Opinion

Modeste v. Michael

Court: District Court, S.D. Florida
Filed: Feb 18, 2021
Cited by: 0 cases
Authority: More cited than 20.1%

“[A]n action is frivolous if it is without arguable merit either in law or fact.”

How later courts described this case

“[A]n action is frivolous if it is without arguable merit either in law or fact.”

Written by the judges who cited it.

The opinion

UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF FLORIDA

Case No. 21-cv-20637-BLOOM

DEXTER ETIENNE MODESTE,

Plaintiff,

MICHAEL, et al.,

Defendants.

ORDER

THIS CAUSE is before the Court on Plaintiff Dexter Etienne Modeste’s Complaint

pursuant to 42 U.S.C. § 1983, (“Complaint”), ECF No. [2], and his Application to Proceed in

District Court without Prepaying Fees or Costs (“Application”), ECF No. [1]. The Complaint and

Application were filed in the United States District Court for the Southern District of New York

but are now before the Court pursuant to a transfer order. ECF No. [3]. For reasons set forth below,

the Application to Proceed in District Court without Prepaying Fees or Costs is denied, and the

Complaint is dismissed with leave to amend.

I. APPLICATION TO PROCEED IN FORMA PAUPERIS

Civil complaints filed by prisoners seeking in forma pauperis status under 28 U.S.C. §

1915 are subject to the provisions of the Prison Litigation Reform Act (“PLRA”). In order to

promote the speedy, just, and efficient administration of civil rights complaints subject to the

PLRA, the court has established forms to be used by prisoners for filing civil rights actions. The

court-approved form consists of (1) a cover sheet, (2) a complaint, (3) an application to proceed in

forma pauperis, and (4) an authorization form. The authorization form, when completed by the

plaintiff, directs the agency holding the plaintiff in custody to forward to the clerk of court a

certified copy of the plaintiff’s institutional trust fund account and to disburse from the plaintiff’s

account the full statutory filing fee in amounts specified by § 1915(b). Properly completing and

filing the authorization form satisfies the plaintiff’s obligation under § 1915(a)(2) to submit a

certified copy of the plaintiff’s trust fund account with the complaint.

Plaintiff’s Application is not accompanied by a certified copy of his inmate account

statement for the six-month period immediately preceding the filing of the Complaint nor does his

Application contain an authorization form. Plaintiff’s Application to Proceed in District Court

without Prepaying Fees or Costs is denied. Plaintiff may re-file his Application using the court-

approved form or he may pay the filing fee of $402 by the filing deadline.

II. FACTUAL ALLEGATIONS

Plaintiff alleges on December 21, 2020 he was attacked by “a drunk white female” he refers

to as “Sarah Anderson.” ECF No. [2] at 4. Later in the morning he was detained by a “black female

officer,” handcuffed, and taken to the Miami Beach Police Department in her cruiser. Id. Plaintiff

asked the officer if he was under arrest and she replied “no.” Id. Another officer took photos of

Plaintiff and Plaintiff was never given his Miranda rights. Id. Plaintiff was placed in a holding cell

and told again by the “black female officer” that he was not under arrest. Id. Different police

officers went through Plaintiff’s property and he was told by Detective Alsina that his property

was being impounded. Id. Detective Alsina screamed in his face telling him, “I know you did

everything, I will be pressing charges, trust me.” Id. Detective Alsina threatened to hurt Plaintiff

and then Plaintiff was returned to his cell. Id. at 5. Officer Smith walked by Plaintif’s cell and also

threatened Plaintiff, “Boy I will take you somewhere and hurt you.” Id. Officer Smith then placed

Plaintiff in handcuffs again and led him out of the cell and more words were exchanged between

Plaintiff and the officers. Id.

Plaintiff states that he suffered pain to his head and experiences frequent headaches. He

also states, “shoulder, wrist, right hand drainage [sic] mental stress trauma not able to sleep.” Id.

(alterations added). Plaintiff requests that his current case be dismissed, that he be assigned a

“special attorney,” and he requests $850,00 in compensation for punitive damages. Id.

III. STANDARD OF REVIEW

The Prison Litigation Reform Act (“PLRA”), as partially codified at 18 U.S.C.

§ 1915(e)(2)(B)(i)-(iii), requires courts to screen prisoner complaints and dismiss as frivolous

claims that are “based on an indisputably meritless legal theory” or “whose factual contentions are

clearly baseless.” Denton v. Hernandez, 504 U.S. 25, 32-33 (1992); Pullen v. Sec’y, Dep’t of Corr.,

No. 19-11797-C, 2019 WL 5784952, at *1 (11th Cir. Sept. 4, 2019) (“[A]n action is frivolous if it

is without arguable merit either in law or fact.”) (quoting Napier v. Preslicka, 314 F.3d 528, 531

(11th Cir. 2002)).

Under § 1915(e)(2)(B)(ii), a complaint may be dismissed if the court determines that the

complaint fails to state a claim on which relief may be granted. Wright v. Miranda, 740 F. App’x

692, 694 (11th Cir. 2018). The standard for determining whether a complaint states a claim upon

which relief can be granted is the same whether under section 1915(e)(2)(B) or Fed. R. Civ. P.

12(b)(6). See Pullen, No. 19-11797-C, WL 5784952, at *1 (citing Mitchell v. Farcass, 112 F.3d

1483, 1490 (11th Cir. 1997)).

Pursuant to Fed. R. Civ. P. 8, a complaint must contain “a short and plain statement of the

claim showing that the pleader is entitled to relief.” See Fed. R. Civ. P. 8(a)(2). There is no required

technical form, but “each allegation must be simple, concise, and direct.” Fed. R. Civ. P. 8(d)(1).

The statement must “give the defendant fair notice of what the . . . claim is and the grounds upon

which it rests.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007) (quotation marks omitted).

Thus, “a complaint must allege sufficient facts to state a claim that is plausible on its face.”

Pullen, No. 19-11797-C, 2019 WL 5784952 at *1 (citing Ashcroft v. Iqbal, 556 U.S. 662, 678

(2009)). The “factual allegations must be enough to raise a right to relief above the speculative

level.” Bell Atl. Corp., 550 U.S. at 555 (citations omitted). Plaintiff is obligated to allege “more

than mere labels and legal conclusions, and a formulaic recitation of the elements of a cause of

action will not do.” Quality Auto Painting Ctr. of Roselle, Inc. v. State Farm Indemnity Co., 917

F.3d 1249, 1262 (11th Cir. 2019) (quoting Bell Atl. Corp., 550 U.S. at 555).

However, a district court is not required to “rewrite an otherwise deficient pleading in order

to sustain an action.” Rodriguez, 794 F. App’x at 603) (quotation marks omitted) (citation omitted)

(quoting Campbell v. Air Jamaica Ltd., 760 F.3d 1165, 1169 (11th Cir. 2014)). Moreover, a district

court “should not abandon its neutral role and begin creating arguments for a party, even an

unrepresented one.” Sims v. Hastings, 375 F. Supp. 2d 715, 718 (N.D. Ill. 2005) (citing Anderson

v. Hardman, 241 F.3d 544, 545 (7th Cir. 2001)). When read liberally, a pro se pleading “should

be interpreted ‘to raise the strongest arguments that [it] suggest[s].’” Graham v. Henderson, 89

F.3d 75, 79 (2d Cir. 1996) (quoting Burgos v. Hopkins, 14 F.3d 787, 790 (2d Cir. 1994)).

Notwithstanding the leniency afforded to pro se litigants, it does not permit them to file an

impermissible “shotgun” pleading. The Eleventh Circuit has identified four rough types or

categories of shotgun pleadings. See Weiland v. Palm Beach Cnty. Sheriff’s Office, 792 F.3d 1313,

1321-23 (11th Cir. 2015) (citations omitted).

The most common type of shotgun pleading is one “containing multiple counts where each

count adopts the allegations of all preceding counts, causing each successive count to carry all that

came before and the last count to be a combination of the entire complaint.” Id. The next most

common type is a complaint that is “replete with conclusory, vague, and immaterial facts not

obviously connected to any particular cause of action.” Id. The third type of shotgun pleading is

one that does not separate into a different count each cause of action or claim for relief. Id. Fourth,

and finally, there is the relatively rare shotgun pleading that asserts multiple claims against

multiple defendants without specifying which of the defendants are responsible for which acts or

omissions or which of the defendants the claim is brought against. Id.

“The unifying characteristic of all types of shotgun pleadings is that they fail to one degree

or another, and in one way or another, to give the defendants adequate notice of the claims against

them and the grounds upon which each claim rests.” Id. The Eleventh Circuit has repeatedly

condemned the use of shotgun pleadings for “imped[ing] the administration of the district courts’

civil docket.” PVC Windoors, Inc. v. Babbitbay Beach Constr., N.V., 598 F.3d 802, 806 n. 4 (11th

Cir. 2010). Indeed, shotgun pleadings require the court to sift through rambling and often

incomprehensible allegations in an attempt to separate the meritorious claims from the

unmeritorious, resulting in a “massive waste of judicial and private resources.” Id. (citation

omitted). The Eleventh Circuit, thus, has established that shotgun pleading is an unacceptable form

of establishing a claim for relief. Strategic Income Fund, LLC v. Spear, Leeds & Kellogg Corp.,

305 F.3d 1293, 1296 (11th Cir. 2002).

IV. DISCUSSION

First, Plaintiff’s Complaint is replete with conclusory, vague, and immaterial facts not

obviously connected to any particular cause of action and is therefore a quintessential shotgun

pleading.

Second, because the Complaint identifies more than one defendant, adherence to Fed. R.

Civ. P. 10 should be followed more closely. Pursuant to Fed. R. Civ. P. 10(b), “[a] party must state

its claims or defenses in numbered paragraphs, each limited as far as practicable to a single set of

circumstances.” To promote clarity, “each claim founded on a separate transaction or occurrence

. . . must be stated in a separate count or defense.” Fed. R. Civ. P. 10(b). Here, Plaintiff’s claims

against multiple defendants would be clearer if different claims were separated by count. Plaintiff’s

failure to do so also reveals that the Complaint qualifies as the third category of shotgun pleading

for not separating into different paragraphs each count or claim for relief. See Weiland, 792 F.3d

at 1321-23. Consistent with the goal of Fed. R. Civ. P. 8, the amended complaint and its

memorandum shall not exceed twenty pages in length.

Lastly, Plaintiff is suing Defendants in their official capacity. The governmental entity that

the defendants represent, the City of Miami Beach, is the real party in interest. Hafer v. Melo, 502

U.S. 21, 25 (1991). If Plaintiff intends to bring an action against a municipality he must plead and

show the following: “(1) that his constitutional rights were violated; (2) that the municipality had

a custom or policy that constituted deliberate indifference to that constitutional right; and (3) that

the policy or custom caused the violation.” McDowell v. Brown, 392 F.3d 1283, 1289 (11th Cir.

2004) (emphasis added) (citing City of Canton v. Harris, 489 U.S. 378, 388 (1989)).

Accordingly, a municipality may only be held liable under § 1983 “when a constitutional

injury is caused by the execution of a government entity’s policy or custom.” Laster v. City of

Tampa Police Dep’t, 575 F. App’x 869, 872 (11th Cir. 2014).

A policy is a decision that is officially adopted by the municipality or created by an

official of such rank that he or she could be said to be acting on behalf of the

municipality. A custom is a practice that is so settled and permanent that it takes on

the force of law.

Groover v. Israel, 684 F. App’x 782, 787 (11th Cir. 2017) (quoting Sewell v. Town of Lake

Hamilton, 117 F. 3d 488, 489 (11th Cir. 1997) (citation omitted)). “In order for a plaintiff to

demonstrate a policy or custom, ‘it is generally necessary to show a persistent and wide-spread

practice.’” Martin v. Wood, 648 F. App’x 911, 914 (11th Cir. 2016) (quoting McDowell, 392 F.3d

at 1290).

This is not an exhaustive list of the potential deficiencies in Plaintiff’s complaint. Plaintiff

shall have one opportunity to rectify his complaint. Plaintiff is instructed to follow the directives

and applicable rules articulated in this order if he still wishes to pursue this action.

V. CONCLUSION

Plaintiff’s allegations fail to state a viable § 1983 claim against the named Defendants. In

order to proceed, Plaintiff shall file an amended complaint on the appropriate form providing

sufficient, factual allegations to permit the Court to review his complaint. Plaintiff is reminded that

he must state with specificity the facts supporting his claims. Plaintiff is also cautioned that each

claim should be numbered in a separate paragraph and should be set forth using short and plain

statements, with numbered paragraphs stating why the relief requested should be granted.

Furthermore, the petition must be verified – that is – signed and dated under the penalty of perjury,

pursuant to Local Rule 88.2(a)(4). Consistent with the goal of Fed. R. Civ. P. 8, the amended

complaint and its memorandum shall not exceed twenty pages in length.

Accordingly, it is ORDERED AND ADJUDGED as follows:

1. Plaintiff=s Application to Proceed in District Court without Prepaying Fees or Costs,

ECF No. [1], is DENIED without prejudice.

2. On or before March 18, 2021, Plaintiff shall either pay the $402 filing fee or may

renew his motion to proceed in forma pauperis.

3. If Plaintiff renews his motion to proceed in forma pauperis, he must have the

certificate concerning his jail bank account completed by an officer of the

institution and attach a certified copy of his jail account for the six-month period

preceding the filing of the Complaint in accordance with 28 U.S.C. § 1915.

4. The failure to pay the filing fee or renew his motion to proceed in forma pauperis

in accordance with the foregoing instructions will result in dismissal of this case.

5. Consistent with the purpose of Fed. R. Civ. P. 8, Plaintiff is granted leave to file an

amended complaint not to exceed twenty pages in length.

6. On or before March 18, 2021, Plaintiff shall file an amended complaint, signed

Case No. 21-cv-20637-BLOOM

under the penalty of perjury, providing a short and plain statement of a claim for

relief, a basis for federal jurisdiction, and a demand for judgment. The Complaint

for Violation of Civil Rights form is attached.

7. The amended complaint must be labeled “Amended Complaint” and must show

Case No.: 21-CV-20637-BLOOM, so that it will be filed in this case.

8. The amended complaint must contain a separate paragraph as to each defendant

explaining what that defendant did and the supporting facts to show why that person

is being sued.

9. Plaintiff is warned that failure to file the amended complaint on time and in

compliance with this Court’s orders will probably result in dismissal of this case

for failure to prosecute or failure to comply with court orders. See Fed. R. Civ. P.

A1(b).

10. Plaintiff is reminded that his amended complaint should at the very least cure the

factual deficiencies identified to state a plausible claim for relief

DONE AND ORDERED in Chambers at Miami, Florida, on February 18, 2021.

UNITED STATES DISTRICT JUDGE

Copies to:

Counsel of Record

Dexter Etienne Modeste, Pro Se

200154154

Metro West Detention Center

13850 NW 41st Street

Miami, FL 33178

IN THE UNITED STATES DISTRICT COURT

FOR THE __________ DISTRICT OF __________

__________ DIVISION

(Write the District and Division, if any, of the

court in which the complaint is filed.)

_________________________________________

Complaint for Violation of Civil

_________________________________________

Rights

_________________________________________

(Prisoner Complaint)

(Write the full name of each plaintiff who is filing

this complaint. If the names of all the plaintiffs Case No. _______________________

cannot fit in the space above, please write “see

(to be filled in by the Clerk’s Office)

attached” in the space and attach an additional

page with the full list of names.)

Jury Trial: ☐ Yes ☐ No

(check one)

-against-

_________________________________________

(Write the full name of each defendant who is

being sued. If the names of all the defendants

cannot fit in the space above, please write “see

attached” in the space and attach an additional

page with the full list of names. Do not include

addresses here.)

NOTICE

Federal Rules of Civil Procedure 5.2 addresses the privacy and security concerns resulting from public

access to electronic court files. Under this rule, papers filed with the court should not contain: an

individual’s full social security number or full birth date; the full name of a person known to be a minor; or

a complete financial account number. A filing may include only: the last four digits of a social security

number; the year of an individual’s birth; a minor’s initials; and the last four digits of a financial account

number.

Except as noted in this form, plaintiff need not send exhibits, affidavits, grievance or witness statements, or

any other materials to the Clerk’s Office with this complaint.

In order for your complaint to be filed, it must be accompanied by the filing fee or an application to

I. The Parties to This Complaint

A. The Plaintiff(s)

Provide the information below for each plaintiff named in the complaint. Attach

additional pages if needed.

Name __________________________________________

All other names by which you have been known:

__________________________________________

ID Number __________________________________________

Current Institution __________________________________________

Address __________________________________________

__________________________________________

B. The Defendant(s)

Provide the information below for each defendant named in the complaint, whether

the defendant is an individual, a government agency, an organization, or a

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

contained in the above caption. For an individual defendant, include the person’s job

or title (if known) and check whether you are bringing this complaint against them in

their individual capacity or official capacity, or both. Attach additional pages if

needed.

Defendant No. 1

Name __________________________________________

Job or Title __________________________________________

(if known)

Shield Number __________________________________________

Employer __________________________________________

Address __________________________________________

__________________________________________

☐ Individual capacity ☐ Official capacity

Defendant No. 2

Name __________________________________________

Job or Title __________________________________________

(if known)

Shield Number __________________________________________

Employer __________________________________________

Address __________________________________________

__________________________________________

☐ Individual capacity ☐ Official capacity

Defendant No. 3

Name __________________________________________

Job or Title __________________________________________

(if known)

Shield Number __________________________________________

Employer __________________________________________

Address __________________________________________

__________________________________________

☐ Individual capacity ☐ Official capacity

Defendant No. 4

Name __________________________________________

Job or Title __________________________________________

(if known)

Shield Number __________________________________________

Employer __________________________________________

Address __________________________________________

__________________________________________

☐ Individual capacity ☐ Official capacity

II. Basis for Jurisdiction

Under 42 U.S.C. § 1983, you may sue state or local officials for the “deprivation of any rights,

privileges, or immunities secured by the Constitution and [federal laws].” Under Bivens v. Six

Unknown Named Agents of Federal Bureau of Narcotics, 403 U.S. 388 (1971), you may sue

federal officials for the violation of certain constitutional rights.

A. Are you bringing suit against (check all that apply):

☐ Federal officials (a Bivens claim)

☐ State or local officials (a § 1983 claim)

B. Section 1983 allows claims alleging the “deprivation of any rights, privileges, or

immunities secured by the Constitution and [federal laws].” 42 U.S.C. § 1983. If you

are suing under section 1983, what federal constitutional or statutory right(s) do you

claim is/are being violated by state or local officials?

__________________________________________________________________

C. Plaintiffs suing under Bivens may only recover for the violation of certain

constitutional rights. If you are suing under Bivens, what constitutional right(s) do you

claim is/are being violated by federal officials?

__________________________________________________________________

D. Section 1983 allows defendants to be found liable only when they have acted “under

color of any statute, ordinance, regulation, custom, or usage, of any State or Territory

or the District of Columbia.” 42 U.S.C. § 1983. If you are suing under section 1983,

explain how each defendant acted under color of state or local law. If you are suing

under Bivens, explain how each defendant acted under color of federal law. Attach

additional pages if needed.

__________________________________________________________________

III. Prisoner Status

Indicate whether you are a prisoner or other confined person as follows (check all that apply):

☐ Pretrial detainee

☐ Civilly committed detainee

☐ Immigration detainee

☐ Convicted and sentenced state prisoner

☐ Convicted and sentenced federal prisoner

☐ Other (explain) ______________________________

IV. Statement of Claim

State as briefly as possible the facts of your case. Describe how each defendant was

personally involved in the alleged wrongful action, along with the dates and locations of all

relevant events. You may wish to include further details such as the names of other persons

involved in the events giving rise to your claims. Do not cite any cases or statutes. If more

than one claim is asserted, number each claim and write a short and plain statement of each

claim in a separate paragraph. Attach additional pages if needed.

A. If the events giving rise to your claim arose outside an institution, describe where and

when they arose.

__________________________________________________________________

B. If the events giving rise to your claim arose in an institution, describe where and when

they arose.

__________________________________________________________________

C. What date and approximate time did the events giving rise to your claim(s) occur?

__________________________________________________________________

D. What are the facts underlying your claim(s)? (For example: What happened to you?

Who did what? Was anyone else involved? Who else saw what happened?)

__________________________________________________________________

V. Injuries

If you sustained injuries related to the events alleged above, describe your injuries and state

what medical treatment, if any, you required and did or did not receive.

________________________________________________________________________

VI. Relief

State briefly what you want the court to do for you. Make no legal arguments. Do not cite any

cases or statutes. If requesting money damages, include the amounts of any actual damages

and/or punitive damages claimed for the acts alleged. Explain the basis for these claims.

________________________________________________________________________

VII. Exhaustion of Administrative Remedies Administrative Procedures

The Prison Litigation Reform Act (“PLRA”), 42 U.S.C. § 1997e(a), requires that “[n]o action

shall be brought with respect to prison conditions under section 1983 of this title, or any other

Federal law, by a prisoner confined in any jail, prison, or other correctional facility until such

administrative remedies as are available are exhausted.”

Administrative remedies are also known as grievance procedures. Your case may be

dismissed if you have not exhausted your administrative remedies.

A. Did your claim(s) arise while you were confined in a jail, prison, or other correctional

facility?

☐ Yes

☐ No

If yes, name the jail, prison, or other correctional facility where you were confined at

the time of the events giving rise to your claim(s).

__________________________________________________________________

B. Does the jail, prison, or other correctional facility where your claim(s) arose have a

grievance procedure?

☐ Yes

☐ No

☐ Do not know

C. Does the grievance procedure at the jail, prison, or other correctional facility where

your claim(s) arose cover some or all of your claims?

☐ Yes

☐ No

☐ Do not know

If yes, which claim(s)?

__________________________________________________________________

D. Did you file a grievance in the jail, prison, or other correctional facility where your

claim(s) arose concerning the facts relating to this complaint?

☐ Yes

☐ No

If no, did you file a grievance about the events described in this complaint at any other

jail, prison, or other correctional facility?

☐ Yes

☐ No

E. If you did file a grievance:

1. Where did you file the grievance?

____________________________________________________________

2. What did you claim in your grievance?

____________________________________________________________

3. What was the result, if any?

____________________________________________________________

4. What steps, if any, did you take to appeal that decision? Is the grievance

process completed? If not, explain why not. (Describe all efforts to appeal to

the highest level of the grievance process.)

____________________________________________________________

F. If you did not file a grievance:

1. If there are any reasons why you did not file a grievance, state them here:

____________________________________________________________

2. If you did not file a grievance but you did inform officials of your claim, state

who you informed, when and how, and their response, if any:

____________________________________________________________

G. Please set forth any additional information that is relevant to the exhaustion of your

administrative remedies.

__________________________________________________________________

(Note: You may attach as exhibits to this complaint any documents related to the

exhaustion of your administrative remedies.)

VIII. Previous Lawsuits

The “three strikes rule” bars a prisoner from bringing a civil action or an appeal in federal

court without paying the filing fee if that prisoner has “on three or more prior occasions, while

incarcerated or detained in any facility, brought an action or appeal in a court of the United

States that was dismissed on the grounds that it is frivolous, malicious, or fails to state a claim

upon which relief may be granted, unless the prisoner is under imminent danger of serious

physical injury.” 28 U.S.C. § 1915(g).

To the best of your knowledge, have you had a case dismissed based on this “three strikes

rule”?

☐ Yes

☐ No

If so, state which court dismissed your case, when this occurred, and attach a copy of the

order if possible.

__________________________________________________________________

A. Have you filed other lawsuits in state or federal court dealing with the same facts

involved in this action?

☐ Yes

☐ No

B. If your answer to A is yes, describe each lawsuit by answering questions 1 through 7

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

page, using the same format.)

1. Parties to the previous lawsuit

Plaintiff(s) ________________________________________________

Defendant(s) ________________________________________________

2. Court (if federal court, name the district; if state court, name the county and

State)

____________________________________________________________

3. Docket or index number

____________________________________________________________

4. Name of Judge assigned to your case

____________________________________________________________

5. Approximate date of filing lawsuit

____________________________________________________________

6. Is the case still pending?

☐ Yes

☐ No

If no, give the approximate date of disposition. _____________________

7. What was the result of the case? (For example: Was the case dismissed? Was

judgment entered in your favor? Was the case appealed?)

____________________________________________________________

C. Have you filed other lawsuits in state or federal court otherwise relating to the

conditions of your imprisonment?

☐ Yes

☐ No

D. If your answer to C is yes, describe each lawsuit by answering questions 1 through 7

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

page, using the same format.)

1. Parties to the previous lawsuit

Plaintiff(s) ________________________________________________

Defendant(s) ________________________________________________

2. Court (if federal court, name the district; if state court, name the county and

State)

____________________________________________________________

3. Docket or index number

____________________________________________________________

4. Name of Judge assigned to your case

____________________________________________________________

5. Approximate date of filing lawsuit

____________________________________________________________

6. Is the case still pending?

☐ Yes

☐ No

If no, give the approximate date of disposition. _____________________

7. What was the result of the case? (For example: Was the case dismissed?

Was judgment entered in your favor? Was the case appealed?)

____________________________________________________________

IX. Certification and Closing

Under Federal Rule of Civil Procedure 11, by signing below, I certify to the best of my

knowledge, information, and belief that this complaint: (1) is not being presented for an

improper purpose, such as to harass, cause unnecessary delay, or needlessly increase the cost

of litigation; (2) is supported by existing law or by a nonfrivolous argument for extending,

modifying, or reversing existing law; (3) the factual contentions have evidentiary support or,

if specifically so identified, will likely have evidentiary support after a reasonable opportunity

for further investigation or discovery; and (4) the complaint otherwise complies with the

requirements of Rule 11.

A. For Parties Without an Attorney

I agree to provide the Clerk’s Office with any changes to my address where case-

related papers may be served. I understand that my failure to keep a current address

on file with the Clerk’s Office may result in the dismissal of my case.

Date of signing: __________, 20__.

Signature of Plaintiff ____________________________________________

Printed Name of Plaintiff ____________________________________________

Prison Identification # ________________________________________________

Prison Address _____________________________________________________

_____________________________________________________

City State Zip Code

B. For Attorneys

Date of signing: __________, 20__.

Signature of Attorney ___________________________________________

Printed Name of Attorney ___________________________________________

Bar Number ___________________________________________

Name of Law Firm ___________________________________________

Address ___________________________________________

Telephone Number ___________________________________________

E-mail Address ___________________________________________

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.