McCarty v. Egnor ( 2021 )

1 WO JL 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA 8 9 Jyles Jon Dale McCarty, No. CV 21-00473-PHX-MTL (MTM) 10 Plaintiff, 11 v. ORDER 12 Logan Jeffrey Egnor, et al., 13 Defendants. 14 15 On March 19, 2021, Plaintiff Jyles Jon Dale McCarty, who is confined in a 16 Maricopa County Jail, filed a pro se civil rights Complaint pursuant to 42 U.S.C. § 1983 17 and an Application to Proceed In Forma Pauperis. In a March 26, 2021 Order, the Court 18 granted the Application to Proceed and dismissed the Complaint because Plaintiff had 19 failed to state a claim. The Court gave Plaintiff 30 days to file an amended complaint that 20 cured the deficiencies identified in the Order. 21 On March 30, 2021, Plaintiff filed his First Amended Complaint (Doc. 7) and a 22 second Application to Proceed In Forma Pauperis. Because the Court previously granted 23 Plaintiff’s Application to Proceed In Forma Pauperis, the new Application to Proceed will 24 be denied as moot. The Court will dismiss the First Amended Complaint with leave to 25 amend. 26 I. Statutory Screening of Prisoner Complaints 27 The Court is required to screen complaints brought by prisoners seeking relief 28 against a governmental entity or an officer or an employee of a governmental entity. 28 1 U.S.C. § 1915A(a). The Court must dismiss a complaint or portion thereof if a plaintiff 2 has raised claims that are legally frivolous or malicious, that fail to state a claim upon which 3 relief may be granted, or that seek monetary relief from a defendant who is immune from 4 such relief. 28 U.S.C. § 1915A(b)(1)–(2). 5 A pleading must contain a “short and plain statement of the claim showing that the 6 pleader is entitled to relief.” Fed. R. Civ. P. 8(a)(2) (emphasis added). While Rule 8 does 7 not demand detailed factual allegations, “it demands more than an unadorned, the- 8 defendant-unlawfully-harmed-me accusation.” Ashcroft v. Iqbal, 556 U.S. 662, 678 9 (2009). “Threadbare recitals of the elements of a cause of action, supported by mere 10 conclusory statements, do not suffice.” Id. 11 “[A] complaint must contain sufficient factual matter, accepted as true, to ‘state a 12 claim to relief that is plausible on its face.’” Id. (quoting Bell Atlantic Corp. v. Twombly, 13 550 U.S. 544, 570 (2007)). A claim is plausible “when the plaintiff pleads factual content 14 that allows the court to draw the reasonable inference that the defendant is liable for the 15 misconduct alleged.” Id. “Determining whether a complaint states a plausible claim for 16 relief [is] . . . a context-specific task that requires the reviewing court to draw on its judicial 17 experience and common sense.” Id. at 679. Thus, although a plaintiff’s specific factual 18 allegations may be consistent with a constitutional claim, a court must assess whether there 19 are other “more likely explanations” for a defendant’s conduct. Id. at 681. 20 But as the United States Court of Appeals for the Ninth Circuit has instructed, courts 21 must “continue to construe pro se filings liberally.” Hebbe v. Pliler, 627 F.3d 338, 342 22 (9th Cir. 2010). A “complaint [filed by a pro se prisoner] ‘must be held to less stringent 23 standards than formal pleadings drafted by lawyers.’” Id. (quoting Erickson v. Pardus, 551 24 U.S. 89, 94 (2007) (per curiam)). 25 If the Court determines that a pleading could be cured by the allegation of other 26 facts, a pro se litigant is entitled to an opportunity to amend a complaint before dismissal 27 of the action. See Lopez v. Smith, 203 F.3d 1122, 1127-29 (9th Cir. 2000) (en banc). 28 Plaintiff’s First Amended Complaint will be dismissed for failure to state a claim, but 1 because it may possibly be amended to state a claim, the Court will dismiss it with leave 2 to amend. 3 II. First Amended Complaint 4 In his three-count First Amended Complaint,1 Plaintiff sues Phoenix Police 5 Department Officers A. Branvits, Logan Jeffrey Egnor, Emily Huskisson, and Sanjo Sabu. 6 Plaintiff asserts claims of excessive force, unlawful detainment, and “harassment and/or 7 intimidation of a citizen.” He seeks monetary relief and for “all parties to be fired ASAP.” 8 In Count One, Plaintiff alleges that on October 20, 2020, Defendant Egnor stopped 9 Plaintiff, shot him with five bean bag rounds, searched him, and took him to jail without a 10 warrant or probable cause. Plaintiff asserts that he was not “being [a] threat” to himself, 11 the officers, or the public. Plaintiff claims that Defendant Egnor falsified government 12 documents, tampered with public records, assaulted and slandered Plaintiff, and neglected 13 his duty. Plaintiff does not identify any injury he suffered as a result of the conduct 14 described in Count One. 15 In Count Two, Plaintiff alleges that Defendant Egnor held Plaintiff in the 4th Avenue 16 Jail, where Deputy Sheriffs assaulted Plaintiff. Plaintiff asserts he was denied medical 17 attention and placed on suicide watch pursuant to Defendant Egnor’s orders. As his injury, 18 Plaintiff claims he was physically injured and detained due to Defendant Egnor’s actions. 19 Plaintiff designates Count Three as a claim for harassment and intimidation. He 20 repeats his allegations that on October 20, 2020, Defendant Egnor assaulted, harassed, and 21 injured him. 22 III. Failure to State a Claim 23 To prevail in a § 1983 claim, a plaintiff must show that (1) acts by the defendants 24 (2) under color of state law (3) deprived him of federal rights, privileges or immunities and 25 (4) caused him damage. Thornton v. City of St. Helens, 425 F.3d 1158, 1163-64 (9th Cir. 26 1 Plaintiff includes with the First Amended Complaint several pages of exhibits 27 concerning previous instances of misconduct or excessive force by Defendant Egnor. First, the instructions accompanying the form complaint explicitly state not to submit exhibits. 28 Second, previous instances of misconduct do not establish a constitutional violation in this case. If Plaintiff files a second amended complaint, he must not submit exhibits. 1 2005) (quoting Shoshone-Bannock Tribes v. Idaho Fish & Game Comm’n, 42 F.3d 1278, 2 1284 (9th Cir. 1994)). In addition, a plaintiff must allege that he suffered a specific injury 3 as a result of the conduct of a particular defendant and he must allege an affirmative link 4 between the injury and the conduct of that defendant. Rizzo v. Goode, 423 U.S. 362, 371- 5 72, 377 (1976). 6 Although pro se pleadings are liberally construed, Haines v. Kerner, 404 U.S. 519, 7 520-21 (1972), conclusory and vague allegations will not support a cause of action. Ivey 8 v. Bd. of Regents, 673 F.2d 266, 268 (9th Cir. 1982). Further, a liberal interpretation of a 9 civil rights complaint may not supply essential elements of the claim that were not initially 10 pled. Id. 11 A. Defendants Branvits, Huskisson, and Sabu 12 Plaintiff does not connect any of the allegations in the First Amended Complaint to 13 Defendants Branvits, Huskisson, and Sabu. The Court will therefore dismiss these 14 Defendants. 15 B. Defendant Egnor 16 1. Excessive Force 17 The use of excessive force by police officers in the course of an arrest can violate 18 the arrestee’s Fourth Amendment right to be free from unreasonable seizures. See White 19 by White v. Pierce County, 797 F.2d 812, 816 (9th Cir. 1986). The Fourth Amendment 20 does not prohibit the use of reasonable force. Tatum v. City & County of S.F., 441 F.3d 21 1090, 1095 (9th Cir. 2006). Whether the force was excessive depends on “whether the 22 officers’ actions [were] ‘objectively reasonable’ in light of the facts and circumstances 23 confronting them, without regard to their underlying intent or motivation.” Graham v. 24 Connor, 490 U.S. 386, 397 (1989); Tatum, 441 F.3d at 1095; Lolli v. County of Orange, 25 351 F.3d 410, 415 (9th Cir. 2003). The Court must balance the nature and quality of the 26 intrusion against the countervailing governmental interests at stake. Graham, 490 U.S. at 27 396; Lolli, 351 F.3d at 415. Moreover, 28 [t]he “reasonableness” of a particular use of force must be judged from the 1 perspective of a reasonable officer on the scene, rather than with the 20/20 2 vision of hindsight. . . . . “Not every push or shove, even if it may later seem unnecessary in the peace of a judge’s chambers,” violates the Fourth 3 Amendment. 4 5 Graham, 490 U.S. at 396 (citations omitted). “Whether a particular use of force was 6 ‘objectively reasonable’ depends on several factors, including the severity of the crime that 7 prompted the use of force, the threat posed by a suspect to the police or to others, and 8 whether the suspect was resisting arrest.” Tatum, 441 F.3d at 1095. 9 Plaintiff has not alleged sufficient facts concerning his arrest, including the 10 circumstances surrounding his arrest, whether Plaintiff had resisted or attempted to flee, 11 the crime or crimes for which he was arrested, and the events that resulted in Defendant 12 Egnor shooting Plaintiff with beanbag rounds. Absent additional information, Plaintiff 13 fails to state an excessive force claim against Defendant Egnor. 14 2. False Arrest 15 “False arrest, a species of false imprisonment, is the detention of a person without 16 his consent and without lawful authority.” Donahoe v. Arpaio, 869 F. Supp. 2d 1020, 1064 17 (D. Ariz. 2012) (quoting Reams v. City of Tucson, 701 P.2d 598, 601 (Ariz. Ct. App. 1985)), 18 aff’d sub nom. Stapley v. Pestalozzi, 733 F.3d 804 (9th Cir. 2013). Under Arizona law, 19 false imprisonment and false arrest consist of non-consensual detention of a person 20 “without lawful authority.” Slade v. City of Phx., 541 P.2d 550, 552 (Ariz. 1975). 21 “Reflective of the fact that false imprisonment consists of detention without legal process, 22 a false imprisonment ends once the victim becomes held pursuant to such process—when, 23 for example, he is bound over by a magistrate or arraigned on charges.” Wallace v. Kato, 24 549 U.S. 384, 389 (2007) (emphasis in original). 25 To state a § 1983 claim for false arrest, Plaintiff must show that Defendant Egnor 26 made the arrest without probable cause or other justification. Gravelet-Blondin v. Shelton, 27 728 F.3d 1086, 1097 (9th Cir. 2013). “‘Probable cause exists if the arresting officers ‘had 28 knowledge and reasonably trustworthy information of facts and circumstances sufficient 1 to lead a prudent person to believe that [the arrestee] had committed or was committing a 2 crime.’” Id. at 1097-98 (quoting Maxwell v. County of San Diego, 697 F.3d 941, 951 (9th 3 Cir. 2012)); see also Edgerly v. City & County of S.F., 599 F.3d 946, 953 (9th Cir. 2010) 4 (“To determine whether the Officers had probable cause at the time of the arrest, we 5 consider ‘whether at that moment the facts and circumstances within [the Officers’] 6 knowledge . . . were sufficient to warrant a prudent man in believing that the petitioner had 7 committed or was committing an offense.’”) (quoting Beck v. Ohio, 379 U.S. 89, 91 8 (1964)). “[P]robable cause supports an arrest so long as the arresting officers had probable 9 cause to arrest the suspect for any criminal offense, regardless of their stated reason for the 10 arrest.” Edgerly, 599 F.3d at 954 (emphasis added). “If an officer has probable cause to 11 believe that an individual has committed even a very minor criminal offense in his 12 presence, he may, without violating the Fourth Amendment, arrest the offender.” Atwater 13 v. City of Lago Vista, 532 U.S. 318, 354 (2001). 14 “[A] claim for false arrest turns only on whether probable cause existed to arrest a 15 defendant, and . . . it is not relevant whether probable cause existed with respect to each 16 individual charge, or, indeed, any charge actually invoked by the arresting officer at the 17 time of arrest.” Jaegly v. Couch, 439 F.3d 149, 154 (2d Cir. 2006); see also Price v. Roark, 18 256 F.3d 364, 369 (5th Cir. 2001) (“Claims for false arrest focus on the validity of the 19 arrest, not on the validity of each individual charge made during the course of the arrest.”). 20 “Thus . . . ‘[i]f there was probable cause for any of the charges made . . . then the arrest 21 was supported by probable cause, and the claim for false arrest fails.’” Price, 256 F.3d at 22 369 (quoting Wells v. Bonner, 45 F.3d 90, 95 (5th Cir. 1995)); see also Barry v. Fowler, 23 902 F.2d 770, 773 n.5 (9th Cir. 1990) (no unconstitutional seizure where police had 24 probable cause to arrest plaintiff for one offense, even if police lacked probable cause to 25 arrest for a second offense). 26 Plaintiff’s conclusory allegation that there was no probable cause to arrest him is 27 insufficient to state a false arrest claim. As noted above, Plaintiff has not alleged sufficient 28 facts regarding the circumstances surrounding his arrest or the crime or crimes for which 1 he was arrested. Thus, Plaintiff has failed to state a false arrest claim against Defendant 2 Egnor. 3 3. Harassment/Intimidation 4 To the extent that Plaintiff alleges that Defendant Egnor harassed or intimidated 5 him, these allegations do not state a claim for a constitutional violation. See Gaut v. Sunn, 6 810 F.2d 923, 925 (9th Cir. 1987) (defendants’ threats of bodily harm to convince plaintiff 7 not to pursue legal redress were insufficient to state a claim under § 1983; “it trivializes the 8 eighth amendment to believe a threat constitutes a constitutional wrong”); Oltarzewski v. 9 Ruggiero, 830 F.2d 136, 139 (9th Cir. 1987) (“‘[v]erbal harassment or abuse . . . is not 10 sufficient to state a constitutional deprivation under 42 U.S.C. § 1983’”) (quoting Collins 11 v. Cundy, 603 F.2d 825, 827 (10th Cir. 1979)); see also McFadden v. Lucas, 713 F.2d 143, 12 146 (5th Cir. 1983) (“mere threatening language and gestures . . . do not, even if true, 13 amount to constitutional violations”) (quoting Coyle v. Hughes, 436 F. Supp. 591, 593 14 (W.D. Okla. 1977)). 15 IV. Leave to Amend 16 For the foregoing reasons, Plaintiff’s First Amended Complaint will be dismissed 17 for failure to state a claim upon which relief may be granted. Within 30 days, Plaintiff may 18 submit a second amended complaint to cure the deficiencies outlined above. The Clerk of 19 Court will mail Plaintiff a court-approved form to use for filing a second amended 20 complaint. If Plaintiff fails to use the court-approved form, the Court may strike the second 21 amended complaint and dismiss this action without further notice to Plaintiff. 22 Plaintiff must clearly designate on the face of the document that it is the “Second 23 Amended Complaint.” The second amended complaint must be retyped or rewritten in its 24 entirety on the court-approved form and may not incorporate any part of the original 25 Complaint or First Amended Complaint by reference. Plaintiff may include only one claim 26 per count. 27 A second amended complaint supersedes the original Complaint and First Amended 28 Complaint. Ferdik v. Bonzelet, 963 F.2d 1258, 1262 (9th Cir. 1992); Hal Roach Studios v. 1 Richard Feiner & Co., 896 F.2d 1542, 1546 (9th Cir. 1990). After amendment, the Court 2 will treat the original Complaint and First Amended Complaint as nonexistent. Ferdik, 3 963 F.2d at 1262. Any cause of action that was raised in the original Complaint or First 4 Amended Complaint and that was voluntarily dismissed or was dismissed without 5 prejudice is waived if it is not alleged in a second amended complaint. Lacey v. Maricopa 6 County, 693 F.3d 896, 928 (9th Cir. 2012) (en banc). 7 V. Warnings 8 A. Release 9 If Plaintiff is released while this case remains pending, and the filing fee has not 10 been paid in full, Plaintiff must, within 30 days of his release, either (1) notify the Court 11 that he intends to pay the unpaid balance of his filing fee within 120 days of his release or 12 (2) file a non-prisoner application to proceed in forma pauperis. Failure to comply may 13 result in dismissal of this action. 14 B. Address Changes 15 Plaintiff must file and serve a notice of a change of address in accordance with Rule 16 83.3(d) of the Local Rules of Civil Procedure. Plaintiff must not include a motion for other 17 relief with a notice of change of address. Failure to comply may result in dismissal of this 18 action. 19 C. Possible “Strike” 20 Because the First Amended Complaint has been dismissed for failure to state a 21 claim, if Plaintiff fails to file a second amended complaint correcting the deficiencies 22 identified in this Order, the dismissal may count as a “strike” under the “3-strikes” 23 provision of 28 U.S.C. § 1915(g). Under the 3-strikes provision, a prisoner may not bring 24 a civil action or appeal a civil judgment in forma pauperis under 28 U.S.C. § 1915 “if the 25 prisoner has, on 3 or more prior occasions, while incarcerated or detained in any facility, 26 brought an action or appeal in a court of the United States that was dismissed on the 27 grounds that it is frivolous, malicious, or fails to state a claim upon which relief may be 28 granted, unless the prisoner is under imminent danger of serious physical injury.” 28 1| U.S.C. § 1915(g). 2 D. Possible Dismissal 3 If Plaintiff fails to timely comply with every provision of this Order, including these 4 warnings, the Court may dismiss this action without further notice. See Ferdik, 963 F.2d at 1260-61 (a district court may dismiss an action for failure to comply with any order of the Court). 7| ITIS ORDERED: 8 (1) Plaintiff's Application to Proceed In Forma Pauperis (Doc. 8) is denied as 9| moot. 10 (2) The First Amended Complaint (Doc. 7) is dismissed for failure to state a 11 | claim. Plaintiff has 30 days from the date this Order is filed to file a second amended 12 | complaint in compliance with this Order. 13 (3) □□ Plaintiff fails to file a second amended complaint within 30 days, the Clerk 14| of Court must, without further notice, enter a judgment of dismissal of this action with 15 | prejudice that states that the dismissal may count as a “strike” under 28 U.S.C. § 1915(g) 16 | and deny any pending unrelated motions as moot. 17 (4) The Clerk of Court must mail Plaintiff a court-approved form for filing a 18 | civil rights complaint by a prisoner. 19 Dated this Ist day of April, 2021. 20 Michal T. Hbhurdle Michael T. Liburdi 23 United States District Judge 24 25 26 27 28 tc Instructions for a Prisoner Filing a Civil Rights Complaint in the United States District Court for the District of Arizona 1. Who May Use This Form. The civil rights complaint form is designed to help incarcerated persons prepare a complaint seeking relief for a violation of their federal civil rights. These complaints typically concern, but are not limited to, conditions of confinement. This form should not be used to challenge your conviction or sentence. If you want to challenge a state conviction or sentence, you should file a petition under 28 U.S.C. ' 2254 for a writ of habeas corpus by a person in state custody. If you want to challenge a federal conviction or sentence, you should file a motion under 28 U.S.C. § 2255 to vacate sentence in the federal court that entered the judgment. 2. The Form. Local Rule of Civil Procedure (LRCiv) 3.4 provides that complaints by incarcerated persons must be filed on the court-approved form. The form must be typed or neatly handwritten. The form must be completely filled in to the extent applicable. All questions must be answered clearly and concisely in the appropriate space on the form. If needed, you may attach additional pages, but no more than fifteen additional pages, of standard letter-sized paper. You must identify which part of the complaint is being continued and number all pages. If you do not fill out the form properly, you will be asked to submit additional or corrected information, which may delay the processing of your action. You do not need to cite law. 3. Your Signature. You must tell the truth and sign the form. If you make a false statement of a material fact, you may be prosecuted for perjury. 4. The Filing and Administrative Fees. The total fees for this action are $402.00 ($350.00 filing fee plus $52.00 administrative fee). If you are unable to immediately pay the fees, you may request leave to proceed in forma pauperis. Please review the “Information for Prisoners Seeking Leave to Proceed with a (Non-Habeas) Civil Action in Federal Court In Forma Pauperis Pursuant to 28 U.S.C. ' 1915” for additional instructions. 5. Original and Judge=s Copy. You must send an original plus one copy of your complaint and of any other documents submitted to the Court. You must send one additional copy to the Court if you wish to have a file-stamped copy of the document returned to you. All copies must be identical to the original. Copies may be legibly handwritten. This section does not apply to inmates housed at an Arizona Department of Corrections facility that participates in electronic filing. 6. Where to File. You should file your complaint in the division where you were confined when your rights were allegedly violated. See LRCiv 5.1(a) and 77.1(a). If you were confined in Maricopa, Pinal, Yuma, La Paz, or Gila County, file in the Phoenix Division. If you were confined in Apache, Navajo, Coconino, Mohave, or Yavapai County, file in the Prescott Division. If you were confined in Pima, Cochise, Santa Cruz, Graham, or Greenlee County, file in the Tucson Division. Mail the original and one copy of the complaint with the $402 filing and administrative fees or the application to proceed in forma pauperis to: 1 Revised 12/1/20 Phoenix & Prescott Divisions: OR Tucson Division: U.S. District Court Clerk U.S. District Court Clerk U.S. Courthouse, Suite 130 U.S. Courthouse, Suite 1500 401 West Washington Street, SPC 10 405 West Congress Street Phoenix, Arizona 85003-2119 Tucson, Arizona 85701-5010 7. Change of Address. You must immediately notify the Court and the defendants in writing of any change in your mailing address. Failure to notify the Court of any change in your mailing address may result in the dismissal of your case. 8. Certificate of Service. You must furnish the defendants with a copy of any document you submit to the Court (except the initial complaint and application to proceed in forma pauperis). Each original document (except the initial complaint and application to proceed in forma pauperis) must include a certificate of service on the last page of the document stating the date a copy of the document was mailed to the defendants and the address to which it was mailed. See Fed. R. Civ. P. 5(a), (d). Any document received by the Court that does not include a certificate of service may be stricken. This section does not apply to inmates housed at an Arizona Department of Corrections facility that participates in electronic filing. A certificate of service should be in the following form: I hereby certify that a copy of the foregoing document was mailed this (month, day, year) to: Name: Address: Attorney for Defendant(s) (Signature) 9. Amended Complaint. If you need to change any of the information in the initial complaint, you must file an amended complaint. The amended complaint must be written on the court- approved civil rights complaint form. You may file one amended complaint without leave (permission) of Court within 21 days after serving it or within 21 days after any defendant has filed an answer, whichever is earlier. See Fed. R. Civ. P. 15(a). Thereafter, you must file a motion for leave to amend and lodge (submit) a proposed amended complaint. LRCiv 15.1. In addition, an amended complaint may not incorporate by reference any part of your prior complaint. LRCiv 15.1(a)(2). Any allegations or defendants not included in the amended complaint are considered dismissed. All amended complaints are subject to screening under the Prison Litigation Reform Act; screening your amendment will take additional processing time. 10. Exhibits. You should not submit exhibits with the complaint or amended complaint. Instead, the relevant information should be paraphrased. You should keep the exhibits to use to support or oppose a motion to dismiss, a motion for summary judgment, or at trial. 11. Letters and Motions. It is generally inappropriate to write a letter to any judge or the staff of any judge. The only appropriate way to communicate with the Court is by filing a written pleading or motion. 2 12. Completing the Civil Rights Complaint Form. HEADING: 1. Your Name. Print your name, prison or inmate number, and institutional mailing address on the lines provided. 2. Defendants. If there are four or fewer defendants, print the name of each. If you name more than four defendants, print the name of the first defendant on the first line, write the words “and others” on the second line, and attach an additional page listing the names of all of the defendants. Insert the additional page after page 1 and number it “1- A” at the bottom. 3. Jury Demand. If you want a jury trial, you must write “JURY TRIAL DEMANDED” in the space below “CIVIL RIGHTS COMPLAINT BY A PRISONER.” Failure to do so may result in the loss of the right to a jury trial. A jury trial is not available if you are seeking only injunctive relief. Part A. JURISDICTION: 1. Nature of Suit. Mark whether you are filing the complaint pursuant to 42 U.S.C. ' 1983 for state, county, or city defendants; “Bivens v. Six Unknown Federal Narcotics Agents” for federal defendants; or “other.” If you mark “other,” identify the source of that authority. 2. Location. Identify the institution and city where the alleged violation of your rights occurred. 3. Defendants. Print all of the requested information about each of the defendants in the spaces provided. If you are naming more than four defendants, you must provide the necessary information about each additional defendant on separate pages labeled “2-A,” “2-B,” etc., at the bottom. Insert the additional page(s) immediately behind page 2. Part B. PREVIOUS LAWSUITS: You must identify any other lawsuit you have filed in either state or federal court while you were a prisoner. Print all of the requested information about each lawsuit in the spaces provided. If you have filed more than three lawsuits, you must provide the necessary information about each additional lawsuit on a separate page. Label the page(s) as “2-A,” “2-B,” etc., at the bottom of the page and insert the additional page(s) immediately behind page 2. Part C. CAUSE OF ACTION: You must identify what rights each defendant violated. The form provides space to allege three separate counts (one violation per count). If you are alleging more than three counts, you must provide the necessary information about each additional count on a separate page. Number the additional pages “5-A,” “5-B,” etc., and insert them immediately behind page 5. Remember that you are limited to a total of fifteen additional pages. 3 1. Counts. You must identify which civil right was violated. You may allege the violation of only one civil right per count. 2. Issue Involved. Check the box that most closely identifies the issue involved in your claim. You may check only one box per count. If you check the box marked “Other,” you must identify the specific issue involved. 3. Supporting Facts. After you have identified which civil right was violated, you must state the supporting facts. Be as specific as possible. You must state what each individual defendant did to violate your rights. If there is more than one defendant, you must identify which defendant did what act. You also should state the date(s) on which the act(s) occurred, if possible. 4. Injury. State precisely how you were injured by the alleged violation of your rights. 5. Administrative Remedies. You must exhaust any available administrative remedies before you file a civil rights complaint. See 42 U.S.C. § 1997e. Consequently, you should disclose whether you have exhausted the inmate grievance procedures or administrative appeals for each count in your complaint. If the grievance procedures were not available for any of your counts, fully explain why on the lines provided. Part D. REQUEST FOR RELIEF: Print the relief you are seeking in the space provided. SIGNATURE: You must sign your name and print the date you signed the complaint. Failure to sign the complaint will delay the processing of your action. Unless you are an attorney, you may not bring an action on behalf of anyone but yourself. FINAL NOTE You should follow these instructions carefully. Failure to do so may result in your complaint being stricken or dismissed. All questions must be answered concisely in the proper space on the form. If you need more space, you may attach no more than fifteen additional pages. But the form must be completely filled in to the extent applicable. If you attach additional pages, be sure to identify which section of the complaint is being continued and number the pages. 4 ___________________________________________ Name and Prisoner/Booking Number ___________________________________________ Place of Confinement ___________________________________________ Mailing Address ___________________________________________ City, State, Zip Code (Failure to notify the Court of your change of address may result in dismissal of this action.) IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF ARIZONA _________________________________________ , (Full Name of Plaintiff) ) Plaintiff, v. CASE NO. __________________________________ (To be supplied by the Clerk) (1) _______________________________________ , (Full Name of Defendant) CIVIL RIGHTS COMPLAINT (2) _______________________________________ , BY A PRISONER (3) _______________________________________ , G Original Complaint (4) _______________________________________ , G First Amended Complaint G Second Amended Complaint Defendant(s). G Check if there are additional Defendants and attach page 1-A listing them. A. JURISDICTION 1. This Court has jurisdiction over this action pursuant to: G 28 U.S.C. § 1343(a); 42 U.S.C. § 1983 G 28 U.S.C. § 1331; Bivens v. Six Unknown Federal Narcotics Agents, 403 U.S. 388 (1971). G Other: . 2. Institution/city where violation occurred: . 550/555 B. DEFENDANTS 1. Name of first Defendant: . The first Defendant is employed as: ______________________________________________ at_______________________________________. (Position and Title) (Institution) 2. Name of second Defendant: . The second Defendant is employed as: as: ______________________________________________ at_______________________________________. (Position and Title) (Institution) 3. Name of third Defendant: . The third Defendant is employed as: ______________________________________________ at_______________________________________. (Position and Title) (Institution) 4. Name of fourth Defendant: . The fourth Defendant is employed as: ______________________________________________ at_______________________________________. (Position and Title) (Institution) If you name more than four Defendants, answer the questions listed above for each additional Defendant on a separate page. C. PREVIOUS LAWSUITS 1. Have you filed any other lawsuits while you were a prisoner? G Yes G No 2. If yes, how many lawsuits have you filed? . Describe the previous lawsuits: a. First prior lawsuit: 1. Parties: v. 2. Court and case number: . 3. Result: (Was the case dismissed? Was it appealed? Is it still pending?) . b. Second prior lawsuit: 1. Parties: v. 2. Court and case number: . 3. Result: (Was the case dismissed? Was it appealed? Is it still pending?) . c. Third prior lawsuit: 1. Parties: v. 2. Court and case number: . 3. Result: (Was the case dismissed? Was it appealed? Is it still pending?) . If you filed more than three lawsuits, answer the questions listed above for each additional lawsuit on a separate page. 2 D. CAUSE OF ACTION COUNT I 1. State the constitutional or other federal civil right that was violated: . 2. Count I. Identify the issue involved. Check only one. State additional issues in separate counts. G Basic necessities G Mail G Access to the court G Medical care G Disciplinary proceedings G Property G Exercise of religion G Retaliation G Excessive force by an officer G Threat to safety G Other: . 3. Supporting Facts. State as briefly as possible the FACTS supporting Count I. Describe exactly what each Defendant did or did not do that violated your rights. State the facts clearly in your own words without citing legal authority or arguments. . 4. Injury. State how you were injured by the actions or inactions of the Defendant(s). . 5. Administrative Remedies: a. Are there any administrative remedies (grievance procedures or administrative appeals) available at your institution? G Yes G No b. Did you submit a request for administrative relief on Count I? G Yes G No c. Did you appeal your request for relief on Count I to the highest level? G Yes G No d. If you did not submit or appeal a request for administrative relief at any level, briefly explain why you did not. . 3 COUNT II 1. State the constitutional or other federal civil right that was violated: . 2. Count II. Identify the issue involved. Check only one. State additional issues in separate counts. G Basic necessities G Mail G Access to the court G Medical care G Disciplinary proceedings G Property G Exercise of religion G Retaliation G Excessive force by an officer G Threat to safety G Other: . 3. Supporting Facts. State as briefly as possible the FACTS supporting Count II. Describe exactly what each Defendant did or did not do that violated your rights. State the facts clearly in your own words without citing legal authority or arguments. . 4. Injury. State how you were injured by the actions or inactions of the Defendant(s). . 5. Administrative Remedies. a. Are there any administrative remedies (grievance procedures or administrative appeals) available at your institution? G Yes G No b. Did you submit a request for administrative relief on Count II? G Yes G No c. Did you appeal your request for relief on Count II to the highest level? G Yes G No d. If you did not submit or appeal a request for administrative relief at any level, briefly explain why you did not. . 4 COUNT III 1. State the constitutional or other federal civil right that was violated: . 2. Count III. Identify the issue involved. Check only one. State additional issues in separate counts. G Basic necessities G Mail G Access to the court G Medical care G Disciplinary proceedings G Property G Exercise of religion G Retaliation G Excessive force by an officer G Threat to safety G Other: . 3. Supporting Facts. State as briefly as possible the FACTS supporting Count III. Describe exactly what each Defendant did or did not do that violated your rights. State the facts clearly in your own words without citing legal authority or arguments. . 4. Injury. State how you were injured by the actions or inactions of the Defendant(s). . 5. Administrative Remedies. a. Are there any administrative remedies (grievance procedures or administrative appeals) available at your institution? G Yes G No b. Did you submit a request for administrative relief on Count III? G Yes G No c. Did you appeal your request for relief on Count III to the highest level? G Yes G No d. If you did not submit or appeal a request for administrative relief at any level, briefly explain why you did not. . If you assert more than three Counts, answer the questions listed above for each additional Count on a separate page. 5 E. REQUEST FOR RELIEF State the relief you are seeking: . I declare under penalty of perjury that the foregoing is true and correct. Executed on DATE SIGNATURE OF PLAINTIFF ___________________________________________ (Name and title of paralegal, legal assistant, or other person who helped prepare this complaint) ___________________________________________ (Signature of attorney, if any) ___________________________________________ (Attorney=s address & telephone number) ADDITIONAL PAGES All questions must be answered concisely in the proper space on the form. If you need more space, you may attach no more than fifteen additional pages. But the form must be completely filled in to the extent applicable. If you attach additional pages, be sure to identify which section of the complaint is being continued and number all pages. 6