Free Complaint - District Court of Delaware - Delaware

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F Case 1:05-cv-00295-SLR Document 2-3 Filed 05/13/2005 Page 1 of 3
(Del. Rev,IZ'9H)
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF DELAWARE
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(Name ot`Plaintiffor Plaintiff's)N N A l ''--.'-' H!@ 5
v. CIVIL ACTION NO.
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A ..¢ » / /_/L--7225/gig
(Name r Defendant or Defendants)
COMPLAINT
l. This action is brought pursuant to ,4; fi ·
(Federal statute on which action is based)
rar arserrnrmrten related to jurisdiction exists by virtue af
(In what area did di ( rimination occur? c.g. race, sex, religion)
(Federal statute on whichjurisdiction is based) v
’ I - - ·— .
_2. Plaintiff resides at ,2 / v ’ 4 ·£r’L. ` »·¢'L·’ ¢/{..i¢J&'.· t3 / 7
nl { ' (S rect Address)
` /;*2T(»§’ua.-’L"/ _ .— , Q_ 4}
I (Ci ) (County) (State) (Zip Code)
gf /Q-?ég_L’ gg";lT‘5 .
(Area Code) (Phone Number)
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3. Defendant resides at, or its business is located at 51 I ./ ` ..·» J 7~¢~ ·
` G [ (Street Address)
~ 6* .&¤<»i/fe Zta- F I .e. . / ’ 6 2 .
(City) (County) (State) (Zip Code)
4. The alleged discriminatory acts occurred on { [ , %M£ gy , [2 Q 0 Chr- .
(Day) (r ontlr) (Year)
5. The alleged discriminatory practice EY is El is not continuing.

—· Case 1:05-cv-00295-SLR Document 2-3 Filed 05/13/2005 Page 2 of 3
6. Plaintii’f(s) filed charges with the
(Agency)
(Street Address) (City) (County) (State) (Zip)
regarding defendant(s) alleged discriminatory conduct on:
(Date)
7. Attach decision of the agency which investigated the charges referred in paragraph 6 above.
8. Was an appeal taken from the agency‘s decision? Yes EK No IZ]
If yes, to whom was the appeal taken? 1 ‘ · » ,— A;/¢.· / /4.
9. The discriminatory acts alleged in this suit concem: ( Describe facts on additional sheets if
necessary) , I
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( _ _ = g : _ T _ .
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l0. De1c.1dant’s conduct is discriminatory with respect to thc following:
A. Q Plai11tiff’s race ,_p_ :,_
B. 6 Plaintiffs color H .
C. E Plaintiffs sex
.·. j Z m y ._
D. El Plaintiffs religion
E. H Plaintiffs national origin

Case 1:05-cv-00295-SLR Document 2-3 Filed 05/1
11. Plaintiff prays for the following relief: (Indicate the exact relief requested)
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-’ - ia . . * . ` C C Ce / C S I OO
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I declare under penalty of perjury that the foregoing is true and correct.
Dated: ` ci 2 C? G if
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gg (Signature of Plaintiil) f I
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