Sie sind auf Seite 1von 4

RD

l4

265 9

Case 5:14-cv-02559-PD
Document
Filed 05/02/14 Page 1 of 4
CIVIL
COVER1-1
SHEET

JS_M (Rev. 12/12)

'the JS 44 civil cover sheet and


t
on contained herein neither replace nor supplement the filing and service of pleadin&s or other papers as required by law, except as
provided by local rules of court. his
, 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 doc et stiect. (SHE INS7'!UJCTIONS ON NHXT l'AG!i OF THIS HJllM.)

I. (a) PLAINTIFFS

l,jJ, .Mt- (Vt,,~(_ /1

t(), ~

~.

1 IV[jj it( r;

ffl.f1Hr1~

(b) County of Residence of First Listed Plaintiff ------


(EXCEPT IN U.S. l'l.AINTIFF CASES)

f-<\ f\'t-vtW61/\AM
(c) Attorneys (Firm Name,

Address, and

r"v A;--

7e~phone

II. BASIS OF JURISDICTION (!'lace an


01

02

U.S. Government
Plaintiff

Number)

III. CITIZENSHIP OF PRINCIPAL PARTIES {Pla,e an "x" 1n One Box/or Plain1tf!

"X" in One Box Only)

(For Diversity Cases Only)


PTF
0 I

Federal Question
(U.S. Government Not a !'arty)

U.S. Government
Defendant

04

IV NATURE OF SUIT
I :~:J!)\t-0f"'CONTRlt.crc;i'l:r<.!>7 ':'
0 110 Insurance
0120 Marine
0 130 Miller Act
0 140 Negotiable Instrument
0 150 Recovery of Overpayment
& Enforcement of Judgment
0 151 Medicare Act
0 152 Recovery of Defaulted
Student Loans
(Excludes Veterans)
0 153 Recovery of Overpayment
of Veteran's Benefits
0 160 Stockholders' Suits
0 190 Other Contract
0 195 Contract Product Liability
0 196 Franchise

Citizen of This State

Diversity
(Indicate Citizenship of Parties in Item /II)

(l'Iace an "X" 111


0 ne Box 0 nY.
I~

l:li!,F' ;/ .-:''c'~;,;,:."i':,

TORTS'i'

PERSONAL INJURY
0 310 Airplane
0 315 Airplane Product
Liability
D 320 Assault, Libel &
Slander
D 330 Federal Employers'
Liability
D 340 Marine
D 345 Marine Product
Liability
D 350 Motor Vehicle
0 355 Motor Vehicle
Product Liability
0 360 Other Personal
Injury
D 362 Personal Injury
Medical Malpractice

,,

KJt2
"71t- Vt

*"

Incorporated and Principal Place


of Business In Another State

0 5

Citizen or Subject of a
Foreign Country

03

Fo~eign Nation

06

.
;

..

'

o-'.i;

PERSONAL INJURY
0 365 Personal Injury
Product Liability
0 367 Health Care/
Pharmaceutical
Personal Injury
Product Liability
0 368 Asbestos Personal
Injury Product
Liability
PERSONAL PROPERTY
0 370 Other Fraud
0 371 Truth in Lending
0 380 Other Personal
Property Damage
0 385 Property Damage
Product Liability

Remanded from
Appellate Court

and One Box for Defendant)


PTF
DEF
0 4
0 4

Incorporated or Principal Place


of Business In This State

Citizen of Another State

' FORFEITt:JRE/PtNAL'IY
0 625 Drug Related Seizure
of Property 21 USC 881
06900ther

LJ 4

''

BANKRUPTCY; ,

O'J'HlllJt::STATUTES

0 422 Appeal 28 USC 158


0 423 Withdrawal
28 USC 157

0
0
0
0
0
0
0

PROPERTY RIGH'FS'
0 820 Copyrights
0830 Patent
0 840 Trademark
. 1- . ;

LABOR:"
0 71 0 Fair Labor Standards
Act
0720 Labor/Management
Relations
0740 Railway Labor Act
0751 Family and Medical
Leave Act
0790 Other Labor Litigation
I 'J:>Z,f/lf!ii JUjAiPRQJ'E~T.W\:'1f'i';1.1 ~!~'' .(;;IYJJ:;RIGHT$,i~i1', ( :;P~ISQl'IERlPE1'1'J'IQNsl\ 0791 Employee Retirement
D 210 Land Condemnation
0 440 Other Civil Rights
Income Security Act
Habeas Corpus:
0 463 Alien Detainee
0 220 Foreclosure
0 441 Voting
D 442 Employment
0 510 Motions to Vacate
0 230 Rent Lease & Ejectment
Sentence
0 240 Torts to Land
0 443 Housing/
0 245 Tort Product Liability
Accommodations
~530 General
'
535 Death Penalty
0 290 All Other Real Property
IMMl~RATION
D 445 Amer. w/Disabilities
O 462 Naturalization Appl1cat10n
Employment
Other:
D 446 Amer. w/Disabilities 0 540 Mandamus & Other 0465 Other Immigration
Other
0 550 Civil Rights
Actions
0 448 Education
0 555 Prison Condition
0 560 Civil Detainee
Conditions of
Confinement

V. ORIGIN (Place an "X" in One Box Only)


lV1 Original
U 2 Removed from U
I\ Proceeding
State Court

Reinstated or
Reopened

0
0
0

S01AL SECURITY:
D 861 HIA (1395tl)
0 862 Black Lung (923)
D 863 DIWC/DIWW (405(g))
0 864 SSID Title XVI
D 865 RSI (405(g))

FEDEAALJ'A~su1rs1 :'
U 870 Taxes (U.S. Plaintiff
or Defendant)
0 871 IRS-Third Party
26 USC 7609

0
0
0
0

0
0

375 False Claims Act


400 State Reapportionment
410 Antitrust
430 Banks and Banking
450 Commerce
460 Deportation
470 Racketeer Influenced and
Corrupt Organizations
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 Statutes

LJ 5 Transferred from LJ 6 Multidistrict


Another District

Litigation

(.<pec1/y)

VI. CAUSEOF
ACTION

Brief descriP.tion of cau e:

VII. REQUESTED IN I 0
COMPLAINT: N l /t

VIII. RELATED CASE(S)


IF ANY
b'f._in.<tructwns):

. wl

UI'
CHECK YES only if demanded in complaint:

CHECK IF THIS IS A CLASS ACTION


UNDER RULE 23, F.R.Cv.P.

l\

JURY DEMAND:

JUDGE

DOCKET NUMBER

SIGNATURE OF ATTORNEY OF RECORD

FOR OFFICE USE ONLY


RECEIPT#

AMOUNT

APPL YING IFP

JUDGE

MAG. JUDGE

0Yes

No

MAY - 2 2014

Case 5:14-cv-02559-PD Document 1-1 Filed 05/02/14 Page 2 of 4

PD
LLS-A

IN THE UNITED STATES DISTRICT COURT


FOR THE EASTERN DISTRICT OF PENNSYLVANIA
CASE MANAGEMENT TRACK DESIGNATION FORM

M( (li~L~ t.4-f1i8itt1)'

fefr/7v4er~

CIVIL ACTION

v.

L/ Nti 61

:
S J'U111~1f~f; S LI ff~ l!VfttvJ/c1j :

fl 4!1

(J r~Jln::o~::::e
~::Justice Expense ~d Delay Reduction Plan:~~is court, counsel
l

55 ~
for

'

t f/W plaintiff shall complete a Case Management Track Designation Form in all civil cases at the time of

filing the complaint and serve a copy on all defendants. (See 1:03 of the plan set forth on the reverse
side of this form.) In the event that a defendant does not agree with the plaintiff regarding said
designation, that defendant shall, with its first appearance, submit to the clerk of court and serve on
the plaintiff and all other parties, a Case Management Track Designation Form specifying the track
to which that defendant believes the case should be assigned.
SELECT ONE OF THE FOLLOWING CASE MANAGEMENT TRACKS:
(a) Habeas Corpus- Cases brought under 28 U.S.C. 2241through2255.

(/

(b) Social Security - Cases requesting review of a decision of the Secretary of Health
and Human Services denying plaintiff Social Security Benefits.

( )

(c) Arbitration - Cases required to be designated for arbitration under Local Civil Rule 53.2.

( )

(d) Asbestos - Cases involving claims for personal injury or property damage from
exposure to asbestos.

( )

(e) Special Management- Cases that do not fall into tracks (a) through (d) that are
commonly referred to as complex and that need special or intense management by
the court. (See reverse side of this form for a detailed explanation of special
management cases.)

( )

(f) Standard Management- Cases that do not fall into any one of the other tracks.

( )

Telephone

(Cl..060)

{H (

Attorney-at-law

Attorney for

FAX Number

E-Mail Address

'P~ ffr,/ IJ rrtf/f (<tr Nf

/) l .!"/Al CT

I} IT o!f N.,Y (f ,A "-.Jrllf ( lf.JTC1 \:</I.A~


a,/vr)

f.[rN 111.f/

VlfYvll/

f . l\//l/5r( V)-/\/I .If)


R-e >-p cNc/e/l/fr

MAY - 2 2014

Vf\

14

255 9

U!~lll!..US1Al1SUISTRICTCOURT
Case 5:14-cv-02559-PD
Document 1-1 Filed 05/02/14 Page 3 of 4

FOR 1{.E EASTERN DISTRICT OF PENNSYLVANIA assignment to appropriate calendar.

l>ESIGNA TION FORM to be used by counsel to indicate the category of the case for the purpose of

Place of Accident, Incident or Transaction: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _C_Cl.i_'IVT.__,'._"'.,,,""".,.(Use Reverse Side For Additional Space)
Does this civil action involve a nongovernmental corporate party with any parent corporation and any publicly held corporation owning IOo/o or more of its stock?
(Anach two copies of the Disclosure Statement Form in accordance with Fed.R.Civ.P. 7. l(a))

YesD

Does this case involve multidistrict litigation possibilities?

Not;I'

Yesa

RELATED CASE, IF ANY:


Case Number: _ _ _ _ _ _ _ _ _ _ Judge _ _ _ _ _ _ _ _ _ _ _ _ _ Date T e r m i n a t e d : - - - - - - - - - - - - - - - - - -

Civil cases arc deemed related when yes is answered to any of the following questions:
I. Is this case related to property included in an earlier numbered suit pending or within one year previously terminated action in th's court?
YesO
NortY"
2. Does this case involve the same issue of fact or grow out of the same transaction as a prior suit pending or within one year previously terminated
action in this coun?
No{J/
YesO
3. Does this case involve the validity or infringement of a patent already in suit or any earlier numbered case pending or within one year previou~
terminated action in this court?

YesD

NoQ/

4. Is this case a second or successive habeas corpus, social security appeal, or prose civil rights case filed by the same individual?

Yes~
CIVIL: (Place
A

NoD

t/ in ONE CATEGORY ONLY)


B. Diversity Jurisdiction Cases:

Federal Que.rtion Ca.re.r:

I.

CJ

Indemnity Contract, Marine Contract, and All Other Contracts

I. CJ Insurance Contract and Other Contracts

2.

CJ

FELA

2.
3.
4.
5.
6.
7.
8.
9.

3. o Jones Act-Personal Injury


4. o Antitrust

5. o Patent
6. o Labor-Management Relations
7.

CJ

Civil Rights

8. )(Habeas Corpus
9. o Securities Act(s) Cases
I0.

CJ

Social Security Review Cases

D Airplane Personal Injury


0

Assault, Defamation

D Marine Personal Injury


D Motor Vehicle Personal Injury
D Other Personal Injury (Please specify)
CJ

Products Liability

D Products Liability 0

Asbestos

All other Diversity Cases


(Please specify)

11. o All other Federal Question Cases


(Please specify) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

ARBITRATION CERTIFICATION
(Check Appropriate Category)
counsel of record do hereby certify:
a Pursuant to Local Civil Rule 53.2, Section 3(c)(2), that to the best of my knowledge and belief, the damages recoverable in this civil action case exceed the sum of
$I 50,000.00 exclusive of interest and costs:
a Relief other than monetary damages is sought.

I,

DATE: _ _ _ _ _ _ _ _ __
'Y\ttSRll'' t L w

~aflle'} l.~r,yAY

NOTE: A trial de novo will be a trial by jury only if there has been compliance with F.R.C.P. 38.

I certify that. to my knowledge, the within case is not related to any case now pending or within one year previously terminated action in this court
except as noted above.
><"DATE:

f<\JAi <-\zu\'\

CIV. 609 (S/2012)

(<
"Jrtb311rey-at=Lao

AMS!'Aef I D.#

2 2014

Case 5:14-cv-02559-PD Document 1-1 Filed 05/02/14 Page 4 of 4

AcA~ d iJ-f f1.eNttfc4,(((/,.,,(>)


. '.

~.(o

fV, f) <-Al'f Sf-fle~t, l~ N(~fJfe~ i tf4 17 6CJZ


0, 'ffr:d ,f tfu-Ntf o- f l. "NC"->hr CC-"""Jf;-, f If )

'{(/;"' f/urf'fraw6eo; S~utN t Hc;mScf,U//f, f..1


t t {~ (f ( ,fftvrND' Ge~ O'f letvMY7/vc;'lfl""t

Das könnte Ihnen auch gefallen