JS 44 (Rev. 06/17)
`
`Case 1:20-cv-00007-RGA Document 1-2 Filed 01/03/20 Page 1 of 1 PageID #: 289
` CIVIL COVER SHEET
`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 NEXT PAGE OF THIS FORM.)
`I. (a) PLAINTIFFS
`DEFENDANTS
`
`(b) County of Residence of First Listed Plaintiff
`(EXCEPT IN U.S. PLAINTIFF CASES)
`
`(c) Attorneys (Firm Name, Address, and Telephone Number)
`
`NOTE:
`
`County of Residence of First Listed Defendant
`(IN U.S. PLAINTIFF CASES ONLY)
`IN LAND CONDEMNATION CASES, USE THE LOCATION OF
`THE TRACT OF LAND INVOLVED.
`
` Attorneys (If Known)
`
`II. BASIS OF JURISDICTION (Place an “X” in One Box Only)
`’ 1 U.S. Government
`’ 3 Federal Question
`(U.S. Government Not a Party)
`Plaintiff
`
`III. CITIZENSHIP OF PRINCIPAL PARTIES (Place an “X” in One Box for Plaintiff
`(For Diversity Cases Only)
` and One Box for Defendant)
` PTF DEF
` PTF
` DEF
`Incorporated or Principal Place
`Citizen of This State
`’ 1
`’ 1
`’ 4
`’ 4
` of Business In This State
`
`’ 2 U.S. Government
`Defendant
`
`’ 4 Diversity
`(Indicate Citizenship of Parties in Item III)
`
`Citizen of Another State
`
`’ 2
`
`’ 2
`
`Incorporated and Principal Place
`of Business In Another State
`
`’ 5
`
`’ 5
`
`’ 6
`
`’ 6
`
`Citizen or Subject of a
` Foreign Country
`
`’ 3
`
`’ 3
`
`Foreign Nation
`
`IV. NATURE OF SUIT (Place an “X” in One Box Only)
`CONTRACT
`TORTS
` PERSONAL INJURY
` PERSONAL INJURY
`’ 110 Insurance
`’ 120 Marine
`’ 310 Airplane
`’ 365 Personal Injury -
`’ 130 Miller Act
`’ 315 Airplane Product
` Product Liability
`’ 140 Negotiable Instrument
` Liability
`’ 367 Health Care/
`’ 150 Recovery of Overpayment ’ 320 Assault, Libel &
` Pharmaceutical
` & Enforcement of Judgment
` Slander
` Personal Injury
`’ 151 Medicare Act
`’ 330 Federal Employers’
` Product Liability
`’ 152 Recovery of Defaulted
` Liability
`’ 368 Asbestos Personal
` Student Loans
`’ 340 Marine
` Injury Product
` (Excludes Veterans)
`’ 345 Marine Product
` Liability
` PERSONAL PROPERTY
`LABOR
`’ 153 Recovery of Overpayment
` Liability
`’ 710 Fair Labor Standards
` of Veteran’s Benefits
`’ 350 Motor Vehicle
`’ 370 Other Fraud
` Act
`’ 160 Stockholders’ Suits
`’ 355 Motor Vehicle
`’ 371 Truth in Lending
`’ 720 Labor/Management
`’ 190 Other Contract
` Product Liability
`’ 380 Other Personal
` Relations
`’ 195 Contract Product Liability ’ 360 Other Personal
` Property Damage
`’ 740 Railway Labor Act
`’ 196 Franchise
` Injury
`’ 385 Property Damage
`’ 751 Family and Medical
`’ 362 Personal Injury -
` Product Liability
` Leave Act
` Medical Malpractice
` PRISONER PETITIONS ’ 790 Other Labor Litigation
` CIVIL RIGHTS
`Habeas Corpus:
`’ 791 Employee Retirement
`’ 440 Other Civil Rights
`’ 463 Alien Detainee
` Income Security Act
`’ 441 Voting
`’ 510 Motions to Vacate
`’ 442 Employment
` Sentence
`’ 443 Housing/
`’ 530 General
` Accommodations
`’ 445 Amer. w/Disabilities - ’ 535 Death Penalty
`Other:
` Employment
`’ 446 Amer. w/Disabilities - ’ 540 Mandamus & Other
` Other
`’ 550 Civil Rights
`’ 448 Education
`’ 555 Prison Condition
`’ 560 Civil Detainee -
` Conditions of
` Confinement
`
`Click here for: Nature of Suit Code Descriptions.
`BANKRUPTCY
`OTHER STATUTES
`FORFEITURE/PENALTY
`’ 422 Appeal 28 USC 158
`’ 375 False Claims Act
`’ 625 Drug Related Seizure
` of Property 21 USC 881 ’ 423 Withdrawal
`’ 376 Qui Tam (31 USC
`’ 690 Other
` 28 USC 157
` 3729(a))
`’ 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
`
`PROPERTY RIGHTS
`’ 820 Copyrights
`’ 830 Patent
`’ 835 Patent - Abbreviated
` New Drug Application
`’ 840 Trademark
`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 (U.S. Plaintiff
` or Defendant)
`’ 871 IRS—Third Party
` 26 USC 7609
`
` REAL PROPERTY
`’ 210 Land Condemnation
`’ 220 Foreclosure
`’ 230 Rent Lease & Ejectment
`’ 240 Torts to Land
`’ 245 Tort Product Liability
`’ 290 All Other Real Property
`
`IMMIGRATION
`’ 462 Naturalization Application
`’ 465 Other Immigration
` Actions
`
`V. ORIGIN (Place an “X” in One Box Only)
`’ 1 Original
`’ 2 Removed from
`Proceeding
`State Court
`
`’ 3 Remanded from
`Appellate Court
`
`’ 4 Reinstated or
`Reopened
`
`’ 6 Multidistrict
`Litigation -
`Transfer
`
`’ 8 Multidistrict
` Litigation -
` Direct File
`
`’ 5 Transferred from
`Another District
`(specify)
`Cite the U.S. Civil Statute under which you are filing (Do not cite jurisdictional statutes unless diversity):
`
`Brief description of cause:
`
`’ CHECK IF THIS IS A CLASS ACTION
`UNDER RULE 23, F.R.Cv.P.
`
`DEMAND $
`
`CHECK YES only if demanded in complaint:
`’ Yes
`’ No
`JURY DEMAND:
`
`(See instructions):
`
`JUDGE
`SIGNATURE OF ATTORNEY OF RECORD
`
`DOCKET NUMBER
`
`VI. CAUSE OF ACTION
`
`VII. REQUESTED IN
` COMPLAINT:
`VIII. RELATED CASE(S)
` IF ANY
`DATE
`
`FOR OFFICE USE ONLY
`
`RECEIPT #
`
`AMOUNT
`
`APPLYING IFP
`
`JUDGE
`
`MAG. JUDGE
`
`