Free Civil Rights Complaint - Washington

1 2 3 4 5 6 7 8 9 10 11 12 13 14 Parties to this Complaint: 15 16 17 18 19 20 21 22 23 24 25 Defendant's Name, Address and Phone Number Plaintiff's Name, Address and Phone Number Defendant(s), vs. Plaintiff(s) UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF WASHINGTON
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CIVIL RIGHTS COMPLAINT UNDER 42 U.S.C. §1983 (for use only by plaintiffs not in custody)

Defendant's Name, Address and Phone Number

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Approximate date of disposition: Docket Number: Assigned Judge: Disposition : (For example, was the case dismissed as frivolous or for failure to state a claim? Was it appealed? Is it still pending?) Approximate filing date of lawsuit: Defendant(s) (If there is more than one previous lawsuit, describe the additional lawsuits on another piece of paper using the same outline. Attach additional sheets, if necessary) Court and Name of District: Defendant's Name, Address and Phone Number (If you have more defendants, list them using the same outline on another piece of paper. Attach additional sheets, if necessary) Previous Lawsuits: Have you brought any other lawsuits in any federal court in the United States:? No Describe the lawsuit: Parties to this previous lawsuit: Plaintiff(s) Yes If Yes, how many?

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Statement of Claim State here as briefly as possible the facts of your case. Describe how each defendant is involved, including dates, places, and other persons involved. Do not give any legal arguments or cite any cases or statutes. If you allege a number of related claims, number and set forth each claim in a separate paragraph. (Attach additional sheets if necessary.)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Date Signature of Plaintiff I declare under penalty of perjury that the foregoing is true and correct. Relief State briefly exactly what you want the court to do for you. Make no legal arguments. Cite no cases or statues.