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STEP BY STEP
A SIMPLE GUIDE TO FILING A CIVIL ACTION
IN THE
UNITED STATES DISTRICT COURT
DISTRICT OF MASSACHUSETTS
JUNE 9, 2017
Step by Step
Revised June 9, 2017 - U.S.D.C. - Massachusetts
Page 2
STEP BY STEP
A Simple Guide to Filing a Civil Action
You believe that you have been injured or wronged by someone, some individual, corporation or
government agency. You also believe you should be compensated for the harm you have suffered. In order to
accomplish this, you have decided to file a civil suit in the United States District Court, without the help of an
attorney.
FUNDAMENTAL INFORMATION
First, there are a few simple concepts you must get to know and understand.
The PLAINTIFF is the person who files the lawsuit.
The DEFENDANT is the person who is being sued.
If the you are representing yourself without the benefit of an attorney, you are known as a PRO SE
LITIGANT. "Pro Se" is a Latin term meaning "for yourself."
As a pro se litigant, you enjoy every right entitled to you under the law. You need not worry if you have
had little or no experience with the courts before. However, pro se litigants are expected to follow/abide by the
rules that govern the practice of law in the Federal Courts. Pro Se Litigants should be familiar with the Federal
Rules of Civil Procedure and the Local Rules of this court. The Local Rules are available In the Clerk’s Office or
on the Court’s website - www.mad.uscourts.gov.
The Federal Rules can be accessed in any law library or
through the Federal Judiciary’s website - www.uscourts.gov.
FEDERAL COURT vs STATE COURT
There is a difference between State Court and Federal Court. The difference being in what types of
cases (law suits) they can decide. This is called JURISDICTION. State Court has general/broad jurisdiction,
and Federal Court has limited/specific jurisdiction. Under Federal Court jurisdiction, the two main types of cases
are Federal Question Cases (see
28 U.S.C. § 1331) and Diversity Cases (see 28 U.S.C. § 1332).
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Revised June 9, 2017- U.S.D.C. - Massachusetts
Page 3
FEDERAL QUESTION CASES: are cases where the issue involves violation of Federal Law.
DIVERSITY CASES: are cases where the Plaintiff and Defendant are citizens of
different states and the amount in controversy exceeds the sum
or value of $75,000., exclusive of interest and costs.
STEP ONE: WRITE YOUR COMPLAINT
All cases are comprised of documents prepared and filed by litigants. The most common documents are
the complaint, answer and motions. The first document that you must write is called a COMPLAINT -
(Attachment 1). The function of the COMPLAINT is to tell the Court and defendant the reason for filing the
lawsuit and what relief you desire. The COMPLAINT is made up of four main parts:
1. The NAME AND ADDRESS of the plaintiff and the defendant. These are usually
listed in the first and second paragraphs respectively. If there is more than one
defendant, list each defendant's name and address in separate additional
paragraphs.
2. The JURISDICTION or reason your case is being filed in this federal court. See 28
U.S.C. §1331 et seq.
3. The ALLEGATIONS or claims that you are making against the defendant. Place
each allegation in a short
, clearly-written paragraph. See Rule 10 Federal Rules of
Civil Procedure
4. The RELIEF you are seeking from the court. This can be money or something you
want the judge to make the defendant do or stop doing. This information is usually
written in the last paragraph of the COMPLAINT.
Please be sure to number
each paragraph except for the paragraph that asks the court for relief. If you
believe you are entitled to a trial by jury, you must indicate in a paragraph following the relief requested that you
claim trial by jury. See Rule 38(b) of the Federal Rules of Civil Procedure.
Do not worry that your COMPLAINT is not professionally written. The court will take into consideration
that you are a PRO SE litigant and untrained in drafting legal documents. You should, however, make every
effort to state your case in clear, concise terms. See Rule 8 and 10 of the Federal Rules of Civil Procedure
.
Forms for filing a petition under Title 28 U.S.C. §2254 for writ of habeas corpus by a person in state
custody or a motion under Title 28 U.S.C. §2255 to vacate, set aside, or correct sentence by a person in federal
custody are available from the PRO SE clerk.
1
The filing fee for civil action cases was increased from $350.00 to $400.00 effective May 1, 2013.
2
The filing fee for appeals was increased from $255.00 to $455.00 effective April 9, 2006.
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Revised June 9, 2017 - U.S.D.C. - Massachusetts
Page 4
All pleadings submitted to this court must be on 8 1/2 x 11" paper. See Rule 5.1 of the Local Rules of
this Court.
STEP TWO: FILE YOUR COMPLAINT
Your next step is to file the COMPLAINT with the court. In addition to filing the COMPLAINT, the
following forms will have to be completed and submitted with the complaint:
1. A Civil Cover Sheet - (Attachment 2)
2. A Civil Category Sheet - (Attachment 3)
3. A completed SUMMONS for each defendant - (Attachment 4)
You will also have to pay a filing fee of $
400.00
1
at the time you file your COMPLAINT and cover sheets.
The filing fee for a petition for writ of habeas corpus is $5.00.
The filing fee, however, may be waived if you
cannot afford to pay it. For more information, see below. All checks or money orders should be made payable
to: "CLERK, UNITED STATES DISTRICT COURT".
IF YOU CANNOT AFFORD TO PAY THE FILING FEE
you may be allowed to have the filing fee
waived if you fill out the following form and send it to the court with the COMPLAINT, Cover Sheets and
completed Summons forms:
1. Application to Proceed Without Prepayment of Fees and Affidavit
(AO 240 (Rev. 10/03)) (Attachment 5)
When you file the COMPLAINT, Cover Sheets, Summons forms and Application to Proceed Without
Prepayment of Fees, each of these will be reviewed and forwarded to a United States District Court Judge for his
or her consideration. If your Application is approved, the filing fee will be waived and your case will be drawn to
a United States
District Judge. If your Application is not approved, you must pay the filing fee to have your case
filed and drawn to a United States District Judge. Ask the PRO SE clerk for more information on this subject.
PRISONERS
are now required to pay the full filing fee of $400.00 for civil actions, $5.00 for habeas
corpus applications under 28 U.S.C. §2254 and $455.00
2
for appeals in forma pauperis. If insufficient funds exist
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Revised June 9, 2017 - U.S.D.C. - Massachusetts
Page 5
in the prisoner's account, the court must assess and, when funds exist, collect, an initial partial filing fee of 20
percent of the greater of:
(1) the average monthly deposits to the prisoner's account; or
(2) the average monthly balance in the prisoner's account for the prior six-month period.
Thereafter, the prisoner will be required to make monthly payments of 20 percent of the preceding
month's income. The agency having custody of the prisoner must forward payments from the prisoner's account
to the clerk of court each time the amount exceeds $10.00 until the filing fees are paid in full. See 28 U.S.C.
§1915 as amended effective April 26, 1996 (Attachment 6 ) regarding proceedings In Forma Pauperis pursuant
to the Prison Litigation Reform Act (Pub. L. No. 104-134, 110 Stat. 1321.)
A PRISONER who cannot pay the entire filing fee and who is seeking to proceed in forma pauperis must
submit along with the complaint, cover sheet, category sheet and summons:
1.
the Application to Proceed Without Prepayment of Fees and Affidavit form (AO 240 (Rev.
10/03)) with:
a. completed certificate portion of the AO 240 form by the institution of incarceration; and
2. certified copy of the prisoner's trust fund account (or institutional equivalent) for the prior six-
month
period.
STEP THREE: JUDICIAL REVIEW OF COMPLAINT
Once you have submitted all of the necessary papers, the court will review the complaint and other
documents and shall dismiss the case at any time if the court determines that:
1. the allegation of poverty is untrue;
2. the action or appeal --
a.
is frivolous or malicious;
b. fails to state a claim on which relief may be granted; or
c. seeks monetary relief against a defendant who is immune from such relief.
The court will also review the prior submissions of prisoners to determine if a prisoner proceeding IFP
has, on three or more occasions, while incarcerated, brought an action or appeal in a federal court that was
dismissed on the grounds that it was frivolous, malicious, or failed to state a claim upon which relief may be
granted. Under the Prison Litigation Reform Act, unless a prisoner is under imminent danger of serious physical
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Revised June 9, 2017 - U.S.D.C. - Massachusetts
Page 6
injury, he may not bring a civil action or appeal a judgment in a civil action or proceeding in forma pauperis, if, on
three or more previous occasions, he has brought an action or appeal in a federal court that was dismissed on
the ground that the action or appeal was frivolous, malicious, or failed to state a claim upon which relief could be
granted. In cases in which the prisoner has had three or more previous matters dismissed for one or more of
these reasons, the prisoner must pay the entire filing fee at the time the civil action or appeal is filed or his action
or appeal may be dismissed. See 28 U.S.C. § 1915(g).
Even if your complaint is dismissed, you will still be obligated to pay the full amount of the filing fee.
A copy of Title 28 U.S.C. §1915 - Proceedings in forma pauperis as amended is included with this
package. (Attachment 6)
STEP FOUR: SERVICE OF PROCESS
If your COMPLAINT is filed, your case will be drawn to a District Judge and assigned a civil action
number. The completed SUMMONS (Attachment 4) will be signed and sealed by the clerk and returned to you.
Your next step is to SERVE (inform) each of the defendants that he or she is being sued. This may be
done in two ways:
1. NOTICE & REQUEST FOR WAIVER OF SERVICE
If you are suing the United States (and its agencies, corporations, or officers) or
a state, local or foreign government, you CANNOT use Form AO398 and YOU
MUST arrange for Service of Process
(which is described below).
You may notify the defendant(s) of the commencement of the lawsuit by sending a
"NOTICE OF LAWSUIT AND REQUEST FOR WAIVER OF SERVICE OF SUMMONS"
- Form AO 398 (Attachment 7) and AO 399 (Attachment 8) along with a copy of the
complaint by first-class mail or other reliable means. You must also include a copy of
the Waiver of Service of Summons form - AO 399 and a self addressed return envelope.
See Rule 4(d) of the Federal Rules of Civil Procedure
. If service is waived by the
defendant the Waiver of Service form is returned to the plaintiff for filing with the court
and the action shall proceed. If the defendant does not waive service, the plaintiff must
proceed with service of process.
Step by Step
Revised June 9, 2017 - U.S.D.C. - Massachusetts
Page 7
2. SERVICE OF PROCESS
Making "service of process" involves serving a copy of a summons and a copy of the
complaint to each of the defendants.
A SUMMONS is a writ used to notify the person named as the defendant of the
commencement of the civil action and the requirement to appear and answer. The
summons must contain the name of the court and the names of the parties, be directed
to the defendant, state the name and address of the plaintiff's attorney, if any, otherwise
the plaintiff's address and the time within which the rules require the defendant to
answer the complaint.
If a defendant has not "waived service of summons" OR you are suing a government
(federal, state, local, foreign) YOU MUST ARRANGE to have a copy of an original
summons and a copy of the complaint served upon each defendant.
You must complete a summons for each defendant and present each summons to the
Clerk who will sign and place the court seal on each summons. A copy of the summons
must be served upon each defendant with a copy of the complaint. The original
summons should be kept by the person making service.
You can make service of process by having a "disinterested" person who is over the age
of eighteen deliver copies of the SUMMONS and COMPLAINT to each of the
defendants. When using this method of making service of process, have the server fill
out the back of the original
SUMMONS, and send it to the court. See Rule 4, Federal
Rules of Civil Procedure.
If you have filed an Application to Proceed Without Prepayment of Fees and it has been
allowed by a Judge, service of process will be made upon each defendant, without cost
to you, by the United States Marshal. However, you are responsible for completing
all of the forms required by the Marshal for service. You will receive instructions on
this matter from the PRO SE Clerk after
the Judge has approved your application.
If you have filed a petition under 28 U.S.C. §2254 for writ of habeas corpus by a person
in state custody or a motion under 28 U.S.C. §2255 to vacate, set aside, or correct
sentence by a person in federal custody, an order will be issued by the Court concerning
service upon the respondents. No Summons are issued in these types of cases.
NOTE: Service of the SUMMONS and COMPLAINT on the defendant must be made
within 90 days from the date the complaint was filed or the case will be subject to
dismissal. See Rule 4(m)
, Federal Rules of Civil Procedure.
For more information, read Rule 4 of the Federal Rules of Civil Procedure or contact the PRO SE Clerk.
Step by Step
Revised June 9, 2017 - U.S.D.C. - Massachusetts
Page 8
THINGS YOU SHOULD KNOW ABOUT
The ANSWER is the formal written statement by the defendant responding to a complaint setting forth
any defenses and objections to the claims by the plaintiff.
A MOTION is an application or request made to the court for the purpose of obtaining a ruling or order
directing some act to be done in favor of the applicant. See Rule 7(b), Federal Rules of Civil Procedure and
Local Rule 7.1.
IF YOU CANNOT AFFORD AN ATTORNEY, you may make a written motion asking the court to appoint
an attorney for you. Use the same heading that you used on your COMPLAINT, but entitle the document
"Motion for Appointment of Counsel". In your motion, provide the court with your financial status, your attempts,
if any, to find a lawyer, and any other information which would be helpful to the court in determining whether a
lawyer should be appointed for you. The Court is not required to appoint an attorney, but may request an
attorney who has indicated a willingness to accept such cases on a pro bono basis to represent you. See Title
28 U.S.C. §1915.
AFTER THE ANSWER
In most cases the Court will issue a SCHEDULING ORDER which sets forth a timetable with deadlines
the litigants must follow.
The DISCOVERY PERIOD is the time frame allowed by the court for both plaintiff and defendant to
discover facts, research the law, and gather evidence to be presented at trial to prove the litigant's position/case.
See Local Rules 26.1 through 26.6 and 33.1 through 37.1.
The Discovery period always comes after the filing of
the answer by the defendant, and before the 1st day of the trial.
Whenever you file a document with the court, you must always
:
1. Send a copy to each of the parties, or their lawyers, who are involved in the
case and indicate at the end of the document that you have done so in
accordance with Local Rule 5.2.
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Revised June 9, 2017 - U.S.D.C. - Massachusetts
Page 9
2. Provide the correct civil action number of your case on both the document and
the front of the envelope in which it is enclosed.
3. Sign all documents you file with the court. Place the words "PRO SE" after your
name. Place your address and telephone number on all documents.
The Customer Services Section of the United States District Court Clerk's Office in Boston is located in
Suite 2300, United States Courthouse, 1 Courthouse Way, Boston, MA 02210. Office hours are 8:30 A.M. to
5:00 P.M., Monday through Friday.
If you are located in the Worcester or Springfield area you may contact one of the divisional offices as
indicated below:
United States District Court United States District Court
Donohue Federal Building Federal Building & Courthouse
595 Main Street - Room 502 1550 Main Street
Worcester, MA 01608 Springfield, MA 01103
(508) 929-9900 (413) 785-0015
Pro Se 1 (Rev. 09/16) Complaint for a Civil Case
UNITED STATES DISTRICT COURT
for the
District of Massachusetts
)
)
)
)
)
)
)
)
)
)
)
)
)
)
)
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.)
COMPLAINT FOR A CIVIL CASE
I. The Parties to This Complaint
A. The Plaintiff(s)
Provide the information below for each plaintiff named in the complaint. Attach additional pages if
needed.
Name
Street Address
City and County
State and Zip Code
Telephone Number
E-mail Address
B. The Defendant(s)
Provide the information below for each defendant named in the complaint, whether the defendant is an
individual, a government agency, an organization, or a corporation. For an individual defendant,
include the person's job or title
(if known). Attach additional pages if needed.
Page 1 of 5
Pro Se 1 (Rev. 09/16) Complaint for a Civil Case
Defendant No. 1
Name
Job or Title
(if known)
Street Address
City and County
State and Zip Code
Telephone Number
E-mail Address
(if known)
Defendant No. 2
Name
Job or Title
(if known)
Street Address
City and County
State and Zip Code
Telephone Number
E-mail Address
(if known)
Defendant No. 3
Name
Job or Title
(if known)
Street Address
City and County
State and Zip Code
Telephone Number
E-mail Address
(if known)
Defendant No. 4
Name
Job or Title
(if known)
Street Address
City and County
State and Zip Code
Telephone Number
E-mail Address
(if known)
Page 2 of 5
Pro Se 1 (Rev. 09/16) Complaint for a Civil Case
II. Basis for Jurisdiction
Federal courts are courts of limited jurisdiction (limited power). Generally, only two ty
pes of cases can be
heard in federal court: cases involving a federal question and cases involving diversity of citizenship of the
parties. Under 28 U.S.C. § 1331, a case arising under the United States Constitution or federal laws or treaties
is a federal question case. Under 28 U.S.C. § 1332, a case in which a citizen of one State sues a citizen of
another State or nation and the am
ount at stake is more than $75,000 is a diversity
of citizenship case. In a
diversity
of citizenship case, no defendant may be a citizen of the same State as any plaintiff.
What is the basis for federal court jurisdiction?
(check all that apply)
’ Federal question ’ Diversity of citizenship
Fill out the paragraphs in this section that apply to this case.
A. If the Basis for Jurisdiction Is a Federal Question
List the specific federal statutes, federal treaties, and/or provisions of the United States Constitution that
are at issue in this case.
B. If the Basis for Jurisdiction Is Diversity of Citizenship
1. The Plaintiff(s)
a. If the plaintiff is an individual
The plaintiff,
(name) , is a citizen of the
State of
(name) .
b.
If the plaintiff is a corporation
The plaintiff,
(name) , is incorporated
under the laws of the State of
(name) ,
and has its principal place of business in the State of
(name)
.
(If more than one plaintiff is named in the complaint, attach an additional page providing the
same information for each additional plaintiff.)
2. The Defendant(s)
a. If the defendant is an individual
The defendant,
(name) , is a citizen of
the State of
(name) . Or is a citizen of
(foreign nation)
.
Page 3 of 5
Pro Se 1 (Rev. 09/16) Complaint for a Civil Case
b. If the defendant is a corporation
The defendant,
(name) , is incorporated under
the laws of the State of
(name) , and has its
principal place of business in the State of
(name) .
Or is incorporated under the laws of
(foreign nation) ,
and has its principal place of business in
(name) .
(If more than one defendant is named in the complaint, attach an additional page providing the
same information for each additional defendant.)
3. The Amount in Controversy
The am
ount in controversy-the amount the plaintiff claims the defendant owes or the am
ount at
stake-is m
ore than $75,000, not counting interest and costs of court, because
(explain):
III.
Statement of Claim
Write a short and plain statement of the claim. Do not make legal arguments. State as briefly
as possible the
facts showing that each plaintiff is entitled to the dam
a
ges or other relief sought. State how each defendant was
involved and what each defendant did that caused the plaintiff harm
or violated the plaintiff'
s rights, including
the dates and places of that involvem
ent or conduct. If more than one claim is asserted, number each claim
and
write a short and plain statem
ent of each claim in a separate paragraph. Attach additional pages if needed.
IV. Relief
State briefly and precisely what damages or other relief the plaintiff asks the court to order. Do not ma
ke legal
argum
ents. Include any basis for claiming that the wrongs alleged are continuing at the present tim
e. Include
the am
ounts of any actual damages claimed for the acts alleged and the basis for these amounts. Include any
punitive or exemplary damages claimed, the amounts, and the reasons you claim y
ou are entitled to actual or
punitive money damages.
Page 4 of 5
Pro Se 1 (Rev. 09/16) Complaint for a Civil Case
V. Certification and Closing
Under Federal Rule of Civil Procedure 11, by signing below, I certify to the best of my knowledge, information,
and belief that this complaint: (1) is not being presented for an improper purpose, such as to harass, cause
unnecessary delay, or needlessly increase the cost of litigation; (2) is supported by existing law or by a
nonfrivolous argument for extending, modifying, or reversing existing law; (3) the factual contentions have
evidentiary support or, if specifically so identified, will likely have evidentiary support after a reasonable
opportunity for further investigation or discovery; and (4) the complaint otherwise complies with the
requirements of Rule 11.
A. For Parties Without an Attorney
I agree to provide the Clerk's Office with any changes to my address where case-related papers may be
served. I understand that my failure to keep a current address on file with the Clerk's Office may result
in the dismissal of my case.
Date of signing:
Signature of Plaintiff
Printed Name of Plaintiff
B. For Attorneys
Date of signing:
Signature of Attorney
Printed Name of Attorney
Bar Number
Name of Law Firm
Street Address
State and Zip Code
Telephone Number
E-mail Address
Page 5 of 5
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JS 44 (Rev. 08/18)
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
County of Residence of First Listed Defendant
(EXCEPT IN U.S. PLAINTIFF CASES) (IN U.S. PLAINTIFF CASES ONLY)
NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF
THE TRACT OF LAND INVOLVED.
(c) Attorneys (Firm Name, Address, and Telephone Number)
Attorneys (If Known)
II. BASIS OF JURISDICTION (Place an “X” in One Box Only) III. CITIZENSHIP OF PRINCIPAL PARTIES (Place an “X” in One Box for Plaintiff
(For Diversity Cases Only)
and One Box for Defendant)
’ 1
U.S. Government ’ 3 Federal Question
PTF
DEF
PTF
DEF
Plaintiff (U.S. Government Not a Party) Citizen of This State ’ 1 ’ 1 Incorporated or Principal Place ’ 4 ’ 4
of Business In This State
’ 2 U.S. Government ’ 4 Diversity Citizen of Another State ’ 2 ’ 2 Incorporated and Principal Place ’ 5 ’ 5
Defendant (Indicate Citizenship of Parties in Item III) of Business In Another State
Citizen or Subject of a ’ 3 ’ 3 Foreign Nation ’ 6 ’ 6
Foreign Country
IV. NATURE OF SUIT (Place an “X” in One Box Only) Click here for: Nature of Suit Code Descriptions.
CONTRACT TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES
’ 110 Insurance
PERSONAL INJURY PERSONAL INJURY
’ 625 Drug Related Seizure ’ 422 Appeal 28 USC 158 ’ 375 False Claims Act
’ 120 Marine ’ 310 Airplane ’ 365 Personal Injury - of Property 21 USC 881 ’ 423 Withdrawal ’ 376 Qui Tam (31 USC
’ 130 Miller Act ’ 315 Airplane Product Product Liability ’ 690 Other 28 USC 157 3729(a))
’ 140 Negotiable Instrument Liability ’ 367 Health Care/ ’ 400 State Reapportionment
’ 150 Recovery of Overpayment ’ 320 Assault, Libel & Pharmaceutical
PROPERTY RIGHTS
’ 410 Antitrust
& Enforcement of Judgment Slander Personal Injury ’ 820 Copyrights ’ 430 Banks and Banking
’ 151 Medicare Act ’ 330 Federal Employers’ Product Liability ’ 830 Patent ’ 450 Commerce
’ 152 Recovery of Defaulted Liability ’ 368 Asbestos Personal ’ 835 Patent - Abbreviated ’ 460 Deportation
Student Loans ’ 340 Marine Injury Product New Drug Application ’ 470 Racketeer Influenced and
(Excludes Veterans) ’ 345 Marine Product Liability ’ 840 Trademark Corrupt Organizations
’ 153 Recovery of Overpayment Liability
PERSONAL PROPERTY
LABOR SOCIAL SECURITY
’ 480 Consumer Credit
of Veteran’s Benefits ’ 350 Motor Vehicle ’ 370 Other Fraud ’ 710 Fair Labor Standards ’ 861 HIA (1395ff) ’ 485 Telephone Consumer
’ 160 Stockholders’ Suits ’ 355 Motor Vehicle ’ 371 Truth in Lending Act ’ 862 Black Lung (923) Protection Act
’ 190 Other Contract Product Liability ’ 380 Other Personal ’ 720 Labor/Managem
ent ’ 863 DIWC/DIWW (405(g)) ’ 490 Cable/Sat TV
’ 195 Contract Product Liability ’ 360 Other Personal Property Damage Relations ’ 864 SSID Title XVI ’ 850 Securities/Commodities/
’ 196 Franchise Injury ’ 385 Property Damage ’ 740 Railway Labor Act ’ 865 RSI (405(g)) Exchange
’ 362 Personal Injury - Product Liability ’ 751 Family and Medical ’ 890 Other Statutory Actions
Medical Malpractice Leave Act ’ 891 Agricultural Acts
REAL PROPERTY CIVIL RIGHTS PRISONER PETITIONS
’ 790 Other Labor Litigation
FEDERAL TAX SUITS
’ 893 Environmental Matters
’ 210 Land Condemnation ’ 440 Other Civil Rights
Habeas Corpus:
’ 791 Employee Retirement ’ 870 Taxes (U.S. Plaintiff ’ 895 Freedom of Information
’ 220 Foreclosure ’ 441 Voting ’ 463 Alien Detainee Income Security Act or Defendant) Act
’ 230 Rent Lease & Ejectment ’ 442 Employment ’ 510 Motions to Vacate ’ 871 IRS—Third Party ’ 896 Arbitration
’ 240 Torts to Land ’ 443 Housing/ Sentence 26 USC 7609 ’ 899 Administrative Procedure
’ 245 Tort Product Liability Accommodations ’ 530 General Act/Review or Appeal of
’ 290 All Other Real Property ’ 445 Amer. w/Disabilities - ’ 535 Death Penalty
IMMIGRATION
Agency Decision
Employment
Other:
’ 462 Naturalization Application ’ 950 Constitutionality of
’ 446 Amer. w/Disabilities - ’ 540 Mandamus & Other ’ 465 Other Immigration State Statutes
Other ’ 550 Civil Rights
Actions
’ 448 Education ’ 555 Prison Condition
’ 560 Civil Detainee -
Conditions of
Confinement
V. ORIGIN (Place an “X” in One Box Only)
’ 1 Original
Proceeding
’ 2 Removed from
State Court
’ 3 Remanded from
Appellate Court
’ 4 Reinstated or
Reopened
’ 5
Transferred from
Another District
(specify)
’ 6 Multidistrict
Litigation -
Transfer
’
8 Multidistrict
Litigation -
Direct File
VI. CAUSE OF ACTION
Cite the U.S. Civil Statute under which you are filing (Do not cite jurisdictional statutes unless diversity):
Brief description of cause:
VII. REQUESTED IN
COMPLAINT:
’
CHECK IF THIS IS A CLASS ACTION
UNDER RULE 23, F.R.Cv.P.
DEMAND $
CHECK YES only if demanded in complaint:
JURY DEMAND:
’ Yes ’ No
VIII. RELATED CASE(S)
IF ANY
(See instructions):
JUDGE DOCKET NUMBER
DATE SIGNATURE OF ATTORNEY OF RECORD
FOR OFFICE USE ONLY
RECEIPT # AMOUNT APPLYING IFP JUDGE MAG. JUDGE
ATTACHMENT 2
Print
JS 44 Reverse (Rev. 11/04)
INSTRUCTIONS FOR ATTORNEYS COMPLETING CIVIL COVER SHEET FORM JS 44
Authority For Civil Cover Sheet
The JS 44 civil cover sheet and the information contained herein neither replaces nor supplements the filings and service of pleading 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. Consequently, a civil cover sheet is submitted to the Clerk of Court for each civil complaint
filed. The attorney filing a case should complete the form as follows:
I. (a) Plaintiffs-Defendants. Enter names (last, first, middle initial) of plaintiff and defendant. If the plaintiff or defendant is a government agency, use only
the full name or standard abbreviations. If the plaintiff or defendant is an official within a government agency, identify first the agency and then the official, giving
both name and title.
(b) County of Residence. For each civil case filed, except U.S. plaintiff cases, enter the name of the county where the first listed plaintiff resides at the time
of filing. In U.S. plaintiff cases, enter the name of the county in which the first listed defendant resides at the time of filing. (NOTE: In land condemnation cases,
the county of residence of the “defendant” is the location of the tract of land involved.)
(c) Attorneys. Enter the firm name, address, telephone number, and attorney of record. If there are several attorneys, list them on an attachment, noting
in this section “(see attachment)”.
II. Jurisdiction. The basis of jurisdiction is set forth under Rule 8(a), F.R.C.P., which requires that jurisdictions be shown in pleadings. Place an “X” in one
of the boxes. If there is more than one basis of jurisdiction, precedence is given in the order shown below.
United States plaintiff. (1) Jurisdiction based on 28 U.S.C. 1345 and 1348. Suits by agencies and officers of the United States are included here.
United States defendant. (2) When the plaintiff is suing the United States, its officers or agencies, place an “X” in this box.
Federal question. (3) This refers to suits under 28 U.S.C. 1331, where jurisdiction arises under the Constitution of the United States, an amendment to the
Constitution, an act of Congress or a treaty of the United States. In cases where the U.S. is a party, the U.S. plaintiff or defendant code takes precedence, and box
1 or 2 should be marked.
Diversity of citizenship. (4) This refers to suits under 28 U.S.C. 1332, where parties are citizens of different states. When Box 4 is checked, the citizenship of the
different parties must be checked. (See Section III below; federal question actions take precedence over diversity cases.)
III. Residence (citizenship) of Principal Parties. This section of the JS 44 is to be completed if diversity of citizenship was indicated above. Mark this section
for each principal party.
IV. Nature of Suit. Place an “X” in the appropriate box. If the nature of suit cannot be determined, be sure the cause of action, in Section VI below, is sufficient
to enable the deputy clerk or the statistical clerks in the Administrative Office to determine the nature of suit. If the cause fits more than one nature of suit, select
the most definitive.
V. Origin. Place an “X” in one of the seven boxes.
Original Proceedings. (1) Cases which originate in the United States district courts.
Removed from State Court. (2) Proceedings initiated in state courts may be removed to the district courts under Title 28 U.S.C., Section 1441. When the petition
for removal is granted, check this box.
Remanded from Appellate Court. (3) Check this box for cases remanded to the district court for further action. Use the date of remand as the filing date.
Reinstated or Reopened. (4) Check this box for cases reinstated or reopened in the district court. Use the reopening date as the filing date.
Transferred from Another District. (5) For cases transferred under Title 28 U.S.C. Section 1404(a). Do not use this for within district transfers or multidistrict
litigation transfers.
Multidistrict Litigation. (6) Check this box when a multidistrict case is transferred into the district under authority of Title 28 U.S.C. Section 1407. When this box
is checked, do not check (5) above.
Appeal to District Judge from Magistrate Judgment. (7) Check this box for an appeal from a magistrate judge’s decision.
VI.
Cause of Action. Report the civil statute directly related to the cause of action and give a brief description of the cause. Do not cite jurisdictional statutes
unless diversity. Example: U.S. Civil Statute: 47 USC 553
Brief Description: Unauthorized reception of cable service
VII. Requested in Complaint. Class Action. Place an “X” in this box if you are filing a class action under Rule 23, F.R.Cv.P.
Demand. In this space enter the dollar amount (in thousands of dollars) being demanded or indicate other demand such as a preliminary injunction.
Jury Demand. Check the appropriate box to indicate whether or not a jury is being demanded.
VIII. Related Cases. This section of the JS 44 is used to reference related pending cases if any. If there are related pending cases, insert the docket numbers
and the corresponding judge names for such cases.
Date and Attorney Signature. Date and sign the civil cover sheet.
UNITED STATES DISTRICT COURT
DISTRICT OF MASSACHUSETTS
1. Title of case (name of first party on each side only)
2. Category in which the case belongs based upon the numbered nature of suit code listed on the civil cover sheet. (See local
rule 40.1(a)(1)).
I. 160, 400, 410, 441, 535, 830*, 835*, 850, 891, 893, R.23, REGARDLESS OF NATURE OF SUIT.
II. 110, 130, 190, 196, 370, 375, 376, 440, 442, 443, 445, 446, 448, 470, 751, 820*, 840*, 895, 896, 899.
III.
120, 140, 150, 151, 152, 153, 195, 210, 220, 230, 240, 245, 290, 310, 315, 320, 330, 340, 345, 350, 355, 360, 362,
365, 367, 368, 371, 380, 385, 422, 423, 430, 450, 460, 462, 463, 465, 480, 485, 490, 510, 530, 540, 550, 555, 560,
625, 690, 710, 720, 740, 790, 791, 861-865, 870, 871, 890, 950.
*Also complete AO 120 or AO 121. for patent, trademark or copyright cases.
3. Title and number, if any, of related cases. (See local rule 40.1(g)). If more than one prior related case has been filed in this
district please indicate the title and number of the first filed case in this court.
4. Has a prior action between the same parties and based on the same claim ever been filed in this court?
YES
9 NO 9
5. Does the complaint in this case question the constitutionality of an act of congress affecting the public interest? (See 28 USC
§2403)
YES
9 NO 9
If so, is the U.S.A. or an officer, agent or employee of the U.S. a party?
YES
9 NO 9
6. Is this case required to be heard and determined by a district court of three judges pursuant to title 28 USC §2284?
YES
9 NO 9
7. Do all of the parties in this action, excluding governmental agencies of the United States and the Commonwealth of
Massachusetts (“governmental agencies”), residing in Massachusetts reside in the same divi
sion? - (See Local Rule 40.1(d)).
YES
9 NO 9
A. If yes, in which division do all of the non-governmental parties reside?
Eastern Division
9 Central Division 9 Western Division 9
B. If no, in which division do the majority of the plaintiffs or the only parties, excluding governmental agencies,
residing in Massachusetts reside?
Eastern Division
9 Central Division 9 Western Division 9
8. If filing a Notice of Removal - are there any motions pending in the state court requiring the attention of this Court? (If yes,
submit a separate sheet identifying the motions)
YES
9 NO 9
(PLEASE TYPE OR PRINT)
ATTORNEY'S NAME
ADDRESS
TELEPHONE NO.
(CategoryForm9-2018.wpd )
ATTACHMENT 3
OAO 440 (Rev. 10/93) Summons in a Civil Action
UNITED STATES DISTRICT COURT
District of
SUMMONS IN A CIVIL CASE
V.
CASE
TO: (Name and address of Defendant)
YOU ARE HEREBY SUMMONED and required to serve upon PLAINTIFF’S ATTORNEY (name and address)
an answer to the complaint which is herewith served upon you, within days after service of this
summons upon you, exclusive of the day of service. If you fail to do so, judgment by default will be taken against you for the
relief demanded in the complaint. You must also file your answer with the Clerk of this Court within a reasonable period of time
after service.
CLERK DATE
(By) DEPUTY CLERK
ATTACHMENT 4
OAO 440 (Rev. 10/93) Summons in a Civil Action
RETURN OF SERVICE
Service of the Summons and complaint was made by me
(1)
DATE
NAME OF SERVER (PRINT)
TITLE
Check one box below to indicate appropriate method of service
G Served personally upon the third-party defendant. Place where served:
G Left copies thereof at the defendant’s dwelling house or usual place of abode with a person of suitable age and
discretion then residing therein.
Name of person with whom the summons and complaint were left:
G Returned unexecuted:
G Other (specify):
STATEMENT OF SERVICE FEES
TRAVEL SERVICES TOTAL
DECLARATION OF SERVER
I declare under penalty of perjury under the laws of the United States of America that the foregoing information
contained in the Return of Service and Statement of Service Fees is true and correct.
Executed on
Date Signature of Server
Address of Server
(1) As to who may serve a summons see Rule 4 of the Federal Rules of Civil Procedure.
OAO 240 (Rev. 10/03)
UNITED STATES DISTRICT COURT
District of
APPLICATION TO PROCEED
Plaintiff
WITHOUT PREPAYMENT OF
V.
FEES AND AFFIDAVIT
CASE NUMBER:
Defendant
I, declare that I am the (check appropriate box)
G petitioner/plaintiff/movant G other
in the above-entitled proceeding; that in support of my request to proceed without prepayment of fees or costs
under 28 USC §1915 I declare that I am unable to pay the costs of these proceedings and that I am entitled to the relief
sought in the complaint/petition/motion.
In support of this application, I answer the following questions under penalty of perjury:
1. Are you currently incarcerated? G Yes G No (If “No,” go to Part 2)
If “Yes,” state the place of your incarceration
Are you employed at the institution? Do you receive any payment from the institution?
Attach a ledger sheet from the institution(s) of your incarceration showing at least the past six months’
transactions.
2. Are you currently employed? G Yes G No
a. If the answer is “Yes,” state the amount of your take-home salary or wages and pay period and give the
name and address of your employer.
b. If the answer is “No,” state the date of your last employment, the amount of your take-home salary or wages
and pay period and the name and address of your last employer.
3. In the past 12 twelve months have you received any money from any of the following sources?
a. Business, profession or other self-employment G Yes G No
b. Rent payments, interest or dividends
G Yes G No
c. Pensions, annuities or life insurance payments G Yes G No
d. Disability or workers compensation payments
G Yes G No
e. Gifts or inheritances G Yes G No
f. Any other sources
G Yes G No
If the answer to any of the above is “Yes,” describe, on the following page, each source of money and state the
amount received and what you expect you will continue to receive.
ATTACHMENT 5
AO 240 Reverse (Rev. 10/03)
4.
Do you have any cash or checking or savings accounts?
G Yes G No
If “Yes,” state the total amount.
5. Do you own any real estate, stocks, bonds, securities, other financial instruments, automobiles or any other
thing of value? G Yes G No
If “Yes,” describe the property and state its value.
6. List the persons who are dependent on you for support, state your relationship to each person and indicate
how much you contribute to their support.
I declare under penalty of perjury that the above information is true and correct.
Date Signature of Applicant
NOTICE TO PRISONER: A Prisoner seeking to proceed without prepayment of fees shall submit an affidavit
stating all assets. In addition, a prisoner must attach a statement certified by the appropriate institutional officer
showing all receipts, expenditures, and balances during the last six months in your institutional accounts. If you have
multiple accounts, perhaps because you have been in multiple institutions, attach one certified statement of each
account.
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STEP BY STEP ATTACHMENT 6
Page 1
28 USCS § 1915 (2002)
§ 1915. Proceedings in forma pauperis
(a) (1) Subject to subsection (b), any court of the United States may authorize the
commencement, prosecution or defense of any suit, action or proceeding, civil or criminal, or
appeal therein, without prepayment of fees or security therefor, by a person who submits an
affidavit that includes a statement of all assets such [person] prisoner possesses that the person is
unable to pay such fees or give security therefor. Such affidavit shall state the nature of the
action, defense or appeal and affiant's belief that the person is entitled to redress.
(2) A prisoner seeking to bring a civil action or appeal a judgment in a civil action or
proceeding without prepayment of fees or security therefor, in addition to filing the affidavit
filed under paragraph (1), shall submit a certified copy of the trust fund account statement (or
institutional equivalent) for the prisoner for the 6-month period immediately preceding the filing
of the complaint or notice of appeal, obtained from the appropriate official of each prison at
which the prisoner is or was confined.
(3) An appeal may not be taken in forma pauperis if the trial court certifies in writing
that it is not taken in good faith.
(b) (1) Notwithstanding subsection (a), if a prisoner brings a civil action or files an appeal
in forma pauperis, the prisoner shall be required to pay the full amount of a filing fee. The court
shall assess and, when funds exist, collect, as a partial payment of any court fees required by
law, an initial partial filing fee of 20 percent of the greater of--
(A) the average monthly deposits to the prisoner's account; or
(B) the average monthly balance in the prisoner's account for the 6-month period
immediately preceding the filing of the complaint or notice of appeal.
(2) After payment of the initial partial filing fee, the prisoner shall be required to make
monthly payments of 20 percent of the preceding month's income credited to the prisoner's
account. The agency having custody of the prisoner shall forward payments from the prisoner's
account to the clerk of the court each time the amount in the account exceeds $ 10 until the filing
fees are paid.
(3) In no event shall the filing fee collected exceed the amount of fees permitted by
statute for the commencement of a civil action or an appeal of a civil action or criminal
judgment.
(4) In no event shall a prisoner be prohibited from bringing a civil action or appealing a
civil or criminal judgment for the reason that the prisoner has no assets and no means by which
to pay the initial partial filing fee.
STEP BY STEP ATTACHMENT 6
Page 2
(c) Upon the filing of an affidavit in accordance with subsections (a) and (b) and the prepayment
of any partial filing fee as may be required under subsection (b), the court may direct payment
by the United States of the expenses of (1) printing the record on appeal in any civil or criminal
case, if such printing is required by the appellate court; (2) preparing a transcript of proceedings
before a United States magistrate in any civil or criminal case, if such transcript is required by
the district court, in the case of proceedings conducted under section 636(b) of this title or under
section 3401(b) of title 18, United States Code; and (3) printing the record on appeal if such
printing is required by the appellate court, in the case of proceedings conducted pursuant to
section 636(c) of this title. Such expenses shall be paid when authorized by the Director of the
Administrative Office of the United States Courts.
(d) The officers of the court shall issue and serve all process, and perform all duties in such
cases. Witnesses shall attend as in other cases, and the same remedies shall be available as are
provided for by law in other cases.
(e) (1) The court may request an attorney to represent any person unable to afford counsel.
(2) Notwithstanding any filing fee, or any portion thereof, that may have been paid, the
court shall dismiss the case at any time if the court determines that--
(A) the allegation of poverty is untrue; or
(B) the action or appeal--
(i) is frivolous or malicious;
(ii) fails to state a claim on which relief may be granted; or
(iii) seeks monetary relief against a defendant who is immune from such relief.
(f) (1) Judgment may be rendered for costs at the conclusion of the suit or action as in other
proceedings, but the United States shall not be liable for any of the costs thus incurred. If the
United States has paid the cost of a stenographic transcript or printed record for the prevailing
party, the same shall be taxed in favor of the United States.
(2) (A) If the judgment against a prisoner includes the payment of costs under this
subsection, the prisoner shall be required to pay the full amount of the costs ordered.
(B) The prisoner shall be required to make payments for costs under this subsection in
the same manner as is provided for filing fees under subsection (a)(2).
(C) In no event shall the costs collected exceed the amount of the costs ordered by the
court.
(g) In no event shall a prisoner bring a civil action or appeal a judgment in a civil action or
proceeding under this section if the prisoner has, on 3 or more prior occasions, while
incarcerated or detained in any facility, brought an action or appeal in a court of the United
States that was dismissed on the grounds that it is frivolous, malicious, or fails to state a claim
upon which relief may be granted, unless the prisoner is under imminent danger of serious
physical injury.
STEP BY STEP ATTACHMENT 6
Page 3
(h) As used in this section, the term "prisoner" means any person incarcerated or detained in
any facility who is accused of, convicted of, sentenced for, or adjudicated delinquent for,
violations of criminal law or the terms and conditions of parole, probation, pretrial release, or
diversionary program.
HISTORY: (June 25, 1948, ch 646, § 1, 62 Stat. 954; May 24, 1949, ch 139, § 98, 63 Stat.
104; Oct. 31, 1951, ch 655, § 51 (b), (c), 65 Stat. 727; Sept. 21, 1959, Pub.L. 86-320, 73 Stat.
590; Oct. 10, 1979, Pub.L. 96-82, § 6, 93 Stat. 645.) Dec. 1, 1990, Pub.L. 101-650, Title III §
321, 104 Stat. 5117; Apr. 26, 1996, Pub.L. 104-134, Title I § 101 [(a)] [Title VIII, § 804(a), (c)-
(e)], 110 Stat. 1321-73, 1321-74, 1321-75; renumbered Title I May 2, 1996, Pub.L. 104-140, §
1(a), 110 Stat. 1327.)
28 USCS § 1915A (2002)
§ 1915A. Screening
(a) Screening. The court shall review, before docketing, if feasible or, in any event, as soon as
practicable after docketing, a complaint in a civil action in which a prisoner seeks redress from a
governmental entity or officer or employee of a governmental entity.
(b) Grounds for dismissal. On review, the court shall identify cognizable claims or dismiss the
complaint, or any portion of the complaint, if the complaint--
(1) is frivolous, malicious, or fails to state a claim upon which relief may be granted; or
(2) seeks monetary relief from a defendant who is immune from such relief.
(c) Definition. As used in this section, the term "prisoner" means any person incarcerated or
detained in any facility who is accused of, convicted of, sentenced for, or adjudicated delinquent
for, violations of criminal law or the terms and conditions of parole, probation, pretrial release,
or diversionary program.
HISTORY: (Added Pub.L. 104-134, Title I § 101[(a)] [Title VIII, § 805(a)], April 26, 1996,
110 Stat. 1321-75; renumbered Title I Pub.L. 104-140, § 1(a), May 2, 1996, 110 Stat. 1327.
OAO 398 (Rev. 12/93)
NOTICE OF LAWSUIT AND REQUEST FOR
WAIVER OF SERVICE OF SUMMONS
TO: (A)
as (B) of (C)
A lawsuit has been commenced against you (or the entity on whose behalf you are addressed). A copy of the
complaint is attached to this notice. It has been filed in the United States District Court for the
(D) District of
and has been assigned docket number (E) .
This is not a formal summons or notification from the court, but rather my request that you sign and return the
enclosed waiver of service in order to save the cost of serving you with a judicial summons and an additional copy of the
complaint. The cost of service will be avoided if I receive a signed copy of the waiver
within (F) days after the date designated below as the date on which this Notice and Request
is sent. I enclose a stamped and addressed envelope (or other means of cost-free return) for your use. An extra copy
of the waiver is also attached for your records.
If you comply with this request and return the signed waiver, it will be filed with the court and no summons
will be served on you. The action will then proceed as if you had been served on the date the waiver is filed, except
that you will not be obligated to answer the complaint before 60 days from the date designated below as the date on
which this notice is sent (or before 90 days from that date if your address is not in any judicial district of the United
States).
If you do not return the signed waiver within the time indicated, I will take appropriate steps to effect formal
service in a manner authorized by the Federal Rules of Civil Procedure and will then, to the extent authorized by those
Rules, ask the court to require you (or the party on whose behalf you are addressed) to pay the full costs of such
service. In that connection, please read the statement concerning the duty of parties to waive the service of the
summons, which is set forth at the foot of the waiver form.
I affirm that this request is being sent to you on behalf of the plaintiff, this day of
, .
Signature of Plaintiff’s Attorney
or Unrepresented Plaintiff
A—Name of individual defendant (or name of officer or agent of corporate defendant)
B—Title, or other relationship of individual to corporate defendant
C—Name of corporate defendant, if any
D—District
E—Docket number of action
F—Addressee must be given at least 30 days (60 days if located in foreign country) in which to return waiver
ATTACHMENT 7
OAO 399 (Rev. 10/95)
WAIVER OF SERVICE OF SUMMONS
TO:
(NAME OF PLAINTIFF’S ATTORNEY OR UNREPRESENTED PLAINTIFF)
I, , acknowledge receipt of your request
(DEFENDANT NAME)
that I waive service of summons in the action of ,
(CAPTION OF ACTION)
which is case number in the United States District Court
(DOCKET NUMBER)
for the District of .
I have also received a copy of the complaint in the action, two copies of this instrument, and a means by which I can
return the signed waiver to you without cost to me.
I agree to save the cost of service of a summons and an additional copy of the complaint in this lawsuit by not requiring
that I (or the entity on whose behalf I am acting) be served with judicial process in the manner provided by Rule 4.
I (or the entity on whose behalf I am acting) will retain all defenses or objections to the lawsuit or to the jurisdiction
or venue of the court except for objections based on a defect in the summons or in the service of the summons.
I understand that a judgment may be entered against me (or the party on whose behalf I am acting) if an
answer or motion under Rule 12 is not served upon you within 60 days after ,
(DATE REQUEST WAS SENT)
or within 90 days after that date if the request was sent outside the United States.
(DATE) (SIGNATURE)
Printed/Typed Name:
As of
(TITLE) (CORPORATE DEFENDANT)
Duty to Avoid Unnecessary Costs of Service of Summons
Rule 4 of the Federal Rules of Civil Procedure requires certain parties to cooperate in saving unnecessary costs of service of the summons and complaint. A
defendant located in the United States who, after being notified of an action and asked by a plaintiff located in the United States to waive service of summons, fails to
do so will be required to bear the cost of such service unless good cause be shown for its failure to sign and return the waiver.
It is not good cause for a failure to waive service that a party believes that the complaint is unfounded, or that the action has been brought in an improper place
or in a court that lacks jurisdiction over the subject matter of the action or over its person or property. A party who waives service of the summons retains all defenses
and objections (except any relating to the summons or to the service of the summons), and may later object to the jurisdiction of the court or to the place where the action
has been brought.
A defendant who waives service must within the time specified on the waiver form serve on the plaintiff’s attorney (or unrepresented plaintiff) a response to the
complaint and must also file a signed copy of the response with the court. If the answer or motion is not served within this time, a default judgment may be taken against
that defendant. By waiving service, a defendant is allowed more time to answer than if the summons had been actually served when the request for waiver of service
was received.
OAO 399 (Rev. 10/95)
WAIVER OF SERVICE OF SUMMONS
TO:
(NAME OF PLAINTIFF’S ATTORNEY OR UNREPRESENTED PLAINTIFF)
I, , acknowledge receipt of your request
(DEFENDANT NAME)
that I waive service of summons in the action of ,
(CAPTION OF ACTION)
which is case number in the United States District Court
(DOCKET NUMBER)
for the District of .
I have also received a copy of the complaint in the action, two copies of this instrument, and a means by which I can
return the signed waiver to you without cost to me.
I agree to save the cost of service of a summons and an additional copy of the complaint in this lawsuit by not requiring
that I (or the entity on whose behalf I am acting) be served with judicial process in the manner provided by Rule 4.
I (or the entity on whose behalf I am acting) will retain all defenses or objections to the lawsuit or to the jurisdiction
or venue of the court except for objections based on a defect in the summons or in the service of the summons.
I understand that a judgment may be entered against me (or the party on whose behalf I am acting) if an
answer or motion under Rule 12 is not served upon you within 60 days after ,
(DATE REQUEST WAS SENT)
or within 90 days after that date if the request was sent outside the United States.
(DATE) (SIGNATURE)
Printed/Typed Name:
As of
(TITLE) (CORPORATE DEFENDANT)
Duty to Avoid Unnecessary Costs of Service of Summons
Rule 4 of the Federal Rules of Civil Procedure requires certain parties to cooperate in saving unnecessary costs of service of the summons and complaint. A
defendant located in the United States who, after being notified of an action and asked by a plaintiff located in the United States to waive service of summons, fails to
do so will be required to bear the cost of such service unless good cause be shown for its failure to sign and return the waiver.
It is not good cause for a failure to waive service that a party believes that the complaint is unfounded, or that the action has been brought in an improper place
or in a court that lacks jurisdiction over the subject matter of the action or over its person or property. A party who waives service of the summons retains all defenses
and objections (except any relating to the summons or to the service of the summons), and may later object to the jurisdiction of the court or to the place where the action
has been brought.
A defendant who waives service must within the time specified on the waiver form serve on the plaintiff’s attorney (or unrepresented plaintiff) a response to the
complaint and must also file a signed copy of the response with the court. If the answer or motion is not served within this time, a default judgment may be taken against
that defendant. By waiving service, a defendant is allowed more time to answer than if the summons had been actually served when the request for waiver of service
was received.
ATTACHMENT 8
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