Case 2:15-cv-02778-CBM-JPR Document 1 Filed 04/15/15 Page 1 of 13 Page ID #:1. (Full Name) UNITED STATES DISTRICT COURT



Similar documents
Case 2:14-cv PSG-RZ Document 1 Filed 10/02/14 Page 1 of 20 Page ID #:7

Case 3:13-cv K Document 5 Filed 12/13/13 Page 1 of 32 PageID 52

Case4:14-cv PJH Document1 Filed09/25/14 Page1 of 34

Case 3:15-cv PK Document 1 Filed 09/21/15 Page 1 of 32

UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF GEORGIA ATLANTA DIVISION

Plaza, 333 Washington Avenue North, Suite 300, Minneapolis, Minnesota 55401, alleges

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA. JAMES HARRA WAY ) Case No.: (To be supplied by the Clerk) PLAINTIFF, I.

Case 3:13-cv ST Document 1 Filed 01/15/13 Page 1 of 9 Page ID#: 1 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF OREGON PORTLAND DIVISION

Part Description 1 10 pages 2 Civil Cover Sheet 3 Designation Form 4 Case Management Track Form

1 CENTML DISTRICT OF ~f9l:t~!!a 1 ~ D~UN 10 CENTRAL DISTRICT OF CALIFORNIA. ) COMPLAINT FOR PATENT ) INFRINGEMENT 14 ) TRIAL BY JURY DEMANDED ) )

Case: 1:12-cv Document #: 1 Filed: 01/12/12 Page 1 of 6 PageID #:1

Case 3:15-cv AC Document 1 Filed 06/11/15 Page 1 of 7

FOR THE CENTRAL DISTRICf OF CALIFORNIA

Case 5:12-cv Document 1 Filed 10/19/12 Page 1 of 9 PageID #: 1 IN THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF WEST VIRGINIA

Case 3:15-cv Document 1 Filed 05/06/15 Page 1 of 9

Case 1:11-cv RHS-WDS Document 1-1 Filed 09/27/11 Page 1 of 2

Case 2:13-cv JAK-AGR Document 1 Filed 08/15/13 Page 1 of 10 Page ID #:5

Case 0:15-cv WJZ Document 1 Entered on FLSD Docket 04/03/2015 Page 1 of 7

Case 5:08-cv FL Document 1 Filed 11/14/2008 Page 1 of 6

IN THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF TEXAS HOUSTON DIVISION

Case 1:13-cv KMM Document 1-2 Entered on FLSD Docket 10/31/2013 Page 1 of 2

2 &5 SE? 29 Pil 2:38 /// (~ase 3:O(~-cv~02150-J M-J MA Document 1 Filed 09/29/2006 Page 1 of 8

Case 4:10-cv DCB Document 1 Filed 04/29/10 Page 1 of 10

Case 2:14-cv GHK-PJW Document 1 Filed 03/14/14 Page 1 of 21 Page ID #:8 UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

case 3:12-cv JTM-CAN document 1 filed 07/16/12 page 1 of 5 UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF INDIANA SOUTH BEND DIVISION

Case 2:10-cv KJD -RJJ Document 1 Filed 12/08/10 Page 1 of 18

Case 1:14-cv Document 1 Filed 09/03/14 Page 1 of 8 UNITED STATES DISTRICT COURT WESTERN DISTRICT OF TEXAS AUSTIN DIVISION

l V6,\\J. cacvo ~~ UNITED STATES DISTRICT COURT FOR THE CENTRAL DISTRICT OF CALIFORNIA

Attorneys for Plaintiff Phyllis Hull [Additional Counsel on Signature Page] UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case 1:14-cv SCJ-AJB CIVIL Document COVER SHEET 1-3 Filed 08/08/14 Page 1 of 2

V"'!, Z~Plfh1~1 COMPLAINT FOR-PERMANENT INJUNCTION AND OTHER EQUITABLE RELIEF ORIGINAL ~~ 12. \D\}e1o. DEC a

casu rr: \

Case 1:09-cv REB-MJW Document 1 Filed 12/18/09 USDC Colorado Page 1 of 9 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLORADO

How to Write a Complaint

How To Answer A Complaint In A Civil Case

Case 1:14-cv ERK-JMA Document 1-1 Filed 02/27/14 Page 1 of 2 PageID #: 6 CIVIL COVER SHEET (SEE INSTRUCTIONS ON NEXT PAGE OF THIS FORM.

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW JERSEY

How To Sue Guitar Center, Inc.

Preparing a Federal Case

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF CALIFORNIA

Case: 3:13-cv MPM-SAA Doc #: 1 Filed: 10/02/13 1 of 9 PageID #: 1

1~ ~ The ~~ ':_~cover ' I ti ained ~erein neither replace nor supplement lhi,.ijii~service of

Case 4:14-cv Document 1 Filed in TXSD on 05/07114 Page 1 of 14

Preparing a Federal Case

Case 2:14-cv Document 1 Filed 02/19/14 Page 1 of 9

7:: ):::-I'ifillyi.17',.;1., :i

Plaintiffs, Civil Action No.

Lawyer Referral and Information Service 229 Peachtree Street, Suite 400 Atlanta, GA 30303

Lawyer Referral and Information Service 229 Peachtree Street, Suite 400 Atlanta, GA 30303

Case 3:15-cv D Document 1 Filed 04/20/15 Page 1 of 15 PageID 1

FILING A CIVIL CASE WITHOUT AN ATTORNEY: A GUIDE FOR THE PRO SE LITIGANT UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF ILLINOIS

How To Process A Small Claims Case In Anarizonia

BROWN, M. J. UNDp 15, 14sc-nobt, Edge of Woods Road U S DISTRICT COURT EDNY RO. Box 323 FILED IN CLERK JAN 1 U against

Case: 3:15-cv Document #: 1 Filed: 06/26/15 Page 1 of 18 PageID #:1

Case 2:13-cv JS-AKT Document 1 Filed 07/26/13 Page 1 of 11 PageID #: 1 UNITED STATES DISTRICT COURT EASTERN DISTRICT OF NEW YORK. Case No.

Case 2:05-mc Document 407 Filed 04/08/14 Page 1 of 11 UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF PENNSYLVANIA PITTSBURGH DIVISION

PARRY G. CAMERON, Senior Attorney

Case 2:10-cv Document 1 Filed 09/20/10 Page 1 of 5

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF CALIFORNIA

(Name of Court) Plaintiff Case #:

FILING A COMPLAINT ON YOUR OWN BEHALF

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA

Case 3:07-cv L Document 26 Filed 03/13/08 Page 1 of 6 PageID 979 IN THE UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF TEXAS DALLAS DIVISION

The N.C. State Bar v. Wood NO. COA (Filed 1 February 2011) 1. Attorneys disciplinary action convicted of criminal offense

CL Form Civil Cover Sheet

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF DELAWARE

U.S. District Court Southern District of Indiana (Evansville) CIVIL DOCKET FOR CASE #: 3:11-cv-00???-XXX-YYY

Fla. R. Civ. P Civil Cover Sheet

CASE SCREENING QUESTIONNAIRE Return to: CIP, 225 Cedar Street, San Diego, CA INMATE NAME: CDC#: Prison: Cell Location: PO Box: City, State, Zip:

Entering Default against Defendants

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA SECOND APPELLATE DISTRICT DIVISION EIGHT

SUPREME COURT OF PENNSYLVANIA DOMESTIC RELATIONS PROCEDURAL RULES COMMITTEE RECOMMENDATION 140

IN THE UNITED STATES DISTRICT COURT DISTRICT OF

PINAL COUNTY INSTRUCTIONS AND FORMS

Case 2:16-cv DB Document 2 Filed 01/22/16 Page 1 of 19 IN THE UNITED STATES DISTRICT COURT IN AND FOR THE DISTRICT OF UTAH, NORTHERN DIVISION

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA, WESTERN DIVISION

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF ARKANSAS INSTRUCTIONS FOR FILING COMPLAINT BY PRISONERS UNDER THE CIVIL RIGHTS ACT, 42 U.S.C.

Case 3:15-cv BEN-JMA Document 1 Filed 10/20/15 Page 1 of 27

NOT TO BE PUBLISHED IN OFFICIAL REPORTS IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA FOURTH APPELLATE DISTRICT DIVISION TWO

Federal, State and Local GOV Agencies Where Berkeley Law Students Have Done Summer Internships. Alameda County Public Defender Oakland California

REVISED SCHEDULE OF CHARGES, COSTS AND FEES TO BE CHARGED BY THE CLERKS OF THE CIRCUIT COURTS UNDER COURTS ARTICLE, Effective July 1, 2015

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF VIRGINIA Norfolk/Newport News Division

Civil Suits: The Process

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF DELAWARE

Case 1:14-cv UNA Document 1 Filed 08/21/14 Page 1 of 6 PageID #: 1 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF DELAWARE

Bryan Cave LLP Rankings

UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF LOUISIANA

CIRCUIT COURT FILING FEE SUMMARY Effective August 1, 2013 Prepared by Milwaukee County Clerk of Circuit Court John Barrett TOTAL FEE*

Case 3:14-cv MAS-DEA Document 1 Filed 08/19/14 Page 1 of 15 PageID: 1 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW JERSEY

Case 1:09-cv MSK Document 1 Filed 04/02/2009 Page 1 of 15 IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLORADO

UNITED STATES DISTRICT COURT WESTERN DISTRICT OF NORTH CAROLINA CRIMINAL JUSTICE ACT ( CJA ) PANEL APPLICATION FORM

JUSTICE COURT # 2 GRAHAM COUNTY STATE OF ARIZONA P.O. BOX 1159, 136 WEST CENTER STREET, PIMA AZ PHONE (928) FAX (928)

IN THE COURT OF APPEALS OF INDIANA

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF VIRGINIA Richmond Division

MAIN BIO EXPERIENCE SPEECHES PUBLICATIONS NEWS

t3) UNFAIR COMPETITION

Case 8:14-cv EAK-AEP Document 1 Filed 08/15/14 Page 1 of 17 PageID 1 UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF FLORIDA TAMPA DIVISION

COURT SCHEDULING ISSUES

Case 1:14-cv RC Document 3 Filed 08/27/14 Page 1 of 8

Transcription:

Case :-cv--cbm-jpr Document Filed // Page of Page ID #: Ron Newt (Full Name) d nondronnewt@yahoo. CO(Uiail Address) R.. Joost St. (Address Line I) San Francisco Ca. (Address Line) - - (Phone Number) Ron Newt (indicate Plaintiff or Defendant) Ron Newt vs. in Pro Per UNITED STATES DISTRICT COURT DISTRICT OF CENTRAL DISTRICT OF CALIFORNIA PLAINTIFF, Rupert MurdochABrotth eiiig, Tmpire lrision Showi, Lee Daniels, Danny Strong, Terrence Howard, Malcolm Spellman DEFENDANT(S).. This Court has jurisdiction under Case No.: L A C V (To be supplied by the Clerk) COMPLAINT FOR: I. JURISDICTION cnpyrigh Tnfringemit & Plagiarism by Tv series "Empire" Entertainment Co. in connection with the book, story, script Bigger than Big Jury Trial Demanded: eyes Nc Federal Question Jurisdiction U.S.C. and Diversity Jurisdiction (federal law-yes) (amount over,) Personal Jurisdiction (resident or citizen california-yes) suing the defendant for for something don in california-yes- personal Jurisdiction Revised: July Form Prepared by Public Counsel, Public Counsel. All Rights Reserved. /

Case :-cv--cbm-jpr Document Filed // Page of Page ID #: IL VENUE. Venue is proper pursuant to Substantial part of event suing for happened in this dis trict?-yes at least one defendant lives in this district-yes fa III. PARTIES. Plaintiff s name is ori Newt. Plaintiff resides at: San Francisco Ca Joost St.. Defendant Rupert Murdock / Fox Televisio, Empire Television Show is responsible for airing the showrnpirs" without permission of and credits by the real writer end creator. Defendant ee Daniels Claims to be cre ator a n d witer HI

Case :-cv--cbm-jpr Document Filed // Page of Page ID #: I Defendant Terrence Howard Insert When Terrence Howard an tn Newt met at the four season hotel to discuss Rons life story in the book "Lggor than Big" Terrence told Ron that he wanted to play him in the film. Terrence.was given the book and script of "Bigger than Big" Defendant Danny Strong Insert J# io claims to be creator and writer Defendant Malcolm Spellman Insert co-producer episodes & writer (claims to be original writer of the story) Defendant PTIV.

Case :-cv--cbm-jpr Document Filed // Page of Page ID #:. V. CAUSES OF ACTION FIRST CAUSE OF ACTION (_Copyright Infringement and Pagi.vim insert title of cause of action (As against Defendant(s): Rupert Murdoch,Fox Broadcasting, Lee Daniels, Danny Strong, Terrence Howard, Malcom Spellmtn mpire "R emember those drug dealers you killed back in the day? / "Bigger than Big" chapter, Trudy, Tippy, Outlaw & Mack Major ( drug dealers killed) empire "Lucious shoots his mug time friend than Big" page Prince shoots his friend. "Bigger tha: Bmpire Lucious kids are performing as he is being arrest ed. "Bigger than Big" they were broadcasting the newtron concert at the coliseum. While they were hancuffing us, I, was thinking of the newtrons page O,

Case :-cv--cbm-jpr Document Filed // Page of Page ID #: N SECOND CAUSE OF ACTION (_Copyright Infringement and Plagiarism insert title of cause of action (As against Defendant(s): Rupert Murdoch,p ox Broadcasting, Lee Daniels, Danny Strong, Terrence Howard, Menrn Spell Empire: Cookie is released from prison. "Bigger than Big" page I want you to take over absolute control of all the hos, until China Doll is released from r Empire roundtable, "Bigger than Big" roundtable page Empire Kids clothes and hairstyle. "Bigger than, Big" Like newtrons, clothes and hair

Case :-cv--cbm-jpr Document Filed // Page of Page ID #: I THIRD CAUSE OF ACTION Copyright Infringement and Plagiarism ( insert title of cause of action (As against Defendant(s): Rupert Murdoch. Fox Broadcasting, Lee Daniels, Danny Strong, Terrence HOward, Malcom Spell Insert Empire sons "Bigger than Big" sons Empire coats worn by Lucius "Bigger than Big" coats are Insert same style as worn by Ron Empire (pilot) Cookie with h "Bigger than Big" page same look of China Doll in the hat

Case :-cv--cbm-jpr Document Filed // Page of Page ID #: ( FOURTH CAUSE OF ACTION Copyright Infringement and Plagiarism insert title of cause of action (As against Defendant(s): Rupert Murdoch Fox Broadcasting Lee Daniels, Danny Strong, Terrence Howard, Malcolm_Spelnn Empire Cookiegoestojailfordrugs"BiggerthanBig" page China Doll goes to jail for drugs Empire Lu InsertH sysi was years _old in the Empire story, Big " P $re "_ "Bigger_ than _ page _says _ He _is_ myon _ God _ and i have taught him everythini about the game aiiki he was years old. Empire lucious and Jamal write songs _together_"btgeha T Big. Ron and bob write songs together Insert # )

Case :-cv--cbm-jpr Document Filed // Page of Page ID #: IV. STATEMENT OF FACTS Rrrn tc,r c iriih ir+c + n tnt-.tr tisyr +.hn Ti Inseri # is - a Drama & Musical story. Ron Newt bases this story on a true and fictional story of a feuding entertainment Industral family. After being a gsns er pimp,and drug dealer, Ron Newt a known ghetto player plays himself in the documentary. Also his wife and kido, Ohina doll and the Newtrons.In addition Ron signs a multimillion dollar; deal in with Mea major record deal with Michael Jacksons family Jackson Records and also the major mogul Insert Deathrow Records. The two boys were J. Valentine and Bobby Newt. Insert f

Case :-cv--cbm-jpr Document Filed // Page of Page ID #: ii: I WHEREFORE, the Plaintiff requests: VI. REQUEST FOR RELIEF That the court (Federal District, United States Insert # District Court of California awards me(ron Newt) Billion Dollars for Copyright Infringement and Plagiarism from my book and life "Bigger than Big". Dated: Sign: Print Name:

Case :-cv--cbm-jpr Document Filed // Page of Page ID #: DEMAND FOR JURY TRIAL Plaintiff hereby requests a jury trial on all issues raised in this complaint. Dated: Sign. Print Name:

Case :-cv--cbm-jpr Document Filed // Page of Page ID #: itt - UNITED STATES DISTRICT COURT, CENTRAL DISTRICT OF CALIFORNIA CIVILOVER SHEET I. (a) PLAINTIFFS (Check box )orerepresentin yourself (b) County of Residence of First Listed Plaintiff (EXCEPT IN U.S. PLAINTIFF CASES) (c) Attorneys (Firm Name, Address and Telephone Number) If you are representing yourself, provide the same information. jo - S (Check box if you are representing yourself /cud*i MA(.o,c ft,tf, L p County of Residence o f first Liste bfedt (IN U.S. PLAINTIFF CASES ONLY) (Firm Name, Address and Telephone Number) If you are g yourself, provide the same information. II. BASIS OF JURISDICTION (Place an X in one box only.) Government. Federal Question (U.S. Plaintiff Government Not a Party) Government F-]. Diversity (Indicate Citizenship Defendant of Parties in Item Ill) III. CITIZENSHIP OF PRINCIPAL PARTIES-For Diversity Cases Only (Place an X in one box for plaintiff and one for defendant) PTF DEF Citizen of This State Incorporated or Principal Place of Business in this State PTF Ej Citizen of Another State Incorporated and Principal Place of Business in Another State Citizen or Subject of a Foreign Country DEF o Foreign Nation IV. ORIGIN (Place an X in one box only.),_-toriginal. Removed from -. Remanded from ri. Reinstated or. Transferred from Another Proceeding L_J State Court i Appellate Court L_J Reopened District (Specify). Multi - District Litigation V. REQUESTED IN COMPLAINT: JURY DEMAND: es No (Check "Yes" only if demanded in complaint.) CLASS ACTION under F.R.Cv.P. : Yes gtno EjJNEY DEMANDED IN COMPLAINT: $ / &,O, O VI. CAUSE OF ACTION (Cite the U.S. Civil Statute under which you are filing and write a brief statement of cause. Do not cite jurisdictional statutes unless diversity.) VII. NATURE OF SUIT (Place an X in one box only). O False Claims Act Ej State Reapportionment O Antitrust LJ Insurance o Marine Miller Act Banks and Banking -, Negotiable Li Instrument Commerce/ICC - Recovery of Rates/Etc. o Overpayment& Deportation Enforcement of Judgment - Racketeer Influ- jj Torts to Land Tort Product Liability All Other Real Pro ert Airplane Airplane -i Product Liability Assault, Libel & Slander Fed. Employers L I enced & Corrupt Org. J Medicare Act O Consumer Credit Recovery of O Cable/Sat V o Defaulted Student Liability Loan (Excl. Vet.) Securities/Com- O Recovery of modities/exchange Marine Overpayment of Marine Product Other Statutory Vet. Benefits Liability Actions Motor Vehicle Stockholders O Agricultural Acts Suits r-i Motor Vehicle O o Product Liability Environmental Other Matters r-, Other Personal Contract Injury Freedom of Info. Act r- Contract Personal Injury- J Product Liability Med Malpratice Arbitration o Franchise Personal Injury- Product Liability Admin. Procedures Health Caret Act/Review of Appeal of Land Pharmaceutical Agency Decision Condemnation Personal Injury O Foreclosure Product Liability Constitutionality of Asbestos O State Statutes Rent Lease & o Personal Injury D Naturalization Application O Other Immiciration Actions Other Fraud Habeas Corpus: Alien Detainee D Motions to Vacate Sentence General o Death Penalty o Truth in Lending ID Mandamus/Other O o Other Personal D Civil Rights Property Damage Prison Condition Property Damage Civil Detainee Product Liability D D Appeal USC D Withdrawal USC F- Other Civil Rights Voting Employment D Housing! Accommodations O American with Disabilities- Employment American with Disabilities-Other R Education Drug Related Seizure of Property USC Other O lo Fair Labor Standards Act LabortMgmt. Relations E] Railway Labor Act O Family and Medical Leave Act O Other Labor Litigation Employee Ret. Inc. curitv Act [ Copyrights :) Patent Trademark II HIA (ff) o Black Lung () DIWC/DIWW ( (g)) SSID Title XVI o RSI ( (g)) O Taxes (U.S. Plaintiff or Defendant) O IRS-Third Party USC FOR OFFICE USE ONLY: Case Number: W r - CV- (/) CIVIL COVER SHEET Page of

Case :-cv--cbm-jpr Document Filed // Page of Page ID #: UNITED STATES DISTRICT COURT, CENTRAL DISTRICT OF CALIFORNIA CIVIL COVER SHEET V assigned. This initial assignment is subject -...,. ------. - QUESTION A: Was this case removed from state c our t? Yes ff"no, Los Angeles, Ventura, Santa Barbara, or San Luis Obispo I Western If "no, skip to Question B. If yes, check the box to the right that applies, enter the fl Orange Southern corresponding division in response to Question E, below, and continue from there. Riverside or San Bernardino Eastern QUESTION B: Is the United States, or one of its agencies or employees, a PLAINTIFF in this action? Yes E- No B.. Do % or more of the defendants wh the district reside in Orange Co.? check one of the boxes to the right YES. Your case will initially be assigned to the Southern Division. Enter "Southern" in response to Question E, below, and continue from there. NO. Continue to Question B.. "no," skip to Question C. If yes, answer uestion B., at right. Do % or more of the defendants who reside in I district reside in Riverside and/or San Bernardino inties? (Consider the two counties together.) I lo YES. Your case will initially be assigned to the Eastern Division. Enter "Eastern" in response to Question E, below, and continue from there. check one of the boxes to the right NO. Your case will initially be assigned to the Western Division. Enter "Western" in response to Question E, below, and continue from there. SIlO N C: Is the United States, or of its agencies or employees, a ENDANT in this action? Yes If no," skip to Question D. If yes," answer Question Cl, at right.. Do%ormoreofthep ;trict reside in Orange Co.? of the boxes to the right C.. Do % or more of the plaintiffs who reside in district reside in Riverside and/or San Bernardino Counties? (Consider the two counties together.) check one of the boxes to the right YES. Your case will initially be assigned to the Southern Division. Enter "Southern" in response to Question E, below, and continue from there.. Continue to Question C.. YES. Your case will initially be assigned to the Eastern Division. Enter "Eastern" in response to Question E, below, and continue from there. NO. Your case will initially be assigned to the Western Division. "Enter Western in response to Question E, below, and continue from there. Indicate the location(s) in which % or more of plaintiffs who reside in this district reside. (Check up to two boxes, or leave blank if none of these choices apply.) Indicate the location(s) in which % or more of defendants who reside in this district reside. (Check up to two boxes, or leave blank if none of these choices El I El I El I El I D.. Is there at least one answer in Column A? Yes I"No If "yes," your case will initially be assigned to the SOUTHERN DIVISION. Enter "Southern" in response to Question E, below, and continue from there. If "no," go to question D to the right. D.. Is there at least one answer in Column B? El Yes Ft-J-No If "yes," your case will initially be assigned to the EASTERN DIVISION. Enter "Eastern" in response to Question E, below. If "no," your case will be assigned to the WESTERN DIVISION. Enter "Western" in response to Question E, below. Enter the initial division determined by Question A, B, C, or D above: Do % or more of plaintiffs or defendants in this district reside in Ventura, Santa Barbara, or San Luis Obispo counties? Yes RicIo CV- (/) CIVIL COVER SHEET Page of

Case :-cv--cbm-jpr Document Filed // Page of Page ID #: UNITED STATES DISTRICT COURT, CENTRAL DISTRICT OF CALIFORNIA CIVIL COVER SHEET IX(a). IDENTICAL CASES: Has this action been previously filed in this court? YES If yes, list case number(s): IX(b). RELATED CASES: Is this case related (as defined below) to any civil or criminal case(s) previously filed in this court? If yes, list case number(s): fl YES Civil cases are related when they (check all that apply): A. Arise from the same or a closely related transaction, happening, or event; B. Call for determination of the same or substantially related or similar questions of law and fact; or C. For other reasons would entail substantial duplication of labor if heard by different judges. Note: That cases may involve the same patent, trademark, or copyright is not, in itself, sufficient to deem cases related. A civil forfeiture case and a criminal case are related when they (check all that apply): A. Arise from the same or a closely related transaction, happening, or event; B. Call for determination of the same or substantially related or similar questions of law and fact; or C. Involve one or more defendants from the criminal case in common and would entail substantial duplication of labor if heard by different judges. X. SIGNATURE OF ATTORNEY (OR SELF-REPRESENTED LITIGANT): DATE: $, Notice to Counsel/Parties: The submission of this Civil Cover Sheet is required by Local Rule -. This Form CV- and the information contained herein neither replaces nor supplements the filing and service of pleadings or other papers as required by law, except as provided by local rules of court. For more detailed instructions, see separate instruction sheet (CV-A). Key to Statistical codes relating to Social Security Cases: Nature of Suit Code Abbreviation Substantive Statement of Cause of Action All claims for health insurance benefits (Medicare) under Title, Part A, of the Social Security Act, as amended. Also, HIA include claims by hospitals, skilled nursing facilities, etc., for certification as providers of services under the program. ( U.S.C. FF(b)) BL All claims for Black Lung" benefits under Title, Part B, of the Federal Coal Mine Health and Safety Act of. ( U.S.C. ) All claims filed by insured workers for disability insurance benefits under Title of the Social Security Act, as amended; plus DIWC all claims filed for child s insurance benefits based on disability. ( U.S.C. (g)) DIWW SSID All claims filed for widows or widowers insurance benefits based on disability under Title of the Social Security Act, as amended. ( U.S.C. (g)) All claims for supplemental security income payments based upon disability filed under Title of the Social Security Act, as amended. RSI All claims for retirement (old age) and survivors benefits under Title of the Social Security Act, as amended. ( U.S.C. (g)) CV- (/) CIVIL COVER SHEET Page of