IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF OREGON F ILED(I4 AUG '14 11 :!J9USDC ·ORP 

tSK.\\oxo l-eW s fned,g'n~ ~ (Enter full name of plaintiff(s)) 

Plaintiff(s), 

v. 

Set. Do..ve.- Q~eJ 

Oeyuhf 5\'K\i ~ ~ C..h\A.~ 

~'ru..v\f-9- hM H~Killf'C nne\ =fut., 

(Enter full name of defendant(s)) 

Defendant(s). 

cv-125 o-cL ~~ , .. Civil Case No. 

CIVIL RIGHTS COMPLAINT 

I. 

A. Have you brought any other action or appeal in a court of the United States while a 

prisoner? 

Yes ~ No -XB. If your answer to A is yes, how many? Q . Describe the lawsuit(s) in the 

space below. (If there is more than one lawsuit, describe the additional lawsuits on 

another piece of paper, using the same outline.) 

1. Parties to the previous lawsuit: .. Plaintiff(s): ~6~.~~10)M~d~~jp~l@!;~""-;;!h£.S~l£l~~~~~~~Y~'lf-=~~ 

Defendant(s): -----------------

CIVIL RIGHTS COMPLAINT 

Revised: October 26, 2001 

Page 1 

Case 6:14-cv-01250-CL Document 2 Filed 08/04/14 Page 1 of 8
2. Court: 0 1 ¥J4 \ &>cu-+ tJ~ AppeoJ:S 

3. DocketNumber: ~ A15S /5S 

4. Name of judge to whom case was assigned: t.IQmrJ d 

5. Disposition (Was ~e case dismissed? Was it appealed? Is it still pending?) 

fsft~\\ \>&d\'~ 

6. Approximate date of filing: _.Nvs;g;""v\r\'oeJ~....,...-oll:;j:ZO~+~odqt~· 

7. Approximate date of disposition: .....--- t b « ' ,.,. 

B. Is there a prisoner grievance procedure in this institution? 

Yes )( No --- ---

C. . Have you filed a grievance concerning the facts relating to this complaint? 

Yes --- No K 

If your answer is no, explain why not: \=\c,.:, ~~ · :\o 

do , Ja\.. ~~ \no\nuho(\ . 

D. Is the grievance process completed? 

Yes 

CIVIL RIGHTS COMPLAINT 

Revised: October 26, 2001 

--- No ---

Page2 

Case 6:14-cv-01250-CL Document 2 Filed 08/04/14 Page 2 of 8
III. PARTIES 

(In item A below, place your name in the first blank and place your present address in the 

second blank. Do the same for additional plaintiffs, if any.) 

A. Name of plaintiff: H~cho.,.vJ Lew', 'S 6oe.c\ '.fj'hft ffi'€ 6 

Security Identification No.: \ ~ ~ 51 <o d. S 

Address: 3'l:l~ ~urm;ooc\ va Mo..e\v-~, DR 

________________________ 9,/7~1 

(In item B, place the full name of each defendant, his/her official position, and his/her place 

of employment. 

B. Defendant 

at ynn 

O<k"Ve oee.\ is emplo:ed as Se.a.v-¢ 

~~ S~,ffi off,ce.- \\\'S~nSt 5E J\\~.t:Q.. Cf1~22-

Defendant "Ste.ve.o CbuY<:h is employed as ~u_N ~er\ff 

at L,nn Ctli."<\..'h.f Sh-e.Yl£fs r:RIM~ '\ l'OJ~ st.% Atba.n-{ ,of.... 

'{732...2 

Defendant '11M t\v.el\.e Y · is employed as $)\gy~_£..£ 

at UYW\ Ctl t.cli 5\uYttfs cffiCR.~ /1)5 r.Lcd<so1st Sf 11/flw(,att 

?732--2 

Defendant Gn'(\ c~ ~ iJ-p}oyed as -=======:...__-

at //15 dQci<St>n. "31- S£ Al~y 1 D/t 97322_ 

Defendant ________ is employed as ______ _ 

ru _____________________ _ 

Additional defendants:----------------

CIVIL RIGHTS COMPLAINT 

Revised: October 26, 2001 

Page 3 

Case 6:14-cv-01250-CL Document 2 Filed 08/04/14 Page 3 of 8
IV. STATEMENT OF CLAIM 

Claim I 

State what right under the Constitution, laws, or treaties of the United States has been 

violated. 

Supporting Facts: (State here as briefly as possible the facts of your case. Describe how 

each defendant is involved and when the conduct occurred. It is not necessary to give any legal 

II)?" 11 rments or cite any ccz_ses or statutes.J. "'· • , 

~ Wli.JI<Jrs davJO tk hh-«t 1n oRil-mn wurrly)qnr .fa.\nrca Glhc\. IV\\~ "0 "M.f bv._fil. ~ ~~ ~- t: ~ 

a>f'tO~ bt ~ OW!-L'-L )\.O~Wf-\!t\ ~\\m a& 'M1..1>,~!\ clu.n ttw~">\un3 ~~L ~ du((d~. ~a.~~~tk.cl ~ -h'tc4 -to CoM'~~ cd ~ ~~~ u~ ::f~ ~"' ~ ~ ~ ~~ ~''~ \;""\A.d.•e.)'"'. :t ~~~ do\,Ul\ ~ \1\L cam~ "h -h>~q IY\\1 \rAncVo 00. Ml.i woo\ i .t.>hlc~ 'l: o\d . EtJ:U\ ~"'€>~ ~ ~ 

en ~ ~ ha... ~t 'Oel"f'O CAt (\I'CL. ~ rlb ec:.e • ~ ~ 01\~ f':"-\\~ ~ ().1'\~ ~~ cvt t:R- "'~ cor. --r. -\u.'ffi -\b \m1. o.M ~ ~ \nc,Xleh o.re eo~ 'nt ~ All of~'~ ace~ ~~c. ~\&L hJ,..n-Cl.<e.~ <!.£..U.\ '«tck.- ~T "(\"(.., ~ ~ ~ \~~ C¥\W\+cd or. ,(.3) ~ ~ ~ -\t. ~ ~\-, C~ 

~ ~~~~~~1t ~~~Gd~("'e.~~k~ ;c ~ h~~~~ 

~~ ~ d\d -\o' ~ ~ -:t "-\.\. 'h ~ ooc.e. .L':$ ."* "'~'"'~ ~~nt QL\~,~ od- 'W-ic.. t!> ~ ·\1 u~e; ~~ 

~ ~ ~ ID -\\1\a.. o.i~ .Uo.) ~,l~ o\-nk.im -Gem ~(" rkQ~d ~ D~i r ~ 

4o ,,....__ .... i)~~ll~~~~~~~ 

~ ~" oq~ 2 ~ e,&y ~~ -\o ~sv-e<'* U>~ ~ ~· 

t6) ~ ~ -l-eJuu1 fo AibCtftt Gr.rur:d f-k,s{;rkJ /Or ,Ot>:b/!1!< fo.cJtJ {lya.Jt,u.e_ 

a.u.c.rd~ k Lyfltl6 /;:MT~ ]'kL, pt>Siib~ -IJ.u~J -{frochtrr:. t!JCC U~ A--o111 

sa+. Dre.ls ad-tons as IYJ?Itftorre& ,'n (3). /+II af #,/6 oCCW'1'V<.9 

oo ,4:3 ~ C)o Ja a-t- o..p,o coQl '~21 g :oo fM. 

CIVIL RlGHTS COMPLAINT 

Revised: October 26, 2001 

Page4 

Case 6:14-cv-01250-CL Document 2 Filed 08/04/14 Page 4 of 8
Claim II 

State what right under the Constitution, laws, or treaties of the United States has been 

vi.olated. 

Supporting Facts: (State here as briefly as possible the facts of your case. Describe how 

each defendant is involved and when the conduct occurred. It is not necessary to give any legal 

arguments or cite any cases or statutes.) . 

:r:: 'rfll\\.e~f (3) ~~) l'i\ Su.\'~Of~ focl-s \n ~\o.\ro \ ) 

. &d. c\.uo =to =""' \~ :I . "5uffired se ve_re_ \) \'('\ ?)N\ 

CIVIL RIGHTS COMPLAINT 

Revised: October 26, 2001 

Page 5 

Case 6:14-cv-01250-CL Document 2 Filed 08/04/14 Page 5 of 8
Claim III 

State what right under the Constitution, laws, or treaties of the United States has been 

violated. 

.. E '<a "'-±h 1\ fi"\.U\tl~ <'t 

Supporting Facts: (State here as briefly as possible the facts of your case. Describe how 

each defendant is involved and when the conduct occurred. It is not necessary to give any legal 

arguments or cite any cases or statutes.) 

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

CIVIL RIGHTS COMPLAINT 

Revised: October 26, 2001 

Page 6 

Case 6:14-cv-01250-CL Document 2 Filed 08/04/14 Page 6 of 8
V. RELIEF 

State briefly exactly relief you are seeking. Make no legal arguments. Cite no cases or 

statutes. 

Signed this 31 day of__.... J'-=u"'-'-\'-f .,._ ____ , 20 li_. 

CIVIL RIGHTS CO:MJ>LAINT 

Revised: October 26, 2001 

Page 7 

Case 6:14-cv-01250-CL Document 2 Filed 08/04/14 Page 7 of 8
F ILED04 AUG '14 11 :()8\JSDC·ORP 

AFFIDAVIT OF MAILING 

CASENAME: 'R,~ ~S ~~v· ~~\-\~~~"~~1.\.<>J ~o~~ 

CASE NUMBER: (if known) ___________________ _ 

being duly sworn on oath, depose 

and say: That I am incarcerated by the Oregon Department of Corrections at \)e.OJ( 'R\C~~ 

c~~ ~:\uttoo e 39~ £ &>~d v-c:\ ~('o....s, o~ ccn'-} 1 

That on the 311< day of J,J'1 , 20 If, I personally placed in the 

Correctional Institution's mailing service A TRUE COPY of the following: 

J;nnok &'tcic9'ku~ ~WJ fluount J f.qftf,cuk. of fJCCUY~ ~fo.rcdr~ 1 flpp /,c.ufton ~.eVek~n 

-h. ~~ ,;., ~ f~~ ; 6vil Covu Skc!:1 Gvil ((cjk±s C'oMflo,'rt-t-16u£6P s,""':?•'J::ri.tt .. ., 

I placed the above in a securely enclosed, postage prepaid envelope, to the person(s) 

named at the places addressed below: 

::~:::re~ · Signe and s om to (or affirmed) before me on 

L1J 

blic-State of Oregon 

My Commission expires: 4-13 -C)..Oik, I 

Page 1 of 1 -Affidavit ofMailing 

OFFICIAL SEAL 

MARIAN T GEILS 

NOTARY PUBLIC • OREGON 

COMMISSION NO. 467002 

MY COMMISSION EXPIRES APRIL 13,.2016 

Form 02.040 

Case 6:14-cv-01250-CL Document 2 Filed 08/04/14 Page 8 of 8