Civil Rights Complaint Page 11
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3
4
5
6
7
8
9
10
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12c.
Disposition (for example: Was the case dismissed? Was it appealed? Is it still
pending?)
d.
Issues raised:
e.
When did you file the lawsuit?
__________________________________
Date
Month
Year
f.
When was it (will it be) decided? __________________________________
2.
Have you previously sought informal or formal relief from the appropriate administrative
officials regarding the acts complained of in Part C? YES
/ NO
. If your answer
is "YES" briefly describe how relief was sought and the results.
If your answer is "NO"
explain why administrative relief was not sought.
F. REQUEST FOR RELIEF
1.
I believe that I am entitled to the following relief:
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