Expression, Complaint for Violation of Civil Rights (Non-Prisoner)

• Legal Form Number: Pro Se 15
• Court: United States Federal Court
• Section: United States Federal Court

Pro Se 15 (Rev. 12/16) Complaint for Violation of Civil Rights (Non–Prisoner)

UNITED STATES DISTRICT COURT

for the

__________ District of __________

__________ Division

)

)

)

)

)

)

)

)

)

)

)

)

)

)

)

Case No.

(to be filled in by the Clerk’s Office)

Plaintiff(s)

(Write the full name of each plaintiff who is filing this complaint.

If the names of all the plaintiffs cannot fit in the space above,

please write “see attached” in the space and attach an additional

page with the full list of names.)

-v-

Jury Trial: (check one) ’Yes ’No

Defendant(s)

(Write the full name of each defendant who is being sued. If the

names of all the defendants cannot fit in the space above, please

write “see attached” in the space and attach an additional page

with the full list of names. Do not include addresses here.)

COMPLAINT FOR VIOLATION OF CIVIL RIGHTS

(Non-Prisoner Complaint)

NOTICE

Federal Rules of Civil Procedure 5.2 addresses the privacy and security concerns resulting from public access to

electronic court files. Under this rule, papers filed with the court should not contain: an individual’s full social

security number or full birth date; the full name of a person known to be a minor; or a complete financial account

number. A filing may include only: the last four digits of a social security number; the year of an individual’s

birth; a minor’s initials; and the last four digits of a financial account number.

Except as noted in this form, plaintiff need not send exhibits, affidavits, grievance or witness statements, or any

other materials to the Clerk’s Office with this complaint.

In order for your complaint to be filed, it must be accompanied by the filing fee or an application to proceed in

forma pauperis.

Page 1 of 6

__________ District of __________

__________ Division