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had not prigimally been ailing “be Shoe,

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- 8 ia)


Vi. STATEMENT OF CLAIMS:

State what rights under the Constitution, laws, or treaties of the United States you claim have been violated.
Be specific. Number each separate claim and relate it to the facts alleged in Section V. If claims are not
related to the same basic incident or issue, they must be addressed in a separate civil rights

complaint.
Breach of contract - Failure to perform an obligation.

Because of that, I suffered emotional nain They took my mone
under false pretense and they both lied to me on the phone each

time I called. I became aggravated. I have recorded their

conversation with help of the prison staff to use as proof

VIL = RELIEF REQUESTED:
State briefly what relief you seek from the Court. Do not make legal arguments or cite to cases/ statutes.
‘tT Requesting a full refund of $2000. ‘I'm also requesting

reimbursement of $1000 for filing fee, phone calls and
mail correspondence.

1 DECLARE UNDER PENALTY OF PERJURY THAT THE FOREGOING STATEMENTS OF FACT,
INCLUDING ALL CONTINUATION PAGES, ARE TRUE AND CORRECT-- >

May 26, 2010 .
(Date) : (Signature of Plaintiff)

IF MAILED BY PRISONER:

| declare (or certify, verify, or affirm) under penalty of perjury that this complaint was (check one):
O delivered to prison officials for mailing or deposited in the prison's internal mail system on:
the 25 day of __Ma ,20_10.

Wcheberte- Mbetattite cera

(Signature of Plaintiff)

= Revised 03/07


UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF FLORIDA
TALLAHASSEE DIVISION

CIVIL RIGHTS COMPLAINT FORM
TO BE USED BY PRISONERS IN ACTIONS UNDER 42 U.S.C. § 1983

MICHELINE HAMMOUDA

Inmate # _53922-053
(Enter full name of Plaintiff)

CASE NO: 4'10cvald= RikJwes

vs.
(To be assigned by Clerk)

JOSE FRANCISCO & ASSOCIAT.

AND

HENRY E. MARINES

(Enter name and title of each Defendant.
If additional space is required, use the
blank area below and directly to the right.)

ANSWER ALL QUESTIONS ON THE FOLLOWING PAGES:



CERTIFICATE OF SERVICE

This is to certify that I have served a true and correct copy of the foregoing:

CIVIL RIGHTS ACTIONS UNDER. 42 UiS.C. § 1983

: 3
upon the following addresses, by placing same in a sealed envelope, bearing sufficient

postage for delivery via the United States Postal Service, to:

CLERK, U.S. DISTRICT COURT

111 N. ADAMS STREET

SUITE 322

TALLAHASSEE, FLORIDA 32301-7730

and deposited it in the postal box provided for inmates on the: grounds of the Federal

Correctional Institution, Tallahassee, Florida, 32301, on this’ 26th day of

MAY 2010 |

Signature

Register No. 53922-053

Federal Correctional Institution
501 Capital Circle N.E.
Tallahassee, Florida 32301

i Litigation is deemed FILED at the time it was delivered to prison authorities,
See Houston y. Lack, 487 US 266, 101 L Ed 2d 245, 108 S Ct 2379 (£988).



L PLAINTIFF:

State your full name, inmate number (if applicable), and full mailing address in the lines below.

Name of Plaintiff: MICHELINE HAMMOUDA

Inmate Number 53922-053
"| PCI, TALLAHASSEE

Prison or Jail:
Mailing address: 501 CAPITAL CIRCLE, NE
TALLAHASSEE,
e FL. 32301 3
11 DEFENDANT(S):

State the name of the Defendant in the first line, official position in the second line, place of
employment in the third line, and mailing address. Do the same for every Defendant: ,

(4) Defendant's name: JOSE FRANCISCO

Officiat position: PARALEGAL

Employed at: JOSE FRANCISCO & ASSOCIATES
9100 SOUTH DADELAND BLVD:, 15TH FLOOR

‘ Mailing address:

33156

—MIAMI, FL. 33156
(2) Defendant's name:

Official position:
Employed at:

Mailing address:

(3) Defendant's name: HENRY EDUARD MARINES

Official position: ATTORNEY
9885 SW 72ND STREET

Employed at:
Mailing address: SUITE A200

MIAMI, FL. 33173

ATTACH ADDITIONAL PAGES HERE TO NAME ADDITIONAL DEFENDANTS


6. Facts and claims of case:

(Attach additional pages as necessary to list cases.) , *

Vv. STATEMENT OF FACTS:

State briefly the FACTS of this case. Describe how each Defendant was involved and what each person did
or did not do which gives rise to your claim. In describing what happened, state the names of persons
involved, dates, and places. Do not make any legal arguments or cite to any cases or statutes. You must set
forth separate factual allegations in separately numbered paragraphs. You may make copies of this page if
nécessary to supply all the facts. Barring extraordinary circumstahices, no more than five (5) additional pages
should be attached. (If there are facts which are not related to this same basic incident or issue, they
must be-addressed in a separate civil rights complaint.)

SEE ATTACHMENT