UNITED STATES DISTRICT COURT
DISTRICT OF ARIZONA

Civil Cover Sheet

This automated JS-44 conforms generally to manual JS-44 approved by the Judicial Conference of the United States in September 1974. The data is required for the use of the Clerk of Court for the purpose of initiating the civil docket sheet. The information contained herein neither replaces nor supplements the filing and service of pleadings or other papers as required by law. This form is authorized for use only in the District of Arizona. Instructions

I. (a) PLAINTIFFS

DEFENDANTS

(b) County of Residence of First Listed Plaintiff

County of Residence of First Listed Defendant

County Where Claim for Relief Arose

(c) Plaintiff's Attorney
Defendant's Attorney (If known)
    Check here if you are filing a motion to proceed in forma pauperis

II. Basis of Jurisdiction
(Select from drop menu below)
III. Citizenship of Principal Parties (Diversity cases only)
PLAINTIFF


DEFENDANT

IV. Origin
(Select from drop menu below)
V. Nature of Suit (Select one box)

Contract
110 Insurance
120 Marine
130 Miller Act
140 Negotiable Instrument
150 Recovery of Overpayment &
Enforcement of Judgment
151 Medicare Act
152 Student Loan -non VA
153 Recovery of VA Benefits
160 Stockholder Suits
190 Other Contract
195 Contract Product Liability
196 Franchise

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

Bankruptcy
422 Appeal 28 USC 158
423 Withdrawal 28 USC 157

Property Rights
820 Copyrights
830 Patent
840 Trademark

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 Liability
360 Other Personal Injury
362 Med. Malpractice
365 Personal Injury - Product Liability
367 Health Care/Pharmaceutical 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

Civil Rights
440 Other Civil Rights
441 Voting
442 Employment
443 Housing/Accommodations
445 Amer. w/Disabilities - Employment
446 Amer. w/Disabilities - Other
448 Education

Prisoner Petitions
Habeas Corpus:
463 Alien Detainee
510 Motions to Vacate Sentence
530 General
535 Death Penalty
Other:
540 Mandamus & Other
550 Civil Rights
555 Prison Condition
560 Civil Detainee - Conditions of Confinement


Immigration
462 Naturalization Application
465 Other Immigration Actions

Forfeiture/Penalty
625 Drug Related Seizure of Property 21 USC 881
690 Other

Labor
710 Fair Labor Standards Act
720 Labor/Mgmt. Relations
740 Railway Labor Act
751 Family and Medical Leave Act
790 Other Labor Litigation
791 E.R.I.S.A.

 

 

Other Statutes
375 False Claims Act
400 State Reapportionment
410 Antitrust
430 Banks & Banking
450 Commerce/ICC Rates/ etc
460 Deportation
470 RICO
480 Consumer Credit
490 Cable/Sat TV
850 Securities/Commodities/Exchange
890 Other Statutory Actions
891 Agricultural Acts
893 Environmental Matters
895 Freedom of Information Act
896 Arbitration
899 Administrative Procedure Act/Review or Appeal of Agency Decision
950 Constitutionality of State Statute

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

Federal Tax Suits
870 Taxes US Plaintiff or Defendant
871 IRS Third Party 26 USC 7609

Is this a removal from state court?
VI. Cause of Action (CITE THE U. S. STATUTE UNDER WHICH YOU ARE FILING AND WRITE A BRIEF STATEMENT OF CAUSE. DO NOT CITE JURISDICTIONAL STATUTES UNLESS DIVERSITY.)
VII. Requested in Complaint Class Action Under FRCP 23
Not Class Action
Demand
Jury Demand
(requested in Complaint)
Yes No
VIII. This Case is related to case number , assigned to Judge .

DATE:         SIGNATURE OF ATTORNEY OF RECORD: