Civil Rights Complaint Page 6
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12Name:
Address:
Telephone:
UNITED STATES DISTRICT COURT FOR THE DISTRICT OF UTAH
DIVISION
(Full Name)
CIVIL RIGHTS COMPLAINT
PLAINTIFF
(42 U.S.C §1983, §1985)
vs.
CIVIL NO.
(Supplied by Clerk)
DEFENDANTS
A. JURISDICTION
1.
Jurisdiction is proper in this court according to:
a.
42 U.S.C. §1983
b.
42 U.S.C. §1985
c.
Other (Please Specify)
2.
NAME OF PLAINTIFF _____________________________________________
IS A CITIZEN OF THE STATE OF ___________________________________
PRESENT MAILING ADDRESS:
____________________________________
____________________________________
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