Free Complaint - District Court of California - California

Case 3:08-cv-03646-SC 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 26 27 28 v. LISA D. BAYLIS, Plaintiff, BETTY HERRERA (242189)

Document 1

Filed 07/30/2008

Page 1 of 2

1055 Lincoln Avenue Post Office Box 5025 San Jose, California 95150-5025 Telephone: (408) 295-7755 Facsimile: (408) 295-7444 /as Attorney for Plaintiff

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF CALIFORNIA OAKLAND DIVISION ) ) ) ) ) ) ) ) ) ) ) ) Case No.: C08-03646 SC

MICHAEL J. ASTRUE, Commissioner, Social Security Administration, Defendant.

COMPLAINT FOR JUDICIAL REVIEW OF DECISION OF COMMISSIONER OF SOCIAL SECURITY (Administrative Procedure Act Case)

The above-named plaintiff makes the following representations to this court for the purpose of obtaining judicial review of a decision of the defendant adverse to the plaintiff: 1. 2. The plaintiff is a resident of Oakland, California. The plaintiff complains of a decision, which adversely affects the plaintiff in

whole or in part. The decision has become the final decision of the Secretary for purpose of judicial review and bears the following caption:

COMPLAINT

Case 3:08-cv-03646-SC 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 26 27 28 DATE: July 29, 2008 In the case of LISA D. BAYLIS Claimant LISA D. BAYLIS Wage Earner 3.

Document 1

Filed 07/30/2008 Claim for

Page 2 of 2

SOCIAL SECURITY TITLE II ­ DIWC XXX-XX-4194 Social Security Number

The plaintiff has exhausted administrative remedies in this matter and this court

has jurisdiction for judicial review pursuant to 42 U.S.C. 405(g). WHEREFORE, the plaintiff seeks judicial review by this court and the entry of judgment for such belief as may be proper, including costs.

/s/
BETTY HERRERA Attorney for Plaintiff LISA D. BAYLIS

COMPLAINT

Case 3:08-cv-03646-SC
JS 44 - No. CALIF .(Rev. 4/97)

CIVIL COVER SHEET

Document 1-2

Filed 07/30/2008

Page 1 of 2 Clear Form

The JS-44 civil cover sheet and the information contained herein neither replace nor supplement the filing and service of pleadings 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. (SEE INSTRUCTIONS ON PAGE TWO)

I.(a) PLAINTIFFS

DEFENDANTS

LISA D. BAYLIS SSN: XXX-XX-4194
(b)
COUNTY OF RESIDENCE OF FIRST LISTED PLAINTIFF

MICHAEL J. ASTRUE, Commissioner, Social Security Administration
COUNTY OF RESIDENCE OF FIRST LISTED DEFENDANT

(EXCEPT IN U.S. PLAINTIFF CASES)

(IN U.S. PLAINTIFF CASES ONLY)
NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF THE TRACT OF LAND INVOLVED . ATTORNEYS (IF KNOWN)

ALAMEDA
( c) ATTORNEYS (FIRM NAME, ADDRESS, AND TELEPHONE NUMBER)

BETTY HERRERA SACKETT AND ASSOCIATES, A Professional Law Corporation Post Office Box 5025, San Jose, California 95150-5025 II. BASIS OF JURISDICTION (PLACE AN "T " IN ONE BOX ONLY) T III. CITIZENSHIP OF PRINCIPAL PARTIES
PLAINTIFF

(PLACE AN "T " IN ONE BOX FOR T AND ONE BOX FOR DEFENDANT)

1 U.S. Government Plaintiff 2 U.S. Government Defendant

3 Federal Question (U.S. Government Not a Party) 4 Diversity (Indicate Citizenship of Parties in Item III)

(For diversity cases only ) PTF
Citizen of This State Citizen of Another State Citizen or Subject of a Foreign Country 1 2 3

DEF
1 2 3 Incorporated or Principal Place of Business In This State Incorporated and Principal Place of Business In Another State Foreign Nation

PTF
4 5 6

DEF
4 5 6

IV. ORIGIN
1 Original Proceeding 2 Removed from State Court

(PLACE AN "T" IN ONE BOX ONLY) T
3 Remanded from Appellate Court 4 Reinstated or Reopened 5 Transfered from Another district (specify) 6 Multidistrict Litigation 7 Appeal to District Judge from Magistrate Judgment

V. NATURE OF SUIT (PLACE AN "T " IN ONE BOX ONLY) T
CONTRACT
110 Insurance 120 Marine 130 Miller Act 140 Negotiable Instrument 150 Recovery of Overpayment & Enforcement of Judgment 151 Medicare Act 152 Recovery of Defaulted Student Loans (Excl Veterans) 153 Recovery of Overpayment of Veteran's Benefits 160 Stockholders Suits 190 Other Contract 195 Contract Product Liability

TORTS
PERSONAL INJURY
310 Airplane 315 Airplane Product Liability 320 Assault Libel & Slander 330 Federal Employers Liability 340 Marine 345 Marine Product Liability 350 Motor Vehicle 355 Motor Vehicle Product Liabiltiy 360 Other Personal Injury

FORFEITURE/PENALTY
610 Agriculture 620 Other Food & Drug 625 Drug Related Seizure of Property 21 USC 881 630 Liquor Laws 640 RR & Truck 650 Airline Regs 660 Occupational Safety/Health 690 Other

BANKRUPTCY
422 Appeal 28 USC 158 423 Withdrawal 28 USC 157

OTHER STATUTES
400 State Reapportionment 410 Antitrust 430 Banks and Banking 450 Commerce/ICC Rates/etc. 460 Deportation 470 Racketeer Influenced and Corrupt Organizations 810 Selective Service 850 Securities/Commodities/ Exchange 875 Customer Challenge 12 USC 3410 891 Agricultural Acts 892 Economic Stabilization Act 893 Environmental Matters 894 Energy Allocation Act 895 Freedom of Information Act 900 Appeal of Fee Determination Under Equal Access to Justice 950 Constitutionality of State Statutes 890 Other Statutory Actions

PERSONAL INJURY
362 Personal Injury Med Malpractice 365 Personal Injury Product Liability 368 Asbestos Personal Injury Product Liability

PROPERTY RIGHTS
820 Copyrights 830 Patent 840 Trademark

PERSONAL PROPERTY
370 Other Fraud 371 Truth In Lending 380 Other Personal Property Damage 385 Property Damage Product Liability

LABOR
710 Fair Labor Standards Act 720 Labor/Mgmt Relations 730 Labor/Mgmt Reporting & Disclosure Act 740 Railway Labor Act 790 Other Labor Litigation 791 Empl.Ret. Inc. Security Act

SOCIAL SECURITY
861 HIA (1395ff) 862 Black Lung (923) 863 DIWC/DIWW (405(g)) 864 SSID Title XVI 865 RSI (405(g))

REAL PROPERTY
210 Land Condemnation 220 Foreclosure 230 Rent Lease & Ejectment 240 Torts to Land 245 Tort Product Liability 290 All Other Real Property

CIVIL RIGHTS
441 Voting 442 Employment 443 Housing 444 Welfare 440 Other Civil Rights

PRISONER PETITIONS
510 Motion to Vacate Sentence Habeas Corpus: 530 General 535 Death Penalty 540 Mandamus & Other 550 Civil Rights 555 Prison Condition

FEDERAL TAX SUITS
870 Taxes (US Plaintiff or Defendant 871 IRS - Third Party 26 USC 7609

VI. CAUSE OF ACTION (CITE THE US CIVIL STATUTE UNDER WHICH YOU ARE FILING AND WRITE BRIEF STATEMENT OF CAUSE. DO NOT CITE JURISDICTIONAL STATUTES UNLESS DIVERSITY) 42 U.S.C. Section 405(g) Review of final administrative decision. VII. REQUESTED IN COMPLAINT:
CHECK IF THIS IS A CLASS ACTION UNDER F.R.C.P. 23

DEMAND $

CHECK YES only if demanded in complaint: JURY DEMAND: YES NO

VIII. RELATED CASE(S) IF ANY

PLEASE REFER TO CIVIL L.R. 3-12 CONCERNING REQUIREMENT TO FILE "NOTICE OF RELATED CASE".

IX. DIVISIONAL ASSIGNMENT (CIVIL L.R. 3-2) (PLACE A "T " IN ONE BOX ONLY)
DATE SIGNATURE OF ATTORNEY OF RECORD

SAN FRANCISCO/OAKLAND

SAN JOSE

JS 44 Reverse

Case 12/96) 3:08-cv-03646-SC (Rev.

Document 1-2

Filed 07/30/2008

Page 2 of 2

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 the 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: 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 " T " 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 the United States, its officers or agencies, place an " T " 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 of the United States. In cases 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 principal party. IV. Origin. Place an " T " 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 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. V. Nature of Suit. Place an " T " in the appropriate box. If the nature of suit cannot be determined, be sure the cause of action, in Section IV
above, 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.
VI. Cause of Action. Report the civil statute directly related to the cause of action and give a brief description of the cause.
VII. Requested in Complaint. Class Action. Place an " T " 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 Attorney Signature. Date and sign the civil cover sheet.