UNITED STATES DISTRICT COURT 

DISTRICT OF OREGON 

EUGENE DIVISION 

FILED 12 SEP '14 i5:111JSOC·ORE 

Civil €ase No. !e :\~·c.v- 014~3- {\(.(_ 

{to be assigned by Clerk of the Court} 

(Enter Jull name of plaintiff(s)) 

COMPLAINT 

Plaintiff(s), 

Defendant(s). 

I. PARTIES 

List your name, address, and telephone number below, and the same information for each 

defendant. Make sure that the defendant(s) listed below are identical to those contained in the 

caption ofthe complaint. Attach additional sheets of paper if necessary. 

Plaintiff 

COMPLAINT 

Revised: July 20, 20 I 0 

Name: (Y\,cyr\1\ k C--\+A::-N ~v( 

Street Address: 31 ~ '2( tC o;"-i~ lJ A) fSLv .l:f Lj z._ 

City, State & Zi;Code: ~i 2'1-~ 0 fZ.. q ( 4a J 

TelephoneNo. S'Q·), .--~VI- !o '2--r -

Page I 

Case 6:14-cv-01463-MC Document 1 Filed 09/12/14 Page 1 of 5
Defendant No. 1 

Defendant No.2 

Defendant No.3 

Defendant No.4 

Name --~~~~----~--------------~---~0\v,.\o-6 ~ Street Address: J:b ~ ~ a-v~o \ q_ ~ · 

. City, State & Zip Code: Sf r ~ :11 ~<.. Q ~ (!, 

Telephone No. 5'Y t ~ (~ err~ - l roo 

Name: tVll cfA ((_~ :r {":>-Y( M v 

Street Address: .;l :2 [&? I"'\ ~4:> (._" P.,.l) 

City, State & Zip Code: (\'{ 'sp-::JJ , 0 jL. 

Telephone No. :)Lf( ~ s L '6 o{J 

Name: Crxr f\.-frJ £ ~9 IV\ ~~L 

Street Address: · 11_JeD f-{A-rc.ol,4 t2-9 

City, State & Zip Code Sp f/lV~ fid._p o/ 17 '-/7 7 

Telephone No. -----'-· -----------------------

II. JURISDICTION 

··Federal courts are courts of limited jurisdiction. Only two types of cases can be heard in 

federal court: cases involving a federal question and cases involving diversity of citizenship of the 

parties. A case involving the United States Constitution or federal laws or treaties is a federal 

question case. A case in which a citizen of one state sues a citizen oj another state and the amount 

in damages claimed is more than $7 5, 000 is a diversity of citizenship case. 

A. What is the basis for federal court jurisdiction (check all that apply) 

~ ederal-Question D Diversity of Citizenship 

COMPLAINT Page 2 

Revised: July 20, 20 l 0 

Case 6:14-cv-01463-MC Document 1 Filed 09/12/14 Page 2 of 5
v 

B. 

C. 

If the basis for jurisdic~i~m is Federal Question, what feder~l~.onstitution~l, statutory, or 

treaty right is at issue? \\\~Qv\'V~ O~ ~ 1~ ~~ 

Plaintiff(s) state of citizenship---~-·· __________________ _ 

Defendant(s) state(s) of citizenship ___________________ _ 

III. STATEMENT OF CLAIMS 

Claim I 

State here as briefly as possible the [acts of your case. Describe how each defendant was 

involved, when the conduct occurred, and any injuries you have suffered as a result. It is not 

necessary to give any legal arguments or cite any cases or statutes. 

J.re_ .\v Mo-.tV ~ ::) 

COMPLAINT Page 3 

Revised: July 20, 20 I 0 

Case 6:14-cv-01463-MC Document 1 Filed 09/12/14 Page 3 of 5
Claim II 

State here as briefly as possible the [acts of your case. Describe how each defendant was 

involved, when the conduct occurred, and any injuries you have suffered as a result. It is not 

necessary to give any legal arguments or cite any cases or statutes. 

Wail!C;- 0u-\-.- ~ ~ Su:>- ~-

(If you have additional claims, describe them on another piece of paper, using the same outline.) 

COMPLAINT Page 4 

Revised: July 20, 20 I 0 

Case 6:14-cv-01463-MC Document 1 Filed 09/12/14 Page 4 of 5
I"':. 

IV. RELIEF 

.if any, of 

I declare under penalty of perjury that the foregoing is true and correct. 

Signed this i-4=- day of 7 Lr ~-~ _q- ' 20 

COMPLAINT Page 5 

Revised: July 20, 20 l 0 

Case 6:14-cv-01463-MC Document 1 Filed 09/12/14 Page 5 of 5