civil cover sheet
JS 44C/SDNY REV. 1/97 WEB 4.99 |
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 use of the Clerk of Court for the purpose of initiating the civil docket sheet. |
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plaintiffs Name of Plaintiff(s) |
defendants Name of Defendant(s) |
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attorneys (firm name, address, adn telephone number) Plaintiff's attorney |
attorneys (if known) Defendant's attorney |
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cause of action (cite the u.s. civil statute under which you are filing and write a brief statement of cause) basis for subject matter jurisdiction or other federal statute (i.e. 42 U.S.C. Section 1983) |
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Has this or a similar case been previously filed in SNDY at any time? No? ? Yes? ? Judge Previously Assigned__________________ |
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If yes, was this case Vol. ? Invol. D? ismissed. No ? Yes ? If yes, give date ___________________ & Case No._________________ |
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(place an (x) in one box only) NATURE OF SUIT |
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ACTIONS UNDER STATUTES |
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TORTS |
FORFEITURE/PENALTY |
BANKRUPTCY |
OTHER STATUTES |
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CONTRACT |
PERSONAL INJURY |
PERSONAL INJURY |
[ ] 610 agriculture [ ] 620 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 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 |
[ ] 422 appeal 28 usc 158 [ ] 423 withdrawal 28 usc 157 property rights [ ] 820 copyrights [ ] 830 patent [ ] 840 trademark social security [ ] 861 mia (1395ff) [ ] 862 black lung (923) [ ] 863 diwc (405(g)) [ ] 863 diww (4059g)) [ ] 864 ssid title xvi [ ] 865 rsi (405(g)) federal tax suits [ ] 870 taxes [ ] 871 irs-third party 20 usc 7609 |
[ ] 400 state reapportionment [ ] 410 antitrust [ ] 430 banks & banking [ ] 450 commerce/icc rates/etc [ ] 460 deportation [ ] 470 racketeer influ- enced & corrupt organization act (rico) [ ] 810 selective service [ ] 850 securities/ commodities/ exchange [ ] 875 customer challenge 12 usc 3410 [ ] 891 agriculture acts [ ] 892 economic stabilizaiton 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 |
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[ ] 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 real property [ ] 210 land condemnation [ ] 220 foreclosure [ ] 230 rent lease & ejectment [ ] 240 torts to land [ ] 246 tort product liability [ ] 290 all other real property |
[ ] 310 airplane [ ] 315 airplane product liability [ ] 320 assault, libel & slander [ ] 350 Federal employers' liability [ ] 340 marine [ ] 345 marine product liability [ ] 350 motor vehicle [ ] 355 motor vehicle product liability [ ] 360 Other personal injury actions under statutes civil rights [ ] 441 voting [ ] employment [ ] 443 housing accommodations [ ] 444 welfare [ ] 440 other civil rights |
[ ] 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 damage product liability prisoner petitions [ ] 510 motions to vacate sentence 20 usc 2255 [ ] 530 habeas corpus [ ] 535 death penalty [ ] 540 mandamus & other [ ] 550 civil rights [ ] 555 prison condition |
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Check if demanded in complaint: check if this is a class action do you claim this case is related to a civil case now pending in s.d.n.y.? under f.r.c.p. 23 if so, state: demand $amt or "yes" other injunct/decia judge______________________________________ docket number_________________________ Check YES only if demanded in complaint JURY DEMAND: |
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(see reverse)
(PLACE AN X IN ONE BOX ONLY) origin
Proceeding State Court Appellate Court Reopened (Specify District) Litigation Judge from Magistrate Judge Judgment |
(PLACE AN X IN ONE BOX ONLY) basic of jurisdiction if diverity, indicate
U.S NOT A PARTY) (28 USC 1322, 1441) |
CITIZENSHIP OF PRINCIPAL PARTIES (FOR DIVERSITY CASES ONLY) (Place an [X] in one box for Plaintiff and one box for Defendant) PTF DEF PTF DEF PTF DEF CITIZEN OF THIS STATE [ ]1 [ ]1 CITIZEN OR SUBJECT OF A [ ]3 [ ]3 INCORPORATED and PRINCIPAL PLACE [ ]5 [ ]5 FOREIGN COUNTRY OF BUSINESS IN ANOATHER STATE CITIZEN OF ANOTHER STATE [ ]2 [ ]2 INCORPORATED or PRINCIPAL [ ]4 [ ]4 FOREIGN NATION [ ]6 [ ]6 OF BUSINESS IN THIS STATE |
PLAINTIFF(S) ADDRESS(ES) AND COUNTY(IES) (Calendar Rule 4(A)) Plaintiff's address |
DEFENDANT(S) ADDRESS(ES) AND COUNTY(IES) (Calendar Rule 4(A)) Defendant's address (if multiple defendants, use lead defendant's) |
DEFENDANT(S) ADDRESS UNKNOWN REPRESNTATION IS HEREBY MADE THAT, AT THIS TIME, I HAVE BEEN UNABLE, WITH REASONABLE DILIGENCE, TO ASCERTAIN THE RESIDENCE ADDRESSES OF THE FOLLOWING DEFENDANTS: |
Check one: THIS ACTION SHOULD BE ASSIGNED TO: (DO NOT check either box if this a PRISONERPETITION.) |
DATE SIGNATURE OF ATTORNEY OF RECORD ADMITTED TO PRACTICE IN THIS DISTRICT [ ] NO [ ] YES (DATE ADMITTED Mo. ________ Yr. _________) RECEIPT Attorney Bar Code # |
Magistrate Judge is to be designated by the Clerk of the Court. Magistrate Judge is so Designated. James M. Parkison, Clerk of Court by _____________ Deputy Clerk, DATED _________________________. |
UNITED STATES DISTRICT COURT (NEW YORK SOUTHERN) |