JS-CAND 44 (Rev. 07/16) CIVIL COVER SHEET

The JS-CAND 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 in its original form by the Judicial Conference of the United States in September 1974, is required for the Clerk of 

Court to initiate 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)

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

 Of Veteran’s Benefits 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 840 Trademark 460 Deportation 

 Student Loans 340 Marine Injury Product 470 Racketeer Influenced and

 (Excludes Veterans) 345 Marine Product Liability LABOR SOCIAL SECURITY Corrupt Organizations

 153 Recovery of Overpayment Liability PERSONAL PROPERTY 710 Fair Labor Standards 861 HIA (1395ff) 480 Consumer Credit

 of Veteran’s Benefits 350 Motor Vehicle 370 Other Fraud Act 862 Black Lung (923) 490 Cable/Sat TV 

 160 Stockholders’ Suits 355 Motor Vehicle 371 Truth in Lending 720 Labor/Management 863 DIWC/DIWW (405(g)) 850 Securities/Commodities/ 

 190 Other Contract Product Liability 380 Other Personal Relations 864 SSID Title XVI Exchange 

 195 Contract Product Liability 360 Other Personal Property Damage 740 Railway Labor Act 865 RSI (405(g)) 890 Other Statutory Actions 

 196 Franchise Injury 385 Property Damage 751 Family and Medical 891 Agricultural Acts 

362 Personal Injury - Product Liability Leave Act 893 Environmental Matters

 Medical Malpractice 790 Other Labor Litigation 895 Freedom of Information

REAL PROPERTY CIVIL RIGHTS PRISONER PETITIONS 791 Employee Retirement FEDERAL TAX SUITS Act

210 Land Condemnation 440 Other Civil Rights Habeas Corpus: Income Security Act 870 Taxes (U.S. Plaintiff 896 Arbitration

 220 Foreclosure 441 Voting 463 Alien Detainee 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, Fed. R. Civ. P. 

DEMAND $ CHECK YES only if demanded in complaint: 

JURY DEMAND: Yes No 

VIII. RELATED CASE(S), 

 IF ANY (See instructions): JUDGE DOCKET NUMBER 

IX. DIVISIONAL ASSIGNMENT (Civil Local Rule 3-2)

(Place an “X” in One Box Only) SAN FRANCISCO/OAKLAND SAN JOSE EUREKA-MCKINLEYVILLE 

DATE: SIGNATURE OF ATTORNEY OF RECORD:

David Deluca and Barry Francis, individually and on behalf of

all others similarly situated, and on behalf of the general public,

Contra Costa County

Nichols Kaster, LLP

One Embarcadero Center, Suite 720

San Francisco, CA 94111 Phone: (415)277-7235

Farmers Insurance Exchange, Farmers Group, Inc., Farmers Insurance

Company, Inc., and Farmers Speciality Insurance Company, Inc.

Los Angeles County

29 U.S.C. § 201 et seq. (FLSA)

Suit to recover unpaid overtime wages

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01/04/2017 s/ Matthew C. Helland