~JS 44 (Rev. 12/07) CIVIL COVER SHEET 

The JS 44 civil cover sheet and the information contained herein neither replace nor supplement the filing and service ofpleadings 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 requrred for the use of the Clerk of Court for the purpose ofmitiating 

the civil docket sheet. (SEE INSTRUCTIONS ON THE REVERSE OF THE FORM.) 

I. (a) PLAINTIFFS 

(b) County of Residence of First Listed Plaintiff ·1 ;:::u-.,kS 6-T\ ....... (EXCEPT IN U.S. PLAINTIFF CASES) 

(c) Attorney's (Finn Name, Address, and Telephone Number) 

DEFENDANTS 

County of Residence of First Listed Defendant 

(IN U.S. PLAINTIFF CASES ONLY) 

NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF THE 

LAND INVOLVED. 

Attorneys (If Known) 

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

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

01 U.S. Government 03 Federal Question PTF DEF PTF DEF 

Plaintiff (U.S. Government Not a Party) Citizen of This State -,zl1 0 I Incorporated or Principal Place 0 4 0 4 

of Business In This State 

f.;_ U.S. Government 0 4 Diversity Citizen of Another State 0 2 0 2 Incorporated and Principal Place 0 5 0 5 

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

Citizen or Subject of a 0 3 0 3 Foreign Nation 0 6 0 6 

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

···~ti\ii"CONTRA!'m:, .. \'j;:;,: c /,t~it~~y;:NtJXMiL~: 0.~'{:!ATORTS>i\' ;,:>.t •. ,. c.> ?ttJii"\JHlt lbFORFEITUREIPENALTYdhii ;;;,_~.:- ,: .• >BANKRUPTCY'idhi;.· >. t}.%4%\0THER'STATIJTES>ttd!'im 

0 110 Insurance PERSONAL INJURY PERSONAL INJURY 0 610 Agriculture 0 422 Appeal 28 USC 158 0 400 State Reapportionment 

0 120 Marine 0 310 Airplane 0 362 Personal Injury - 0 620 Other Food & Drug 0 4 23 Withdrawal 0 410 Antitrust 

0 130 Miller Act 0 315 Airplane Product Med. Malpractice 0 625 Drug Related Seizure 28 usc 157 0 430 Banks and Banking 

0 140 Negotiable Instrument Liability 0 365 Personal Injury - of Property 21 USC 881 0 450 Commerce 

0 150 Recovery of Overpayment 0 320 Assault, Libel & Product Liability 0 630 Liquor Laws '!10\PRC PER'RY,RIGiffSltvFJ 0 460 Deportation 

& Enforcement ofJudgment Slander 0 368 Asbestos Personal 0 640 R.R. & Truck 0 820 Copyrights 0 470 Racketeer Influenced and 

0 151 Medicare Act 0 330 Federal Employers' Injury Product 0 650 Airline Regs. 0 830 Patent Corrupt Organizations 

0 152 Recovery of Defaulted Liability Liability 0 660 Occupational 0 840 Trademark 0 480 Consumer Credit 

Student Loaus 0 340 Marine PERSONAL PROPERTY Safety/Health 0 490 Cable/Sat TV 

(Excl. Veterans) 0 345 Marine Product 0 370 Other Fraud 0 690 Other 0 810 Selective Service 

0 153 Recovery of Overpayment Liability 0 371 Truth in Lending --"''i«-"~''''" ·.;;JtiJABOR .;)·!~ tJJSOCJAESECURJTYAb·'• .,., 0 850 Securities/Commodities/ 

of Veteran's Benefits 0 350 Motor Vehicle 0 380 Other Personal 0 710 Fair Labor Standards 0 861 HIA (!395ft) Exchange 

0 160 Stockholders' Suits 0 355 Motor Vehicle Property Damage Act 0 862 Black Lung (923) 0 875 Customer Challenge 

0 190 Other Contract Product Liability 0 385 Property Damage 0 720 Labor/Mgmt. Relations 0. 863 DIWC/DIWW (405(g)) 12 usc 3410 

0 195 Contract Product Liability 0 360 Other Personal Product Liability 0 730 Labor/Mgmt.Reporting ~· 864 SSID Title XVI 0 890 Other Statutory Actions 

0 196 Franchise Injury & Disclosure Act 0 865 RSI (405(g)) 0 891 Agricultural Acts 

i#lt.aREAL4 PROPERTY '~'' .. '';".1/GlVWtRIGHTSi;i:i, :i: ':PRJSONER,PETITIONS:·.:· 0 740 Railway Labor Act ,,;;;FEDERAli:I'AXSUITS;;;;~ 0 892 Economic Stabilization Act 

0 210 Land Condemnation 0 441 Voting 0 510 Motions to Vacate 0 790 Other Labor Litigation 0 870 Taxes fU.S. Plaintiff 0 893 Environmental Matters 

0 220 Foreclosure 0 442 Employment Sentence 0 791 Empl. Ret. Inc. or Defendant) 0 894 Energy Allocation Act 

0 230 Rent Lease & Ejectment 0 443 Housing/ Habeas Corpus: Security Act 0 871 IRS-Third Party 0 895 Freedom oflnformation 

0 240 Torts to Land Accommodations 0 530 General 26 usc 7609 Act 

0 245 Tort Product Liability 0 444 Welfare 0 535 Death Penalty ~tii/:IMMIGRAtrlON,,, ;, ··' 0 900Appeal of Fee Determination 

0 290 All Other Real Property 0 445 Amer. w/Disabilities- 0 540 Mandamus & Other 0 462 Naturalization Application Under Equal Access 

Employment 0 550 Civil Rights 0 463 Habeas Corpus- to Justice 

0 446 Amer. w/Disabilities - 0 555 Prison Condition Alien Detainee 0 950 Constitutionality of 

Other 0 465 Other Immigration State Statutes 

0 440 Other Civil Rights Actions 

V. ORIGIN 

0 I Original 

Proceeding 

(Place an "X" in One Box Only) 

0 2 Removed from 0 3 Remanded from 

Appellate Court 

O 4 Reinstated or O 5 Transferred from 

Reopened another district 0 6 Multidistrict ·¢ 7 

Litigation 

Appeal to District 

Judge from 

Magistrate State Court Jud ment 

Citet 

~~====~~~----~~~~~~~~~~-~-P~C~~~~~~~~~~l VII. REQUESTED IN DEMAND$ ly if demanded in complaint: 

COMPLAINT: JURY DEMAND: 0 Yes 0 No 

VIII. RELATED CASE(S) 

IF ANY 

DATE 

FOR OFFICE USE ONLY 

RECEIPT# AMOUNT 

(See instructions): JUDGE 

SIGNATURE OF ATTORNEY OF RECORD 

APPLYING IFP -------- -------------

DOCKET NUMBER 

JUDGE MAG. JUDGE --------- ---------------

Case 1:15-cv-00423-SU Document 1-1 Filed 03/13/15 Page 1 of 1