JS 44 (Rev. 12/12) CIVIL COVER SHEET FILED :3 SEP '1510:181.JSDC·ORP 

The JS 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 by the Judicial Conference of the United States in September 1974, is required for the use of the Clerk of Court for the 

purpose of initiating the civil docket sheet. (SEE INSTRUCTIONS ON NEXT PAGE OF THIS FORM.) 

I. (a) PLAINTIFFS .:;7;.tJt.fJ fl 

'!' 

lf\r ofR'lidence of First Listed Defendant 

\ '\' • ' (IN U.S. PLAIN11FF CASES ONLY) 

(b) County of Residence ofFirst Listed Plaintiff 

(EXCEPT IN U.S. PLAINTIFF CASES) 

N : IN LAND CONDEMNATION CASES, USE THE LOCATION OF • THE TRACT OF LAND INVOLVED. 

( C) Attorneys (Firm Name, Address, and Telephone Number) Attomeys(lfKnown) PoA rJ-AAIP C!rtj Alltf, 

II. BASIS OF JURISDICTION (Place an "X" in One Box Only) 

0 1 U.S. Govermneot 

Plaintiff 

Federal Question 

(US. Government Not a Party) 

III. CITIZENSHIP OF iNCtAL PARTIES (Place an "X" in One Bmcfor Plaintiff 

(For Diversity Cases Only) and One Bmcfor Defendant) 

D PTF DEF 

Citizen of This State 1 1 Incorporated or Principal Place CJ 4 CJ 4 

0 2 U.S. Government 

Defendant 

0 4 Diversity 

(Indicate Citizenship of Parties in Item Ill) 

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

I 

Citizen of Aoodter State 

Citizen or Subject of a 

Forei C 

of Business Jn This State 

CJ 2 CJ 2 Incorporated and Principal Place CJ 5 CJ 5 

of Business Jn Anodter State 

CJ 3 CJ 3 Foreign Nation CJ6 CJ6 

.. CJ l IO Insurance PERSONAL INJURY PERSONAL INJURY CJ 625 Drug Related Seizure CJ 422 Appeal 28 USC 158 CJ 375 False Claims Act 

CJ 120 Marine CJ 310 Airplane CJ 365 Personal lnjmy - of Property 21 USC 881 CJ 423 Wididrawal CJ 400 Stal<: Reapportionment 

CJ 130 Miller Act CJ 315 Airplane Product Product Liability CJ 690 Odter 28 USC 157 CJ 410 Aotitrust 

CJ 140 Negotiable Instrument Liability CJ 367 Health Care/ CJ 430 B...ics and Banking 

CJ 150 Recovery ofOvapayment CJ 320 Assault, Libel & Pharmaceutical J:;J:ijiiiiitii·iii·i]-11[1:,.=::J CJ 450 Commerce 

& Enforcement of Judgment Slander Personal Jnjwy CJ 820 Copyrights CJ 460 Deportation 

CJ 151 Medicare Act CJ 330 Federal Employers' Product Liability CJ 830 Patent CJ 4 70 Racketeer Influenced and 

CJ 152 Recovery of Defaulted Liability CJ 368 Asbestos Personal CJ 840 Trademark Conupt Organizations 

Student Loans CJ 340 Marine Injwy Product CJ 480 Conswner Credit 

(Excludes Veterans) CJ 345 Marine Product Liability i:===j·~ .. Wi•===::t:::m' -i:·ii•.&~, •i:ii'fiiiif·L=:J CJ 490 Cable/Sat TV 

CJ 153 Recovery of Overpayment Liability PERSONAL PROPERTY CJ 710 Fair Labor Standards CJ 861 IDA (13951l) CJ 850 Secmities/Commodities/ 

of Veteran's Benefits CJ 350 Motor Vehicle CJ 370 Other Fraud Act CJ 862 Black Lung (923) Exchange 

CJ 160 Stockholders' Suits CJ 355 Motor Vehicle CJ 371 Truth in Lending _CJ 720 Labor/Management CJ 863 DIWC/DJWW (405(g)) CJ 890 Odter Statutory Actions 

CJ 190 Odter Contract Product Liability CJ 380 Odter Personal Relations CJ 864 SSID Tide XVI CJ 891 A "cultural Acts 

CJ 195 Contract Product Liability CJ 360 Odter Personal Property Damage CJ 740 Railway Labor Act CJ 865 RSI (405(g)) CJ 893 vironmental Matters 

CJ 196 Franchise lnjwy CJ 385 Property Damage CJ 751 Family and Medical CJ 895 reedom oflnfonnation 

CJ 362 Personal Injury - Product Liability Leave Act Act 

Medical cc CJ 790 Odter Labor Litigation CJ 96 Atbitration 

,.---:::_,::.,':":"&1-::pa=,=-,=-TY:::;---t--'='.:1::;w:;-:=: ~Hl'S~L~::tl!§i§!!g[iP~nTflONffill~S[jCJ 791 Employee Retirement t--,n:=n"'••=u"u.,...."=y""u;'=""'='11TI1=,....._, 899 Administrative Procedure 

CJ 210 Land Condemnation CJ 440 Other Civil Rights Habeas Corpus: Income Secmity Act CJ 870 Taxes (U.S. Plaintiff Act/Review or Appeal of 

CJ 220 Foreclosure CJ 441 Voting CJ 463 Alien Detainee or Defendant) Agency Decision 

CJ 230RentLease&Ejectment CJ 442Employrnent CJ 510MotionstoVacate CJ 871 IRS-ThirdParty CJ 950Constitutionalityof 

CJ 240 Torts to Land CJ 443 Housing/ Sentence 26 USC 7609 State Statutes 

CJ 245 Tort Product Liability Accommodations CJ 530 General 

CJ 290 All Other Real Property CJ 445 Amer. w/Disabilities - CJ 535 Death Penalty IMMIGRATION 

Employment Other: 

CJ 446 Arner. w/Disabilities - CJ 540 Mandamus & Odter 

CJ 462 Natundization Application 

CJ 465 Other Immigration 

Odter Actions 

CJ 448 Education 

V._;f)RIGIN (Place an "X" in One Box Only) 

l9'i Original 0 2 Removed from 

Proceeding State Court 

VII. REQUESTED IN 

COMPLAINT: 

CJ 550 Civil Rights 

CJ 555 Prison Condition 

CJ 560 Civil Detainee -

Conditions of 

Confinement 

0 3 Remanded from 

Appellate Court 

VIII. RELATED CASE(S) 

IFANY (See instructions): 

JUDGE 

DATE SIGNA 

FOR OFFICE USE ONLY 

RECEIPT# AMOUNT APPL YING IFP 

0 4 Reinstated or 0 

Reopened 

JUDGE 

0 6 Multidistrict 

Litigation 

C CK YES only if demanded in complaint: 

JURY DEMAND: 0 Yes 0 No 

DOCKET NUMBER 

MAG.JUDGE 

I 

Case 3:15-cv-01666-SI Document 2-1 Filed 09/03/15 Page 1 of 1