Free Civil Rights Complaint Pursuant to 42 - New York

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF NEW YORK ) ) ) ) ) ) )

Plaintiff(s) vs.

Civil Case No.: CIVIL RIGHTS COMPLAINT PURSUANT TO 42 U.S.C. § 1983

Defendant(s)

Plaintiff(s) in the above-captioned action, allege(s) as follows: JURISDICTION 1. This is a civil action seeking relief and/or damages to defend and protect the rights guaranteed by the Constitution of the United States. This action is brought pursuant to 42 U.S.C. § 1983. The Court has jurisdiction over this action pursuant to 28 U.S.C. §§ 1331, 1343(3) and (4) and 2201. PARTIES 2. Plaintiff: Address:

Additional Plaintiffs may be added on a separate sheet of paper. 3. a. Defendant: Official Position: Address:

5/2005

b.

Defendant: Official Position: Address:

c.

Defendant: Official Position: Address:

Additional Defendants may be added on a separate sheet of paper.

4.

FACTS

Set forth the facts of your case which substantiate your claim of violation of your civil and/or Constitutional rights. List the events in the order they happened, naming defendants involved, dates and places. Note: You must include allegations of wrongful conduct as to EACH and EVERY defendant in your complaint. (You may use additional sheets as necessary).

5.

CAUSES OF ACTION

Note: You must clearly state each cause of action you assert in this lawsuit.

FIRST CAUSE OF ACTION

SECOND CAUSE OF ACTION

THIRD CAUSE OF ACTION

6. Plaintiff(s) demand(s) a trial by Jury - or - Court (Circle only one).

7.

PRAYER FOR RELIEF WHEREFORE, plaintiff(s) request(s) that this Court grant the following relief:

I declare under penalty of perjury that the foregoing is true and correct. DATED:

Signature of Plaintiff(s) (all Plaintiffs must sign)