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Case 5:14-cv-02559-PD
Document
Filed 05/02/14 Page 1 of 4
CIVIL
COVER1-1
SHEET
I. (a) PLAINTIFFS
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(c) Attorneys (Firm Name,
Address, and
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7e~phone
02
U.S. Government
Plaintiff
Number)
Federal Question
(U.S. Government Not a !'arty)
U.S. Government
Defendant
04
IV NATURE OF SUIT
I :~:J!)\t-0f"'CONTRlt.crc;i'l:r<.!>7 ':'
0 110 Insurance
0120 Marine
0 130 Miller Act
0 140 Negotiable Instrument
0 150 Recovery of Overpayment
& Enforcement of Judgment
0 151 Medicare Act
0 152 Recovery of Defaulted
Student Loans
(Excludes Veterans)
0 153 Recovery of Overpayment
of Veteran's Benefits
0 160 Stockholders' Suits
0 190 Other Contract
0 195 Contract Product Liability
0 196 Franchise
Diversity
(Indicate Citizenship of Parties in Item /II)
l:li!,F' ;/ .-:''c'~;,;,:."i':,
TORTS'i'
PERSONAL INJURY
0 310 Airplane
0 315 Airplane Product
Liability
D 320 Assault, Libel &
Slander
D 330 Federal Employers'
Liability
D 340 Marine
D 345 Marine Product
Liability
D 350 Motor Vehicle
0 355 Motor Vehicle
Product Liability
0 360 Other Personal
Injury
D 362 Personal Injury
Medical Malpractice
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KJt2
"71t- Vt
*"
0 5
Citizen or Subject of a
Foreign Country
03
Fo~eign Nation
06
.
;
..
'
o-'.i;
PERSONAL INJURY
0 365 Personal Injury
Product Liability
0 367 Health Care/
Pharmaceutical
Personal Injury
Product Liability
0 368 Asbestos Personal
Injury Product
Liability
PERSONAL PROPERTY
0 370 Other Fraud
0 371 Truth in Lending
0 380 Other Personal
Property Damage
0 385 Property Damage
Product Liability
Remanded from
Appellate Court
' FORFEITt:JRE/PtNAL'IY
0 625 Drug Related Seizure
of Property 21 USC 881
06900ther
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BANKRUPTCY; ,
O'J'HlllJt::STATUTES
0
0
0
0
0
0
0
PROPERTY RIGH'FS'
0 820 Copyrights
0830 Patent
0 840 Trademark
. 1- . ;
LABOR:"
0 71 0 Fair Labor Standards
Act
0720 Labor/Management
Relations
0740 Railway Labor Act
0751 Family and Medical
Leave Act
0790 Other Labor Litigation
I 'J:>Z,f/lf!ii JUjAiPRQJ'E~T.W\:'1f'i';1.1 ~!~'' .(;;IYJJ:;RIGHT$,i~i1', ( :;P~ISQl'IERlPE1'1'J'IQNsl\ 0791 Employee Retirement
D 210 Land Condemnation
0 440 Other Civil Rights
Income Security Act
Habeas Corpus:
0 463 Alien Detainee
0 220 Foreclosure
0 441 Voting
D 442 Employment
0 510 Motions to Vacate
0 230 Rent Lease & Ejectment
Sentence
0 240 Torts to Land
0 443 Housing/
0 245 Tort Product Liability
Accommodations
~530 General
'
535 Death Penalty
0 290 All Other Real Property
IMMl~RATION
D 445 Amer. w/Disabilities
O 462 Naturalization Appl1cat10n
Employment
Other:
D 446 Amer. w/Disabilities 0 540 Mandamus & Other 0465 Other Immigration
Other
0 550 Civil Rights
Actions
0 448 Education
0 555 Prison Condition
0 560 Civil Detainee
Conditions of
Confinement
Reinstated or
Reopened
0
0
0
S01AL SECURITY:
D 861 HIA (1395tl)
0 862 Black Lung (923)
D 863 DIWC/DIWW (405(g))
0 864 SSID Title XVI
D 865 RSI (405(g))
FEDEAALJ'A~su1rs1 :'
U 870 Taxes (U.S. Plaintiff
or Defendant)
0 871 IRS-Third Party
26 USC 7609
0
0
0
0
0
0
Litigation
(.<pec1/y)
VI. CAUSEOF
ACTION
VII. REQUESTED IN I 0
COMPLAINT: N l /t
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UI'
CHECK YES only if demanded in complaint:
l\
JURY DEMAND:
JUDGE
DOCKET NUMBER
AMOUNT
JUDGE
MAG. JUDGE
0Yes
No
MAY - 2 2014
PD
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CIVIL ACTION
v.
L/ Nti 61
:
S J'U111~1f~f; S LI ff~ l!VfttvJ/c1j :
fl 4!1
(J r~Jln::o~::::e
~::Justice Expense ~d Delay Reduction Plan:~~is court, counsel
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55 ~
for
'
t f/W plaintiff shall complete a Case Management Track Designation Form in all civil cases at the time of
filing the complaint and serve a copy on all defendants. (See 1:03 of the plan set forth on the reverse
side of this form.) In the event that a defendant does not agree with the plaintiff regarding said
designation, that defendant shall, with its first appearance, submit to the clerk of court and serve on
the plaintiff and all other parties, a Case Management Track Designation Form specifying the track
to which that defendant believes the case should be assigned.
SELECT ONE OF THE FOLLOWING CASE MANAGEMENT TRACKS:
(a) Habeas Corpus- Cases brought under 28 U.S.C. 2241through2255.
(/
(b) Social Security - Cases requesting review of a decision of the Secretary of Health
and Human Services denying plaintiff Social Security Benefits.
( )
(c) Arbitration - Cases required to be designated for arbitration under Local Civil Rule 53.2.
( )
(d) Asbestos - Cases involving claims for personal injury or property damage from
exposure to asbestos.
( )
(e) Special Management- Cases that do not fall into tracks (a) through (d) that are
commonly referred to as complex and that need special or intense management by
the court. (See reverse side of this form for a detailed explanation of special
management cases.)
( )
(f) Standard Management- Cases that do not fall into any one of the other tracks.
( )
Telephone
(Cl..060)
{H (
Attorney-at-law
Attorney for
FAX Number
E-Mail Address
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f.[rN 111.f/
VlfYvll/
MAY - 2 2014
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14
255 9
U!~lll!..US1Al1SUISTRICTCOURT
Case 5:14-cv-02559-PD
Document 1-1 Filed 05/02/14 Page 3 of 4
l>ESIGNA TION FORM to be used by counsel to indicate the category of the case for the purpose of
Place of Accident, Incident or Transaction: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _C_Cl.i_'IVT.__,'._"'.,,,""".,.(Use Reverse Side For Additional Space)
Does this civil action involve a nongovernmental corporate party with any parent corporation and any publicly held corporation owning IOo/o or more of its stock?
(Anach two copies of the Disclosure Statement Form in accordance with Fed.R.Civ.P. 7. l(a))
YesD
Not;I'
Yesa
Civil cases arc deemed related when yes is answered to any of the following questions:
I. Is this case related to property included in an earlier numbered suit pending or within one year previously terminated action in th's court?
YesO
NortY"
2. Does this case involve the same issue of fact or grow out of the same transaction as a prior suit pending or within one year previously terminated
action in this coun?
No{J/
YesO
3. Does this case involve the validity or infringement of a patent already in suit or any earlier numbered case pending or within one year previou~
terminated action in this court?
YesD
NoQ/
4. Is this case a second or successive habeas corpus, social security appeal, or prose civil rights case filed by the same individual?
Yes~
CIVIL: (Place
A
NoD
I.
CJ
2.
CJ
FELA
2.
3.
4.
5.
6.
7.
8.
9.
5. o Patent
6. o Labor-Management Relations
7.
CJ
Civil Rights
8. )(Habeas Corpus
9. o Securities Act(s) Cases
I0.
CJ
Assault, Defamation
Products Liability
D Products Liability 0
Asbestos
ARBITRATION CERTIFICATION
(Check Appropriate Category)
counsel of record do hereby certify:
a Pursuant to Local Civil Rule 53.2, Section 3(c)(2), that to the best of my knowledge and belief, the damages recoverable in this civil action case exceed the sum of
$I 50,000.00 exclusive of interest and costs:
a Relief other than monetary damages is sought.
I,
DATE: _ _ _ _ _ _ _ _ __
'Y\ttSRll'' t L w
~aflle'} l.~r,yAY
NOTE: A trial de novo will be a trial by jury only if there has been compliance with F.R.C.P. 38.
I certify that. to my knowledge, the within case is not related to any case now pending or within one year previously terminated action in this court
except as noted above.
><"DATE:
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2 2014
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