 490 Cable/Sat TV 

CI 850 Securities/Commodities/ 

Exchange 

11 890 Other Statutory Actions 

II 891 Agricultural Acts 

11 893 Environmental Matters 

CI 895 Freedom of Information 

Act 

11 896 Arbitration 

CI 899 Administrative Procedure 

Act/Review or Appeal of 

Agency Decision 

11 950 Constitutionality of 

State Statutes 

1.140PERTY RIGHTS 

II 820 Copyrights 

II 830 Patent 

11 835 Patent - Abbreviated 

New Drug Application 

II 840 Trademark 

II 710 Fair Labor Standards 

Act 

II 720 Labor/Management 

Relations 

11 740 Railway Labor Act 

II 751 Family and Medical 

Leave Act 

11 790 Other Labor Litigation 

II 791 Employee Retirement 

Income Security Act 

II 861 FHA (1395f0 

II 862 Black Lung (923) 

CI 863 DIWC/DIWW (405(g)) 

II 864 SSID Title XVI 

CI 865 RSI (405(g)) 

REAL PROPERTY ICIVIL RIGHTS PRISONER PETITIONS FEDERAL TAX SUITS 1 

II 210 Land Condemnation 

II 220 Foreclosure 

11 230 Rent Lease & Ejectment 

II 240 Torts to Land 

0 245 Tort Product Liability 

II 290 All Other Real Property 

II 440 Other Civil Rights 

II 441 Voting 

II 442 Employment 

II 443 Housing/ 

Accommodations 

II 445 Amer. w/Disabilities - 

Employment 

II 446 Amer. w/Disabilities - 

Other 

II 448 Education 

Habeas Corpus: 

II 463 Alien Detainee 

II 510 Motions to Vacate 

Sentence 

CI 530 General 

0 535 Death Penalty 

Other: 

CI 540 Mandamus & Other 

CI 550 Civil Rights 

II 555 Prison Condition 

CI 560 Civil Detainee - 

Conditions of 

Confinement 

CI 870 Taxes (U.S. Plaintiff 

or Defendant) 

II 871 IRS—Third Party 

26 USC 7609 

IMMIGRATION 

II 462 Naturalization Application 

CI 465 Other Immigration 

Actions 

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

D 1 Original D 2 Removed from D 3 Remanded from D 4 Reinstated or D 5 Transferred from D 6 Multidistrict D 8 Multidistrict 

Proceeding State Court Appellate Court Reopened Another District Litigation - Litigation - 

(specify) Transfer Direct File 

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

VI. CAUSE OF ACTION Brief description of cause: 

VII. REQUESTED IN 0 CHECK IF THIS IS A CLASS ACTION 

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

DEMAND $ CHECK YES only if demanded in complaint: 

JURY DEMAND: D Yes 0No 

VIII. RELATED CASE(S) 

(See instructions): IF ANY JUDGE DOCKET NUMBER 

DATE SIGNATURE OF ATTORNEY OF RECORD 

FOR OFFICE USE ONLY 

RECEIPT # AMOUNT APPLYING IFP JUDGE MAG. JUDGE 

I. (a) PLAINTIFFS 

(b) County of Residence of First Listed Plaintiff 

(EXCEPT IN U.S. PLAINTIFF CASES) 

(C) Attorneys (Firm Name, Address, and Telephone Number) 

DEFENDANTS 

County of Residence of First Listed Defendant 

(IN U.S. PLAINTIFF CASES ONLI9 

NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF 

THE TRACT OF LAND INVOLVED. 

Attorneys (If Known) 

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

0 1 U.S. Government 0 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 HI) 

HI. 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 0 3 0 3 Foreign Nation 

Foreign Country 

0 6 0 6 

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.) 

IV. NATURE OF SUIT (Place an "X" in One Box Only) Click here for: Nature of Suit Code Descriptions. 

CONTRACT . TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES 

II 110 Insurance 

II 120 Marine 

II 130 Miller Act 

II 140 Negotiable Instrument 

11 150 Recovery of Overpayment 

& Enforcement of Judgment 

II 151 Medicare Act 

II 152 Recovery of Defaulted 

Student Loans 

(Excludes Veterans) 

II 153 Recovery of Overpayment 

of Veteran's Benefits 

II 160 Stockholders' Suits 

II 190 Other Contract 

11 195 Contract Product Liability 

II 196 Franchise 

PERSONAL INJURY PERSONAL INJURY 

II 310 Airplane 11 365 Personal Injury - 

II 315 Airplane Product Product Liability 

Liability CI 367 Health Care/ 

11 320 Assault, Libel & Pharmaceutical 

Slander Personal Injury 

CI 330 Federal Employers' Product Liability 

Liability 11 368 Asbestos Personal 

II 340 Marine Injury Product 

II 345 Marine Product Liability 

Liability PERSONAL PROPERTY 

11 350 Motor Vehicle CI 370 Other Fraud 

11 355 Motor Vehicle II 371 Truth in Lending 

Product Liability 11 380 Other Personal 

11 360 Other Personal Property Damage 

Injury 11 385 Property Damage 

II 362 Personal Injury - Product Liability 

Medical Malpractice 

II 625 Drug Related Seizure 

of Property 21 USC 881 

11 690 Other 

LABOR 

II 422 Appeal 28 USC 158 

CI 423 Withdrawal 

28 USC 157 

II 375 False Claims Act 

II 376 Qui Tam (31 USC 

3729(a)) 

11 400 State Reapportionment 

II 410 Antitrust 

II 430 Banks and Banking 

II 450 Commerce 

11 460 Deportation 

CI 470 Racketeer Influenced and 

Corrupt Organizations 

II 480 Consumer Credit 

II 490 Cable/Sat TV 

CI 850 Securities/Commodities/ 

Exchange 

11 890 Other Statutory Actions 

II 891 Agricultural Acts 

11 893 Environmental Matters 

CI 895 Freedom of Information 

Act 

11 896 Arbitration 

CI 899 Administrative Procedure 

Act/Review or Appeal of 

Agency Decision 

11 950 Constitutionality of 

State Statutes 

1.140PERTY RIGHTS 

II 820 Copyrights 

II 830 Patent 

11 835 Patent - Abbreviated 

New Drug Application 

II 840 Trademark 

II 710 Fair Labor Standards 

Act 

II 720 Labor/Management 

Relations 

11 740 Railway Labor Act 

II 751 Family and Medical 

Leave Act 

11 790 Other Labor Litigation 

II 791 Employee Retirement 

Income Security Act 

II 861 FHA (1395f0 

II 862 Black Lung (923) 

CI 863 DIWC/DIWW (405(g)) 

II 864 SSID Title XVI 

CI 865 RSI (405(g)) 

REAL PROPERTY ICIVIL RIGHTS PRISONER PETITIONS FEDERAL TAX SUITS 1 

II 210 Land Condemnation 

II 220 Foreclosure 

11 230 Rent Lease & Ejectment 

II 240 Torts to Land 

0 245 Tort Product Liability 

II 290 All Other Real Property 

II 440 Other Civil Rights 

II 441 Voting 

II 442 Employment 

II 443 Housing/ 

Accommodations 

II 445 Amer. w/Disabilities - 

Employment 

II 446 Amer. w/Disabilities - 

Other 

II 448 Education 

Habeas Corpus: 

II 463 Alien Detainee 

II 510 Motions to Vacate 

Sentence 

CI 530 General 

0 535 Death Penalty 

Other: 

CI 540 Mandamus & Other 

CI 550 Civil Rights 

II 555 Prison Condition 

CI 560 Civil Detainee - 

Conditions of 

Confinement 

CI 870 Taxes (U.S. Plaintiff 

or Defendant) 

II 871 IRS—Third Party 

26 USC 7609 

IMMIGRATION 

II 462 Naturalization Application 

CI 465 Other Immigration 

Actions 

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

D 1 Original D 2 Removed from D 3 Remanded from D 4 Reinstated or D 5 Transferred from D 6 Multidistrict D 8 Multidistrict 

Proceeding State Court Appellate Court Reopened Another District Litigation - Litigation - 

(specify) Transfer Direct File 

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

VI. CAUSE OF ACTION Brief description of cause: 

VII. REQUESTED IN 0 CHECK IF THIS IS A CLASS ACTION 

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

DEMAND $ CHECK YES only if demanded in complaint: 

JURY DEMAND: D Yes 0No 

VIII. RELATED CASE(S) 

(See instructions): IF ANY JUDGE DOCKET NUMBER 

DATE SIGNATURE OF ATTORNEY OF RECORD 

FOR OFFICE USE ONLY 

RECEIPT # AMOUNT APPLYING IFP JUDGE MAG. JUDGE 

I. (a) PLAINTIFFS 

(b) County of Residence of First Listed Plaintiff 

(EXCEPT IN U.S. PLAINTIFF CASES) 

(C) Attorneys (Firm Name, Address, and Telephone Number) 

DEFENDANTS 

County of Residence of First Listed Defendant 

(IN U.S. PLAINTIFF CASES ONLI9 

NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF 

THE TRACT OF LAND INVOLVED. 

Attorneys (If Known) 

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

0 1 U.S. Government 0 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 HI) 

HI. 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 0 3 0 3 Foreign Nation 

Foreign Country 

0 6 0 6 

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.) 

IV. NATURE OF SUIT (Place an "X" in One Box Only) Click here for: Nature of Suit Code Descriptions. 

CONTRACT . TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES 

II 110 Insurance 

II 120 Marine 

II 130 Miller Act 

II 140 Negotiable Instrument 

11 150 Recovery of Overpayment 

& Enforcement of Judgment 

II 151 Medicare Act 

II 152 Recovery of Defaulted 

Student Loans 

(Excludes Veterans) 

II 153 Recovery of Overpayment 

of Veteran's Benefits 

II 160 Stockholders' Suits 

II 190 Other Contract 

11 195 Contract Product Liability 

II 196 Franchise 

PERSONAL INJURY PERSONAL INJURY 

II 310 Airplane 11 365 Personal Injury - 

II 315 Airplane Product Product Liability 

Liability CI 367 Health Care/ 

11 320 Assault, Libel & Pharmaceutical 

Slander Personal Injury 

CI 330 Federal Employers' Product Liability 

Liability 11 368 Asbestos Personal 

II 340 Marine Injury Product 

II 345 Marine Product Liability 

Liability PERSONAL PROPERTY 

11 350 Motor Vehicle CI 370 Other Fraud 

11 355 Motor Vehicle II 371 Truth in Lending 

Product Liability 11 380 Other Personal 

11 360 Other Personal Property Damage 

Injury 11 385 Property Damage 

II 362 Personal Injury - Product Liability 

Medical Malpractice 

II 625 Drug Related Seizure 

of Property 21 USC 881 

11 690 Other 

LABOR 

II 422 Appeal 28 USC 158 

CI 423 Withdrawal 

28 USC 157 

II 375 False Claims Act 

II 376 Qui Tam (31 USC 

3729(a)) 

11 400 State Reapportionment 

II 410 Antitrust 

II 430 Banks and Banking 

II 450 Commerce 

11 460 Deportation 

CI 470 Racketeer Influenced and 

Corrupt Organizations 

II 480 Consumer Credit 

II 490 Cable/Sat TV 

CI 850 Securities/Commodities/ 

Exchange 

11 890 Other Statutory Actions 

II 891 Agricultural Acts 

11 893 Environmental Matters 

CI 895 Freedom of Information 

Act 

11 896 Arbitration 

CI 899 Administrative Procedure 

Act/Review or Appeal of 

Agency Decision 

11 950 Constitutionality of 

State Statutes 

1.140PERTY RIGHTS 

II 820 Copyrights 

II 830 Patent 

11 835 Patent - Abbreviated 

New Drug Application 

II 840 Trademark 

II 710 Fair Labor Standards 

Act 

II 720 Labor/Management 

Relations 

11 740 Railway Labor Act 

II 751 Family and Medical 

Leave Act 

11 790 Other Labor Litigation 

II 791 Employee Retirement 

Income Security Act 

II 861 FHA (1395f0 

II 862 Black Lung (923) 

CI 863 DIWC/DIWW (405(g)) 

II 864 SSID Title XVI 

CI 865 RSI (405(g)) 

REAL PROPERTY ICIVIL RIGHTS PRISONER PETITIONS FEDERAL TAX SUITS 1 

II 210 Land Condemnation 

II 220 Foreclosure 

11 230 Rent Lease & Ejectment 

II 240 Torts to Land 

0 245 Tort Product Liability 

II 290 All Other Real Property 

II 440 Other Civil Rights 

II 441 Voting 

II 442 Employment 

II 443 Housing/ 

Accommodations 

II 445 Amer. w/Disabilities - 

Employment 

II 446 Amer. w/Disabilities - 

Other 

II 448 Education 

Habeas Corpus: 

II 463 Alien Detainee 

II 510 Motions to Vacate 

Sentence 

CI 530 General 

0 535 Death Penalty 

Other: 

CI 540 Mandamus & Other 

CI 550 Civil Rights 

II 555 Prison Condition 

CI 560 Civil Detainee - 

Conditions of 

Confinement 

CI 870 Taxes (U.S. Plaintiff 

or Defendant) 

II 871 IRS—Third Party 

26 USC 7609 

IMMIGRATION 

II 462 Naturalization Application 

CI 465 Other Immigration 

Actions 

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

D 1 Original D 2 Removed from D 3 Remanded from D 4 Reinstated or D 5 Transferred from D 6 Multidistrict D 8 Multidistrict 

Proceeding State Court Appellate Court Reopened Another District Litigation - Litigation - 

(specify) Transfer Direct File 

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

VI. CAUSE OF ACTION Brief description of cause: 

VII. REQUESTED IN 0 CHECK IF THIS IS A CLASS ACTION 

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

DEMAND $ CHECK YES only if demanded in complaint: 

JURY DEMAND: D Yes 0No 

VIII. RELATED CASE(S) 

(See instructions): IF ANY JUDGE DOCKET NUMBER 

DATE SIGNATURE OF ATTORNEY OF RECORD 

FOR OFFICE USE ONLY 

RECEIPT # AMOUNT APPLYING IFP JUDGE MAG. JUDGE 

I. (a) PLAINTIFFS 

(b) County of Residence of First Listed Plaintiff 

(EXCEPT IN U.S. PLAINTIFF CASES) 

(C) Attorneys (Firm Name, Address, and Telephone Number) 

DEFENDANTS 

County of Residence of First Listed Defendant 

(IN U.S. PLAINTIFF CASES ONLI9 

NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF 

THE TRACT OF LAND INVOLVED. 

Attorneys (If Known) 

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

0 1 U.S. Government 0 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 HI) 

HI. 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 0 3 0 3 Foreign Nation 

Foreign Country 

0 6 0 6 

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.) 

IV. NATURE OF SUIT (Place an "X" in One Box Only) Click here for: Nature of Suit Code Descriptions. 

CONTRACT . TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES 

II 110 Insurance 

II 120 Marine 

II 130 Miller Act 

II 140 Negotiable Instrument 

11 150 Recovery of Overpayment 

& Enforcement of Judgment 

II 151 Medicare Act 

II 152 Recovery of Defaulted 

Student Loans 

(Excludes Veterans) 

II 153 Recovery of Overpayment 

of Veteran's Benefits 

II 160 Stockholders' Suits 

II 190 Other Contract 

11 195 Contract Product Liability 

II 196 Franchise 

PERSONAL INJURY PERSONAL INJURY 

II 310 Airplane 11 365 Personal Injury - 

II 315 Airplane Product Product Liability 

Liability CI 367 Health Care/ 

11 320 Assault, Libel & Pharmaceutical 

Slander Personal Injury 

CI 330 Federal Employers' Product Liability 

Liability 11 368 Asbestos Personal 

II 340 Marine Injury Product 

II 345 Marine Product Liability 

Liability PERSONAL PROPERTY 

11 350 Motor Vehicle CI 370 Other Fraud 

11 355 Motor Vehicle II 371 Truth in Lending 

Product Liability 11 380 Other Personal 

11 360 Other Personal Property Damage 

Injury 11 385 Property Damage 

II 362 Personal Injury - Product Liability 

Medical Malpractice 

II 625 Drug Related Seizure 

of Property 21 USC 881 

11 690 Other 

LABOR 

II 422 Appeal 28 USC 158 

CI 423 Withdrawal 

28 USC 157 

II 375 False Claims Act 

II 376 Qui Tam (31 USC 

3729(a)) 

11 400 State Reapportionment 

II 410 Antitrust 

II 430 Banks and Banking 

II 450 Commerce 

11 460 Deportation 

CI 470 Racketeer Influenced and 

Corrupt Organizations 

II 480 Consumer Credit 

II 490 Cable/Sat TV 

CI 850 Securities/Commodities/ 

Exchange 

11 890 Other Statutory Actions 

II 891 Agricultural Acts 

11 893 Environmental Matters 

CI 895 Freedom of Information 

Act 

11 896 Arbitration 

CI 899 Administrative Procedure 

Act/Review or Appeal of 

Agency Decision 

11 950 Constitutionality of 

State Statutes 

1.140PERTY RIGHTS 

II 820 Copyrights 

II 830 Patent 

11 835 Patent - Abbreviated 

New Drug Application 

II 840 Trademark 

II 710 Fair Labor Standards 

Act 

II 720 Labor/Management 

Relations 

11 740 Railway Labor Act 

II 751 Family and Medical 

Leave Act 

11 790 Other Labor Litigation 

II 791 Employee Retirement 

Income Security Act 

II 861 FHA (1395f0 

II 862 Black Lung (923) 

CI 863 DIWC/DIWW (405(g)) 

II 864 SSID Title XVI 

CI 865 RSI (405(g)) 

REAL PROPERTY ICIVIL RIGHTS PRISONER PETITIONS FEDERAL TAX SUITS 1 

II 210 Land Condemnation 

II 220 Foreclosure 

11 230 Rent Lease & Ejectment 

II 240 Torts to Land 

0 245 Tort Product Liability 

II 290 All Other Real Property 

II 440 Other Civil Rights 

II 441 Voting 

II 442 Employment 

II 443 Housing/ 

Accommodations 

II 445 Amer. w/Disabilities - 

Employment 

II 446 Amer. w/Disabilities - 

Other 

II 448 Education 

Habeas Corpus: 

II 463 Alien Detainee 

II 510 Motions to Vacate 

Sentence 

CI 530 General 

0 535 Death Penalty 

Other: 

CI 540 Mandamus & Other 

CI 550 Civil Rights 

II 555 Prison Condition 

CI 560 Civil Detainee - 

Conditions of 

Confinement 

CI 870 Taxes (U.S. Plaintiff 

or Defendant) 

II 871 IRS—Third Party 

26 USC 7609 

IMMIGRATION 

II 462 Naturalization Application 

CI 465 Other Immigration 

Actions 

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

D 1 Original D 2 Removed from D 3 Remanded from D 4 Reinstated or D 5 Transferred from D 6 Multidistrict D 8 Multidistrict 

Proceeding State Court Appellate Court Reopened Another District Litigation - Litigation - 

(specify) Transfer Direct File 

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

VI. CAUSE OF ACTION Brief description of cause: 

VII. REQUESTED IN 0 CHECK IF THIS IS A CLASS ACTION 

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

DEMAND $ CHECK YES only if demanded in complaint: 

JURY DEMAND: D Yes 0No 

VIII. RELATED CASE(S) 

(See instructions): IF ANY JUDGE DOCKET NUMBER 

DATE SIGNATURE OF ATTORNEY OF RECORD 

FOR OFFICE USE ONLY 

RECEIPT # AMOUNT APPLYING IFP JUDGE MAG. JUDGE 

I. (a) PLAINTIFFS 

(b) County of Residence of First Listed Plaintiff 

(EXCEPT IN U.S. PLAINTIFF CASES) 

(C) Attorneys (Firm Name, Address, and Telephone Number) 

DEFENDANTS 

County of Residence of First Listed Defendant 

(IN U.S. PLAINTIFF CASES ONLI9 

NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF 

THE TRACT OF LAND INVOLVED. 

Attorneys (If Known) 

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

0 1 U.S. Government 0 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 HI) 

HI. 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 0 3 0 3 Foreign Nation 

Foreign Country 

0 6 0 6 

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.) 

IV. NATURE OF SUIT (Place an "X" in One Box Only) Click here for: Nature of Suit Code Descriptions. 

CONTRACT . TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES 

II 110 Insurance 

II 120 Marine 

II 130 Miller Act 

II 140 Negotiable Instrument 

11 150 Recovery of Overpayment 

& Enforcement of Judgment 

II 151 Medicare Act 

II 152 Recovery of Defaulted 

Student Loans 

(Excludes Veterans) 

II 153 Recovery of Overpayment 

of Veteran's Benefits 

II 160 Stockholders' Suits 

II 190 Other Contract 

11 195 Contract Product Liability 

II 196 Franchise 

PERSONAL INJURY PERSONAL INJURY 

II 310 Airplane 11 365 Personal Injury - 

II 315 Airplane Product Product Liability 

Liability CI 367 Health Care/ 

11 320 Assault, Libel & Pharmaceutical 

Slander Personal Injury 

CI 330 Federal Employers' Product Liability 

Liability 11 368 Asbestos Personal 

II 340 Marine Injury Product 

II 345 Marine Product Liability 

Liability PERSONAL PROPERTY 

11 350 Motor Vehicle CI 370 Other Fraud 

11 355 Motor Vehicle II 371 Truth in Lending 

Product Liability 11 380 Other Personal 

11 360 Other Personal Property Damage 

Injury 11 385 Property Damage 

II 362 Personal Injury - Product Liability 

Medical Malpractice 

II 625 Drug Related Seizure 

of Property 21 USC 881 

11 690 Other 

LABOR 

II 422 Appeal 28 USC 158 

CI 423 Withdrawal 

28 USC 157 

II 375 False Claims Act 

II 376 Qui Tam (31 USC 

3729(a)) 

11 400 State Reapportionment 

II 410 Antitrust 

II 430 Banks and Banking 

II 450 Commerce 

11 460 Deportation 

CI 470 Racketeer Influenced and 

Corrupt Organizations 

II 480 Consumer Credit 

II 490 Cable/Sat TV 

CI 850 Securities/Commodities/ 

Exchange 

11 890 Other Statutory Actions 

II 891 Agricultural Acts 

11 893 Environmental Matters 

CI 895 Freedom of Information 

Act 

11 896 Arbitration 

CI 899 Administrative Procedure 

Act/Review or Appeal of 

Agency Decision 

11 950 Constitutionality of 

State Statutes 

1.140PERTY RIGHTS 

II 820 Copyrights 

II 830 Patent 

11 835 Patent - Abbreviated 

New Drug Application 

II 840 Trademark 

II 710 Fair Labor Standards 

Act 

II 720 Labor/Management 

Relations 

11 740 Railway Labor Act 

II 751 Family and Medical 

Leave Act 

11 790 Other Labor Litigation 

II 791 Employee Retirement 

Income Security Act 

II 861 FHA (1395f0 

II 862 Black Lung (923) 

CI 863 DIWC/DIWW (405(g)) 

II 864 SSID Title XVI 

CI 865 RSI (405(g)) 

REAL PROPERTY ICIVIL RIGHTS PRISONER PETITIONS FEDERAL TAX SUITS 1 

II 210 Land Condemnation 

II 220 Foreclosure 

11 230 Rent Lease & Ejectment 

II 240 Torts to Land 

0 245 Tort Product Liability 

II 290 All Other Real Property 

II 440 Other Civil Rights 

II 441 Voting 

II 442 Employment 

II 443 Housing/ 

Accommodations 

II 445 Amer. w/Disabilities - 

Employment 

II 446 Amer. w/Disabilities - 

Other 

II 448 Education 

Habeas Corpus: 

II 463 Alien Detainee 

II 510 Motions to Vacate 

Sentence 

CI 530 General 

0 535 Death Penalty 

Other: 

CI 540 Mandamus & Other 

CI 550 Civil Rights 

II 555 Prison Condition 

CI 560 Civil Detainee - 

Conditions of 

Confinement 

CI 870 Taxes (U.S. Plaintiff 

or Defendant) 

II 871 IRS—Third Party 

26 USC 7609 

IMMIGRATION 

II 462 Naturalization Application 

CI 465 Other Immigration 

Actions 

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

D 1 Original D 2 Removed from D 3 Remanded from D 4 Reinstated or D 5 Transferred from D 6 Multidistrict D 8 Multidistrict 

Proceeding State Court Appellate Court Reopened Another District Litigation - Litigation - 

(specify) Transfer Direct File 

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

VI. CAUSE OF ACTION Brief description of cause: 

VII. REQUESTED IN 0 CHECK IF THIS IS A CLASS ACTION 

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

DEMAND $ CHECK YES only if demanded in complaint: 

JURY DEMAND: D Yes 0No 

VIII. RELATED CASE(S) 

(See instructions): IF ANY JUDGE DOCKET NUMBER 

DATE SIGNATURE OF ATTORNEY OF RECORD 

FOR OFFICE USE ONLY 

RECEIPT # AMOUNT APPLYING IFP JUDGE MAG. JUDGE 

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 DEFENDANTS

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

(EXCEPT IN U.S. PLAINTIFF CASES) (IN U.S. PLAINTIFF CASES ONLY)

NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF 

THE TRACT OF LAND INVOLVED.

 

(c) Attorneys (Firm Name, Address, and Telephone Number) Attorneys (If Known)

II. BASIS OF JURISDICTION(Place an “X” in One Box Only) III. CITIZENSHIP OF PRINCIPAL PARTIES (Place an “X” in One Box for Plaintiff

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

’ 1 U.S. Government ’ 3 Federal Question PTF DEF PTF DEF

Plaintiff (U.S. Government Not a Party) Citizen of This State ’ 1 ’ 1 Incorporated or Principal Place ’ 4 ’ 4

 of Business In This State

’ 2 U.S. Government ’ 4 Diversity Citizen of Another State ’ 2 ’ 2 Incorporated and Principal Place ’ 5 ’ 5

Defendant (Indicate Citizenship of Parties in Item III) of Business In Another State

Citizen or Subject of a ’ 3 ’ 3 Foreign Nation ’ 6 ’ 6

 Foreign Country

IV. NATURE OF SUIT (Place an “X” in One Box Only) Click here for: Nature of Suit Code Descriptions.

CONTRACT TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES

’ 110 Insurance PERSONAL INJURY PERSONAL INJURY ’ 625 Drug Related Seizure ’ 422 Appeal 28 USC 158 ’ 375 False Claims Act

’ 120 Marine ’ 310 Airplane ’ 365 Personal Injury - of Property 21 USC 881 ’ 423 Withdrawal ’ 376 Qui Tam (31 USC 

’ 130 Miller Act ’ 315 Airplane Product Product Liability ’ 690 Other 28 USC 157 3729(a))

’ 140 Negotiable Instrument Liability ’ 367 Health Care/ ’ 400 State Reapportionment

’ 150 Recovery of Overpayment ’ 320 Assault, Libel & Pharmaceutical PROPERTY RIGHTS ’ 410 Antitrust

 & Enforcement of Judgment Slander Personal Injury ’ 820 Copyrights ’ 430 Banks and Banking

’ 151 Medicare Act ’ 330 Federal Employers’ Product Liability ’ 830 Patent ’ 450 Commerce

’ 152 Recovery of Defaulted Liability ’ 368 Asbestos Personal ’ 835 Patent - Abbreviated ’ 460 Deportation

 Student Loans ’ 340 Marine Injury Product New Drug Application ’ 470 Racketeer Influenced and

 (Excludes Veterans) ’ 345 Marine Product Liability ’ 840 Trademark Corrupt Organizations

’ 153 Recovery of Overpayment Liability PERSONAL PROPERTY LABOR SOCIAL SECURITY ’ 480 Consumer Credit

 of Veteran’s Benefits ’ 350 Motor Vehicle ’ 370 Other Fraud ’ 710 Fair Labor Standards ’ 861 HIA (1395ff) ’ 490 Cable/Sat TV

’ 160 Stockholders’ Suits ’ 355 Motor Vehicle ’ 371 Truth in Lending Act ’ 862 Black Lung (923) ’ 850 Securities/Commodities/

’ 190 Other Contract Product Liability ’ 380 Other Personal ’ 720 Labor/Management ’ 863 DIWC/DIWW (405(g)) Exchange

’ 195 Contract Product Liability ’ 360 Other Personal Property Damage Relations ’ 864 SSID Title XVI ’ 890 Other Statutory Actions

’ 196 Franchise Injury ’ 385 Property Damage ’ 740 Railway Labor Act ’ 865 RSI (405(g)) ’ 891 Agricultural Acts

’ 362 Personal Injury - Product Liability ’ 751 Family and Medical ’ 893 Environmental Matters

 Medical Malpractice Leave Act ’ 895 Freedom of Information

 REAL PROPERTY CIVIL RIGHTS PRISONER PETITIONS ’ 790 Other Labor Litigation FEDERAL TAX SUITS Act

’ 210 Land Condemnation ’ 440 Other Civil Rights Habeas Corpus: ’ 791 Employee Retirement ’ 870 Taxes (U.S. Plaintiff ’ 896 Arbitration

’ 220 Foreclosure ’ 441 Voting ’ 463 Alien Detainee Income Security Act or Defendant) ’ 899 Administrative Procedure

’ 230 Rent Lease & Ejectment ’ 442 Employment ’ 510 Motions to Vacate ’ 871 IRS—Third Party Act/Review or Appeal of

’ 240 Torts to Land ’ 443 Housing/ Sentence 26 USC 7609 Agency Decision

’ 245 Tort Product Liability Accommodations ’ 530 General ’ 950 Constitutionality of

’ 290 All Other Real Property ’ 445 Amer. w/Disabilities - ’ 535 Death Penalty IMMIGRATION State Statutes

 Employment Other: ’ 462 Naturalization Application

’ 446 Amer. w/Disabilities - ’ 540 Mandamus & Other ’ 465 Other Immigration

 Other ’ 550 Civil Rights Actions

’ 448 Education ’ 555 Prison Condition

’ 560 Civil Detainee -

 Conditions of 

 Confinement

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

’ 1 Original

Proceeding

’ 2 Removed from

State Court

’ 3 Remanded from

Appellate Court

’ 4 Reinstated or

Reopened

’ 5 Transferred from

Another District

(specify)

’ 6 Multidistrict

Litigation -

Transfer

’ 8 Multidistrict

 Litigation - 

 Direct File

VI. CAUSE OF ACTION

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

Brief description of cause:

VII. REQUESTED IN

 COMPLAINT:

’ CHECK IF THIS IS A CLASS ACTION

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

DEMAND $ CHECK YES only if demanded in complaint:

JURY DEMAND: ’ Yes ’ No

VIII. RELATED CASE(S)

 IF ANY (See instructions):

JUDGE DOCKET NUMBER

DATE SIGNATURE OF ATTORNEY OF RECORD

FOR OFFICE USE ONLY

RECEIPT # AMOUNT APPLYING IFP JUDGE MAG. JUDGE

Case 5:20-cv-00712 Document 1-1 Filed 06/18/20 Page 1 of 1