Garcia v. Texas Department of Family and Protective Services

MOTION to Proceed in forma pauperis

W.D. Tex.September 17, 2019

Pro Se 15 (Rev. 12/16) Complaint for Violation of Civil Rights (NonPrisoner) R E C E I V E D UNITED STATES DISTRICT COURT for the S P 1. 7 2019 W&eJiDistrict of Tey. ? CLERK, US TT rii-km&vision wDllOFT S&19cA1128 DAE Case 0 Plaintiff(s) (Write the full name of each plaintf.f who is filing this complaint. If the names of all the plaint ffs 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- ) ) ) ) â Defendant(s) 'gr" .Q_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.) (to be filled in by the Clerk's Office) Jury Trial: (check one) LI Yes [=1 No 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 Case 5:19-cv-01128-DAE-RBF Document 1-1 Filed 09/17/19 Page 1 of 6 Pro Se 15 (Rev. 12/16) Complaint for Violation of Civil Rights (NonPrisoner) 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 c:5lrL4.. v.\- *' Address B c i.'j O%J c' So-rt +y ç City State Zip Code County ..-r Telephone Number - c-v-. E-MailAddress 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) and check whether you are bringing this complaint against them in their individual capacity or official capacity, or both. Attach additional pages if needed. Defendant No. 1 Name o4 1-itj d f Lt4PiL. Job or Title (jf known) Address 3( 3 rn it _Tt5_ 123 City State Zip Code County___________________________________ Telephone Number E-Mail Address ((f known) \ I a. []Individual capacity Official capacity Defendant No. 2 Name Job or Title (if known) Address City State Zip Code County______________________________________________________ Telephone Number E-Mail Address (if known) Individual capacity Official capacity Page 2 of 6 Case 5:19-cv-01128-DAE-RBF Document 1-1 Filed 09/17/19 Page 2 of 6 Pro Se 15 (Rev. 12/16) Complaint for Violation of Civil Rights (NonPrisoner) Defendant No. 3 Name Job or Title (f known) Address County Telephone Number E-Mail Address (f known) Defendant No. 4 Name Job or Title (jf known) Address County Telephone Number E-Mail Address (if known) II. Basis for Jurisdiction City State Zip Code Individual capacity Official capacity City State Zip Code Individual capacity Official capacity Under 42 U.S.C. § 1983, you may sue state or local officials for the "deprivation of any rights, privileges, or immunities secured by the Constitution and [federal laws]." Under Bivens v. Six Unknown Named Agents of Federal Bureau of Narcotics, 403 US. 388 (1971), you may sue federal officials for the violation of certain constitutional rights. A. Are you bringing suit against (check all that apply): Federal officials (a Bivens claim) State or local officials (a § 1983 'claim) B. Section 1983 allows claims alleging the "deprivation of any rights, privileges, or immunities secured by the Constitution and [federal laws]." 42 U.S.C. § 1983. If you are suing under section 1983, what federal constitutional or statutory right(s) do you claim is/are being violated by state or local officials? C. Plaintiffs suing under Bivens may only recover for the violation of certain constitutional rights, If you are suing under Bivens, what constitutional right(s) do you claim is/are being violated by federal officials? Page 3 of 6 Case 5:19-cv-01128-DAE-RBF Document 1-1 Filed 09/17/19 Page 3 of 6 Pro Se 15 (Rev. 12/16) Complaint for Violation of Civil Rights (NonPrisoner) D. Section 1983 allows defendants to be found liable only when they have acted "under color of any statute, ordinance, regulation, custom, or usage, of any State or Territory or the District of Columbia." 42 U.S.C. § 1983. If you are suing under section 1983, explain how each defendant acted under color of state or local law. If you are suing under Bivens, explain how each defendant acted under color of federal law. Attach additional pages if needed. III. Statement of Claim State as briefly as possible the facts of your case. Describe how each defendant was personally involved in the alleged wrongful action, along with the dates and locations of all relevant events. You may wish to include further details such as the names of other persons involved in the events giving rise to your claims. Do not cite any cases or statutes. If more than one claim is asserted, number each claim and write a short and plain statement of each claim in a separate paragraph. Attach additional pages if needed. A. Where did the events giving rise to your claim(s) occur? B. What date and approximate time did the events giving rise to your claim(s) occur? C. What are the facts underlying your claim(s)? (For example: What happened to you? Who did what? Was anyone else involved? Who else saw what happened?) 'dr *o *oQ ''' kho O. JU&.S ip\ jc)C 11 f too p1 Lj O. , )V)OY413 O-tx. !)t* v'- oUov'J roç cr.+ot\ '"-' 4 cx&y Cyi4 tj p. %,jt Qch& jJJ& ko'XQ1n. Page 4 of 6 Case 5:19-cv-01128-DAE-RBF Document 1-1 Filed 09/17/19 Page 4 of 6 Pro Se 15 (Rev. 12/16) Complaint for Violation of Civil Rights (NonPrisoner) IV. Injuries if you sustained injuries related to the events alleged above, describe your injuries and state what medical treatment, if any, you required and did or did not receive. V. Relief State briefly what you want the court to do for you. Make no legal arguments. Do not cite any cases or statutes. If requesting money damages, include the amounts of any actual damages and/or punitive damages claimed for the acts alleged. Explain the basis for these claims. u+-Wr i th-- rvwvvi, 'oU- cr'o Y&Co 4rM OJX \ txon. -- Q' \ \3j * Page 5 of 6 Case 5:19-cv-01128-DAE-RBF Document 1-1 Filed 09/17/19 Page 5 of 6 Pro Se 15 (Rev. 12/16) Complaint for Violation of Civil Rights (NonPrisoner) VI. Certification and Closing Under Federal Rule of Civil Procedure II, by signing below, I certify to the best of my knowledge, information, and belief that this complaint: (I) 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 caserelated 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: . / 7 / 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 Address 'S City State Zip Code Telephone Number E-mail Address Page 6 of 6 Case 5:19-cv-01128-DAE-RBF Document 1-1 Filed 09/17/19 Page 6 of 6