Free Notice of Removal - District Court of Delaware - Delaware


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Case 1 :05-cv-00269-.1.1 F Docu ment 1-2 Filed 05/05/2005 Page 1 of 3
an 44 (ne., 11/04) CIVIL COVER SHEET
The I S 44 civil cover sheet and the information contained herein neither riplace nor supplement the filing and service of pleadings or odier papers as required by law, except as provided
by local rules of court. This form, approved by the Judicial Conference o the United States in September 1974, is required for the use ofthe Clerk of Court for the purpose of initiating
the civil docket sheet. (SEE INSTRUCTIONS ON THE REVERSE OF THE FORM.)
I. (a) PLAINTIFFS DEFENDANTS
Dora Jackson, individually and on behalf Wal—Mart Stores, Inc.
of others similarly situated Sam's West, Inc.
(b) County of Residence of First Listed Plaintiff [Q g I] j: County of Residence of First Listed Defendant BE n j; gn
(EXCEPT IN U.S. PLAINTIFF CASES) (IN U.S. PLAINTIFF CASES ONLY)
NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF THE
LAND INVOLVED.
(C) Attomey’s (Firm Name, Address, and Telephone Number) Attomeys (IYKIWWH)
See attachment See attachment
II. BASIS OF JURISDICTION (Place an *·x*· in One Box Only) III. CITIZENSHIP OF PRINCIPAL PARTIES(P1ace an ··x·· an One Box for Plaintiff
(For Diversity Cases Only) and One Box for Defendant)
lj 1 U.S. Govemment D 3 Federal Question PTF DEF PTF DEF
Plaintiff (U.S. Govemment Not aParty) Citizen of This State XM 1 I] 1 Incorporated or Principal Place D 4 CI 4
of Business In This State
lj 2 U.S. Govemment XX4 Diversity Citizen of Another State I] 2 CI 2 Incorporated and Principal Place lj 5 5
D=f=¤·*¤·" n.nn... nnmsnip .n»4.n.. 1.. nm 111) ¤f*’¤S·¤=SS*¤A¤¤·*·¤*S*¤·=
Citizen or Subject of a U 3 D 3 Foreign Nation lj 6 lj 6
Forei n Count
IV. Place an ‘“X" in One Box Onl
CONTRACT FORFEITURE/PENALTY BANKRUPTCY ornnn srATUTEs
lj 110 Insurance PERSONAL INJURY PERSONAL INJURY D 610 Agriculture E] 422 Appeal 28 USC 158 D 400 State Reapponionment
D 120 Marine CI 310 Airplane D 362 Personal Injury — D 620 Other Food & Drug CI 423 Withdrawal D 410 Antitrust
D 130 Miller Act U 315 Airplane Product Med. Malpractice lj 625 Drug Related Seizure 28 USC 157 D 430 Banks and Banking
lj 140 Negotiable Instrument Liability lj 365 Personal Injury · of Property 21 USC 881 U 450 Commerce
lj 150 Recovery of Overpayment CI 320 Assault, Libel & Product Liability D 630 Liquor Laws PROPERTY RIGHTS CI 460 Deportation
& Enforcement of Judgment Slander lj 368 Asbestos Personal Cl 640 R.R. & Truck D 820 Copyrights D 470 Racketeer Influenced and
CI 151 Medicare Act lj 330 Federal Employers’ Injury Product CI 650 Airline Regs. D 830 Patent Corrupt Organizations
CI 152 Recovery of Defaulted Liability Liability lj 660 Occupational lj 840 Trademark D 480 Consumer Credit
Student Loans U 340 Marine PERSONAL PROPERTY Safety/Health lj 490 Cable/ Sat TV
(Excl. Veterans) lj 345 Marine Product lj 370 Other Fraud Cl 690 Other El 810 Selective Service
I] 153 Recovery of Overpayment Liability lj 371 Truth in Lending LABOR SOCIAL SECURITY G 850 Securities/Commodities/
of Veteran’s Benefits lj 350 Motor Vehicle I] 380 Other Personal 1] 710 Fair Labor Standards lj 861 HIA (1395ft) Exchange
D 160 Stockholders’ Suits lj 355 Motor Vehicle Property Damage Act lj 862 Black Lung (923) D 875 Customer Challenge
lj 190 Other Contract Product Liability lj 385 Property Damage lj 720 Labor/Mgmt. Relations lj 863 DIWC/DIWW (405(g)) 12 USC 3410
lj 195 Contract Product Liability lj 360 Other Personal Product Liability D 730 Labor/Mgmt.Reporting D 864 SSID Title XVI lj 890 Other Statutory Actions
U 196 Franchise In`u & Disclosure Act I] 865 RSI 405( )) lj 891 Agricultural Acts
REAL PROPERTY CIVIL RIGHTS PRISONER PETITIONS D 740 Railway Labor Act FEDERAL TAX SUITS CI 892 Economic Stabilization Act
D 210 Land Condemnation CI 441 Voting D 510 Motions to Vacate 790 Other Labor Litigation lj 870 Taxes (U.S. Plaintiff lj 893 Environmental Matters
I] 220 Foreclosure D 442 Employment Sentence D 791 Empl. Ret. Inc. or Defendant) D 894 Energy Allocation Act
lj 230 Rent Lease & Ejectment I] 443 Housing/ Habeas Corpus: Security Act lj 871 IRS—Third Party D 895 Freedom of Infonnation
lj 240 Torts to Land Accommodations D 530 General 26 USC 7609 Act
CI 245 Ton Product Liability CI 444 Welfare U 535 Death Penalty lj 900Appeal of Fee Detennination
CI 290 All Other Real Property 1] 445 Amer. w/Disabilities — D 540 Mandamus & Other Under Equal Access
Employment lj 550 Civil Rights to Justice
I] 446 Amer. w/Disabilities — 1] 555 Prison Condition lj 950 Constitutionality of
Other State Statutes
D 440 Other Civil Rights
V. ORIGIN (Place an ·—x·· in One anx Only) Aiipcal to Distrim
D 1 _ _ Q 2 D 3 D 4 D 5 Transferred from D 6 D 7 Ju ge from
Original X Removed from Remanded from Reinstated or another district Multidistrict Magistrate
Proceedm State Court A ellate Court Reo ened s eci Liti ation Jud ment
Cite the U.S. Civil Statute under whitglh o§ ge fiéing I5) not citijplrzfdlictionzjl Zazuécs unlesgdivirjitgg
•• . - s. 3 an
VL CAUSE OF ACTION B ef description of cause: 1 1 d l nct a
18.55 &ClZlO1'1 to IGCOVGI W8.g€S 3 GQG Y P
VII. REQUESTED IN XX CHECK IF THIS IS A CLASS ACTION DEMAND $ 5 O O 0 O 0 O CHECK YES only if demanded in complaint:
r I
COMPLAINT: UNDER F-R-CP. 23 JURY DEMAND: X]{Yes EI No
VIII. RELATED CASE(S) S _ _
t t : '
IF ANY ( °" ‘“s “'° ‘°“‘) JUDGE _ 7 DOCKET NUMBER
v
DATE . SIGNAT t · F ATTORNEY OF RE •_;•• .
5 5/ ,..,7,,7,7 ,,»<>f ,. I .4
FOR • ICE U ONLY ,/ .-r· i ’
RECEIPT # AMOUNT APPLYING IFP JUDGE MAG. JUDGE

Case 1 :05-cv-00269-.1.1 F Document 1-2 Filed 05/05/2005 Page 2 of 3
JS 44 Reverse (Rev. 1 1/04)
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 ofthe United States in September 1974, is required for the use
ofthe 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 fonn as follows:
I. (a) Plaintiffs-Defendants. Enter names (last, first, middle initial) of plaintiff and defendant. lf 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 govemment 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 ofthe county where the first listed plaintiff resides at the time
of filing. In U.S. plaintiff cases, enter the name of the county in which the first listed defendant resides at the time of filing. (NOTE: ln 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 attomey 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 boxes. If there is more than one basis of jurisdiction, precedence is given in the order shown below.
United States plaintiff (1) Jurisdiction based on 28 U.S.C. 1345 and 1348. Suits by agencies and officers of the United States are included here.
United States defendant. (2) When the plaintiff is suing die United States, its officers or agencies, place an "X" in 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 Congress or a treaty ofthe United States. In cases where the U.S. is a party, the U.S. plaintiff or defendant code takes precedence, and box
l 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 lll below; federal question actions take precedence over diversity cases.)
III. Residence (citizenship) of Principal Parties. This section ofthe JS 44 is to be completed if diversity of citizenship was indicated above. Mark this section
for each principal party.
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 V1 below, is sufficient
to enable the deputy clerk or the statistical clerks in the Administrative Of`fice to detemiine 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, check 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 l404(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 ofthe cause. Do not cite jurisdictional statutes
unless diversity. Example: U.S. Civil Statute: 47 USC 553 _ _
Br1efDescr1pt1on: 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.

Case 1 :05-cv-00269-JJF Document 1-2 Filed 05/05/2005 Page 3 of 3
Civil Cover Sheet Attachment:
Dora Jackson v. Wal—Mart Stores, Inc.
I. (c)
Plaintiffs Attorneys
Gary S. Nitsche, Esquire
Weik, Nitsche, Dougherty & Componovo
1300 N. Grant Avenue, Suite 101
P.O. Box 2324
Wilmington, DE 19899
(302) 655-4040
Defendants' Attorneys
Barry M. Klayman, Esquire
Wolf, Block, Schorr and Solis-Cohen LLP
Wilmington Trust Center
1100 N. Market Street, Suite 1001
Wilmington, DE 19801
(302) 777-0313