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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

JENNIFER ANDERSON, on behalf of herself and on behalf of a Class of 

all other persons similarly situated

DEFENDANTS

CHEVRON U.S.A. INC., a Delaware Corporation; and DOES 1 

through 100, inclusive

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

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

NOTE: INLAND CONDEMNATION CASES, USE THE LOCATION OF 

THE TRACT OF LAND INVOLVED.

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

Robert D. Eassa / Delia A. Isvoranu

Sedgwick LLP

333 Bush Street, 30th Floor, San Francisco, CA 94104

415-781-7900

Richard E. Quintilone II / Alvin B. Lindsay

Quintilone & Associates

22974 El Toro Road, Suite 100, Lake Forest, CA 92630 949-458-9675

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

(For Diversity Cases Only)

(Place an “X” in One Box for Plaintiff

and One Box for Defendant)

1 U.S. Government

Plaintiff

2 U.S. Government

Defendant

3 Federal Question

(U.S. Government Not a Party)

4 Diversity

(Indicate Citizenship of Parties in Item III)

Citizen of This State

Citizen of Another State

Citizen or Subject of a

Foreign Country

PTF DEF

1 1

2 2

3 3

Incorporated or Principal Place

of Business In This State

Incorporated and Principal Place

of Business In Another State

Foreign Nation

PTF DEF

4 4

5 5

6 6

IV. NATURE OF SUIT (Place an “X” in One Box Only)

CONTRACT TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES

110 Insurance

120 Marine

130 Miller Act

140 Negotiable Instrument

150 Recovery of Overpayment

Of Veteran’s Benefits

151 Medicare Act

152 Recovery of Defaulted

Student Loans 

(Excludes Veterans)

153 Recovery of Overpayment

of Veteran’s Benefits

160 Stockholders’ Suits

190 Other Contract

195 Contract Product Liability

196 Franchise

PERSONAL INJURY

310 Airplane

315 Airplane Product

Liability

320 Assault, Libel &

Slander

330 Federal Employers’

Liability

340 Marine

345 Marine Product

Liability

350 Motor Vehicle

355 Motor Vehicle

Product Liability

360 Other Personal

Injury

362 Personal Injury -

Medical Malpractice

PERSONAL INJURY

365 Personal Injury -

Product Liability

367 Health Care/

Pharmaceutical 

Personal Injury

Product Liability

368 Asbestos Personal

Injury Product 

Liability

PERSONAL PROPERTY

370 Other Fraud

371 Truth in Lending

380 Other Personal

Property Damage

385 Property Damage

Product Liability

625 Drug Related Seizure

of Property 21 USC § 881

690 Other

422 Appeal 28 USC § 158

423 Withdrawal

28 USC § 157

375 False Claims Act

376 Qui Tam (31 USC

§ 3729(a))

400 State Reapportionment

410 Antitrust

430 Banks and Banking

450 Commerce

460 Deportation

470 Racketeer Influenced and

Corrupt Organizations

480 Consumer Credit

490 Cable/Sat TV

850 Securities/Commodities/

Exchange

890 Other Statutory Actions

891 Agricultural Acts

893 Environmental Matters

895 Freedom of Information

Act

896 Arbitration

899 Administrative Procedure

Act/Review or Appeal of 

Agency Decision

950 Constitutionality of

State Statutes

PROPERTY RIGHTS

820 Copyrights

830 Patent

840 Trademark

LABOR SOCIAL SECURITY

710 Fair Labor Standards

Act

720 Labor/Management

Relations

740 Railway Labor Act

751 Family and Medical

Leave Act

790 Other Labor Litigation

791 Employee Retirement

Income Security Act

861 HIA (1395ff)

862 Black Lung (923)

863 DIWC/DIWW (405(g))

864 SSID Title XVI

865 RSI (405(g))

REAL PROPERTY CIVIL RIGHTS PRISONER PETITIONS FEDERAL TAX SUITS

210 Land Condemnation

220 Foreclosure

230 Rent Lease & Ejectment

240 Torts to Land

245 Tort Product Liability

290 All Other Real Property

440 Other Civil Rights

441 Voting

442 Employment

443 Housing/

Accommodations

445 Amer. w/Disabilities

Employment

446 Amer. w/Disabilities

Other

448 Education

Habeas Corpus:

463 Alien Detainee

510 Motions to Vacate

Sentence

530 General

535 Death Penalty

Other:

540 Mandamus & Other

550 Civil Rights

555 Prison Condition

560 Civil Detainee -

Conditions of 

Confinement

870 Taxes (U.S. Plaintiff

or Defendant)

871 IRS-Third Party

26 USC § 7609

IMMIGRATION

462 Naturalization Application

465 Other Immigration

Actions

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): 29 USC Sections 203, 206, 207

Brief description of cause: Failure to Pay Wages, etc.

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: January 9, 2017 SIGNATURE OF ATTORNEY OF RECORD: /s/ Delia A. Isvoranu