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OJS 44

(Rev. 11/04)

CIVIL COVER SHEET

The JS 44 civil cover sheet and the information contained herein neither replace nor supplement th e filing and service of pleadings or oth er papers as requ ired by law, except as provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is required for the use of the Clerk of Court for the purpose of initiating the civil docket sheet. (SEE IN STRU CTIO NS O N THE REV ERSE OF TH E FOR M.)

I. (a)

PLAINTIFFS

DEFENDANTS

(b) County of Resid ence of First Listed Plaintiff
(EXCEPT IN U.S. PLAINTIFF CASES)

County of Residence of First Listed Defendant
( I N U .S . P LA I N T IF F C A SE S O N L Y ) NOTE: I N L A N D CO N D E M N A T I O N CA SE S, U SE T H E LO C A TIO N O F TH E L A N D I N V O LV E D .

(c) Attorney's (Firm Name, A ddress, and

Telephone Number)

Attorneys (If Known)

II. BASIS OF JURISDICTION
1 U.S. Governme nt Plaintiff

(Place an "X" in O ne Box Only)

III. CITIZENSHIP OF PRINCIPAL PARTIES(Place
(For Diversity Cases Only) PTF Citizen of This State 1 DEF 1

3 Federal Question (U.S. Governme nt Not a Party)

an "X " in On e Box for Plain tiff and One Box for De fendant) PTF DEF Incorporated or Principal Place 4 4 of Business In T his State Incorporated and Principal Place of Business In A nother State Foreign Nation 5 5

2

U.S. Governme nt Defendant

4

Diversity (Indicate Citizensh ip of Parties in Item III)

Citizen of Anothe r State

2

2

Citize n or Su bject o f a Foreign Coun try

3

3

6

6

IV. NAT URE O F SUIT
CONTRACT 110 120 130 140 150 Insurance Ma rine Miller Act Negotiable Instrument Recove ry of Overpayment & Enforcement of Judgme nt 151 Medicare Act 152 Recovery of Defaulted Student Loans (Excl. Veterans) 153 Recove ry of Overpayment of Veteran' s Benefits 160 Stoc kholders' S uits 190 Other Contract 195 Co ntract Produc t Liability 196 Franchise REAL PROPERTY 210 Land Condemnation 220 Forec losure 230 Rent Lease & Ejectment 240 Torts to Land 245 Tort Produc t Liability 290 All Othe r Real Prop erty

(Place an "X" in O ne Box Only) TORTS PERSONAL INJURY 310 Airplane 315 Airplane Product Liability 320 A ssault, Libel & Slander 330 Federal Employers' Liability 340 Ma rine 345 Marine Product Liability 350 M otor V ehicle 355 M otor V ehicle Product Liability 360 Other Personal Injury CIVIL RIGHTS 441 Voting 442 Employment 443 Housing/ Accommod ations 444 Welfare 445 Amer. w/Disabilities Employment 446 Amer. w/Disabilities Other 440 Othe r Civil Rights PERSONAL INJURY 362 Personal Injury Med. Malpractice 365 Personal Injury Product Liability 368 Asbestos Personal Injury Product Liability PERSONAL PROPERTY 370 Other Fraud 371 Truth in Lending 380 Other Personal Property Damage 385 Property Da mage Product Liability P R I S O N E R P E T IT I O N S 510 M otions to Va cate Sentence Habeas Corpus: 530 General 535 De ath Penalty 540 Mandamus & Other 550 Civil Rights 555 Prison Condition

F O R F E I T U R E /P E N A L T Y 610 Agriculture 620 Other Food & Drug 625 Drug Related S eizure of Property 21 USC 881 6 3 0 Li q uo r L aw s 640 R.R. & Truck 650 Airline Regs. 660 Occupational Safety/Health 690 Other LABOR 710 Fair Labor Standards Act 720 Labor/M gmt. Relations 730 Labor/M gmt.Reporting & Disclosure Act 740 Railway Labor Act 790 Other Labor Litigation 791 Empl. Ret. Inc. Security Act

BANKRUPTCY 422 Appeal 28 USC 158 423 Withdrawal 28 USC 157 PROPERTY RIGHTS 820 Co pyrights 830 Patent 840 Trad emark

OTHER STATUTES 400 State Reap portionment 410 Antitrust 430 Banks and Banking 450 Commerce 460 Deportation 470 Racke teer Influenced and Corrupt Organizations 480 C onsum er Cre dit 490 Cable/Sat TV 810 Selective Service 850 Securities/Commodities/ Exchange 875 Customer C hallenge 12 USC 3410 890 Other Statutory Actions 891 Agricultural A cts 892 Economic Stabilization Act 893 Environm ental Matters 894 Energy Allocation Act 895 Freedom of Information Act 900Appeal of Fee Determination Under Equal Access to Justice 950 Constitutionality of State Statutes

S O C I A L S E C U R IT Y 861 H IA (13 95ff) 862 Black Lung (923) 863 DIW C/DIW W (405 (g)) 8 6 4 S SI D T it le X V I 865 RS I (405(g)) FEDERAL TAX SUITS 870 T axes ( U.S. Plaintiff or Defenda nt) 871 IRS --Third P arty 26 USC 7609

V. ORIG IN 1 Original
Proceeding

(Place an "X" in O ne Box Only)

Appeal to District

2 Removed from

3 Remanded from

4 Reinstated or

Litigation Reopened Appellate Court State Court (specify) Cite the U.S. Civil Statute under which you are filing (Do not cite jurisdictional statutes unle ss diversity): Brief descript ion of cause: CHECK IF THIS IS A CLASS ACTION UNDER F.R.C.P. 23
(See instructions):

5 Transferred from another district

6 Multidistrict

7 Judge from Magistrate
Judgment

VI. CAUSE OF ACTION VII. REQ UESTE D IN COMPLAINT: VIII. RELATED CASE(S) IF ANY
DATE

DEMAND $

CHECK YES only if demanded in complaint: Yes No JURY DEMAND: DOCKET NUMBER

JUDGE
S I G N A T UR E O F A T TO R N E Y O F R E C O R D

FOR OFFICE USE ONLY RECEIPT # AMOUNT APPLYING IFP JUDGE MAG. JUDGE

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JS 44 Reverse (Rev. 11/04)

INSTRUCTIONS FOR ATTORNEYS COMPLETING CIVIL COVER SHEET FORM JS 44
Authority For Civil Cover Sheet The JS 44 civil cover sheet and the information contained herein neither replaces nor supplements the filings and service of pleading or other papers as required by law, except as provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is required for the use of the Clerk of Court for the purpose of initiating the civil docket sheet. Consequently, a civil cover sheet is submitted to the Clerk of Court for each civil complaint filed. The attorney filing a case should complete the form as follows: I. (a) Plaintiffs-Defendants. Enter names (last, first, middle initial) of plaintiff and defendant. If the plaintiff or defendant is a government agency, use only the full name or standard abbreviations. If the plaintiff or defendant is an official within a government agency, identify first the agency and then the official, giving both name and title. (b) County of Residence. For each civil case filed, except U.S. plaintiff cases, enter the name of th e county wher e the first l isted plaintiff resides at the t ime of filing. In U.S. plai ntiff cases, enter the n ame of the county in which the first listed defendant resides at the time of filing. (NOTE: In land condemnation cases, the county of residence of the "defendant" is the location of the tract of land involved.) (c) Attorneys. Enter the firm name, address, telephone number, and attorney of record. If there are several attorneys, list them on an attachment, noting in this section "(see attachment)". II. Jurisdiction. The basis of jurisdiction is set forth under Rule 8(a), F.R.C.P., which requires that jurisdictions be shown in pleadings. Place an "X" in one of the boxe s. If there is more than o ne basis of j urisdict ion, precedence is given in th e order sho wn below. United States plaintiff. (1) Jurisdiction based on 28 U.S.C. 1345 and 1348. Suit s by agencies and officers of the United States are included here. United States defend ant. (2) When the pl aintiff is suing the Uni ted States, its officers o r agencies, place an "X" i n this box. Federal question. (3) This refers to suits under 28 U.S.C. 1331, where jurisdiction arises under the Constitution of the United States, an amendment to the Constitution, an act of Congre ss or a tr eaty of th e United State s. In cas es where the U.S . is a party, the U.S. plaintiff or defendant code takes precedence, and box 1 or 2 should be marked. Diversity of citizenship. (4) This refers to suits under 28 U.S.C. 1332, where parties are citizens of different states. When Box 4 is checked, the citizenship of the different parties must be checked. (See Section III below; federal question actions take precedence over diversity cases.) III. Residence (citizenship) of Principal Parties. This section of the JS 44 is to be completed if diversity of citizenship was indicated above. Mark this section for each princi pal par ty. IV. Nature of Suit. Place an "X" in the appropriate box. If the nature of suit cannot be determined, be sure the cause of action, in Section VI below, is sufficient to enable the deputy clerk or the statistical clerks in the Administrative Office to determine the nature of suit. If the cause fits more than one nature of suit, select the most definitive. V. Origin. Place an "X" in one of the seven boxes. Original Proceedings. (1) Cases which originate in the United States district courts. Removed from State Court. (2) Proceedings initiated in state courts may be removed to the district courts under Title 28 U.S.C., Section 1441. When the petition for removal is granted, che ck this box. Remanded from Appellate Court. (3) Check this box for cases remanded to the district court for further action. Use the date of remand as the filing date. Reinstated or Reopened. (4) Check this box for cases reinstated or reopened in the district court. Use the reopening date as the filing date. Transferred from Another District. (5) For cases transferred under Title 28 U.S.C. Section 1404(a). Do not use this for within district transfers or multidistrict litigation transfers. Multidistrict Litigation. (6) Check this box when a multidistrict case is transferred into the district under authority of Title 28 U.S.C. Section 1407. When this box is checked, do not check (5) above. Appeal to District Judge from Magistrate Judgment. (7) Check this box for an appeal from a magistrate judge's decision. VI. Cause of Action. Report the civil statute directly related to the cause of action and give a brief description of the cause. Do not cite jurisdictional statutes unless diversity. Example: U.S. Civil Statute: 47 USC 553 Brief Description: Unauthorized reception of cable service VII. Requested in Complaint. Class Action. Place an "X" in this box if you are filing a class action under Rule 23, F.R.Cv.P. Demand. In this space enter the dollar amount (in thousands of dollars) being demanded or indicate other demand such as a preliminary injunction. Jury Demand. Check the appropriate box to indicate whether or not a jury is being demanded. VIII. Related Cases. This section of the JS 44 is used to reference related pending cases if any. If there are related pending cases, insert the docket numbers and the corresponding judge names for such cases. Date and Attorney Signature. Date and sign the civil cover sheet.