Free Sample Format - District of Columbia

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

DO NOT WRITE ON SAMPLE FORM
YOUR NAME YOUR FACILITY ADDRESS CITY, STATE & ZIP CODE YOUR PRISONER IDENTIFICATION NO.

VS.

CIVIL ACTION NO. (To be filled in by Clerk)

DEFENDANT(S) NAME(S) THEIR ADDRESS CITY, STATE & ZIP CODE

COMPLAINT DO NOT WRITE ON SAMPLE FORM SET FORTH THE FACTS OF YOUR CASE. ON THE LAST PAGE OF YOUR COMPLAINT, SPELL OUT THE RELIEF YOU ARE REQUESTING FROM THIS COURT. IF YOU ARE ASKING FOR A TRIAL BY JURY, YOU MUST STATE THIS IN YOUR COMPLAINT. IF YOU ARE REQUESTING A SPECIFIC AMOUNT OF MONEY, STATE THIS IN YOUR COMPLAINT.

ORIGINAL SIGNATURE (IN PEN) YOUR NAME YOUR FACILITY ADDRESS CITY, STATE & ZIP CODE