Case Document 1 Filed 09/02/14 Page 1 of 18
FORM TO BE USED BY A PRISONER IN FILING A CIVIL RIGHTS COMPLAINT

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF 

(1) Lane? [Song [005440107

 

 

 

 

 

 

 

 

 

 

(Nam?e of Plaintiff) (Inmate Number) .
(Address) 
 3 /7/2
(Name of Plaintiff) (Inmate Number) I 
(Case Number)
(Address)
(Each named party must be numbered,
and all names must be printed or typed)
vs. CIVIL COMPLAINT
(?km?I FILED
. 3 I 
(2) do CoSi'Ott SCRANTQN
(3)  95W [or SEES I 2014
(Names of Defdndants) I
PER 
(Each named party must be numbered, QE 
and all names must be printed or typed) 
TO BE FILED UNDER: 42 U.S.C. 1983 STATE OFFICIALS

28 U.S.C. 1331 - FEDERAL OFFICIALS

I. PREVIOUS LAWSUITS 

A. If you have ?led any other lawsuits in federal court while a prisoner, please list the caption and case
number including year, as well as the name of the judicial of?cer to whom it was assigned:

:1 0?  

 

 

 

 

 

Case Document 1 Filed 09/02/14 Page 2 of 18

II. EXHAUSTION OF ADMINISTRATIVE REMEDIES

In order to proceed in federal court, you must fully exhaust any available administrative remedies as to
each ground on which you request action.

1 A. Is there a prisoner grievance procedure available at your present institution?  Yes No
1
B. Have you fully exhausted your available administrative remedies regarding each of your present
claims? Yes No
C. If your answer to is Yes:

1. What steps did you take?

 

 

2. What was the result?

 

 

D. If your answer to is m, explain why not:

 

 

DEFENDAN TS

(1) Name of ?rst defendant: (jg-kt T1 CF CI UgrA

 

. 
Employed as 0 at 5
Mailing address: '5 3 3
(2) Name of second efendant: 5 on 

  
    
 
    
     
 

Employed as (9
Mailing address:
(3) Name of third defendant: .
Employed as 50d] 
Mailing address: 0 I
(List any additional defendants, their employment, an
IV. STATEMENT OF CLAIM

 

ddresses on extra sheets if necessary)

(State here as brie?y as possible the facts of your case. Describe how each defendant is involved, including
dates and places. Do not give any legal arguments or cite any cases or statutes. Attach no more than three
extra sheets if necessaryJagle   bgfs?y
g?f? g4: St) at! H6 being Searcth and 35(ko
its 43.5 gigging asked Ensign ?22213 be Firing Cg?

 

Case Document 1 Filed 09/02/14 Page 3 of 18

4/116) menial Walnut Je?igr Haj; axfglalnagl 4?0 (age.
2. LTL knqi?r? Vlolaalaj AmmAmemL REM: an

Egg}: I.2 l. azng along u?lgl Mme. He. A23.

11 Cm  Gym) la glam me. lo $634?-


Ton?i? Ho reasont?LT. kmqu was "Mtg LT. over

5 0?
3. Crmalgarcl \Ja?egajregj W1 #Ame??me?i {7H0n 

gelng. 2012 We wamm tn 4445 Shower W144
- 

RELIEF

(State brie?y exactly what you want the court to do for you. Make no legal arguments. Cite no cases or
statutes.)

1. ammo. mm rapt/altar 62ml. +145.
areal:an Plain-loll 0t 
?Hui @1643 moi-j egal??wg Left-2M 

a: ill-(6 Umler Con ?84};450111 0"th DIES

 

 

 

 

 

 

 

 

 Case Document 1 Filed 09/02/14 Page 4 of 18

II 

 

I declare under penalty of perjury that the foregoing is true and correct.

45L  .
Signed this  day of 20  .

(Signature of Plaintiff)

 

Case Document 1 Filed 09/02/14 Page 5 of 18

13:1, Mada/#5 Cm?u?

Name wk  my
fnh?ojeck Q3, thkn??l CA M?r?la?an 
m: (134955 

(5m 0cm Mama; 
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mung ca r655. t?mmw?me
Name OQ SFWW 

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?5.30 mc?ress 

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Case Document 1 Filed 09/02/14 Page 6 of 18

or am Caqu?upiz
4M 3 meld  6129qu 

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wages aim-1M6. 7 . ta act/15' he; 
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Case Document 1 Filed 09/02/14 Page 7 of 18

IVSTATWENT 0F cum (1) 3

?Wald; o?o @6314/1 never Ml Jim, on cam/1 j.
me?kk 7?16. V1?er m?iin 94de "gof 7
. had 1x or OCc?as?n  
ULW 'Tmfeq4">49{ 
M49 4?66 SW Germ wyexci M25 QHCL 05k me was 

1' . 3.01m 40 my ce?lh?azqose 094146 Marajrs 
443$? ogu?oer T164640 week babe: 41653 
align?L ans/oer Egg,? Seen it 
96?? 4o Cit/1505f L?EM/l?wakd?d?l?gld 6% Civic; CM
fian  Us% at ehrhh/ ?Hk (Milo/l \m his Len 4

\Tme?hporA ?30de chi?me gatth 41/641 MS 50%}
+0 ?Hat. milk Carla? (7?0 wa m; 40 Sec
ani- WU Tlrb?  Sim/(Ci MS. 
\m an; 004ka 044416, Iraqi/Life, skim Em ?Hid
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Case Document 1 Filed 09/02/14 Page 8 of 18

IM STRTENENT OF caM-?Mf? 

Bjmka LT. know ms ?u?c?se 40 ?Comt?. m3 Jr0
'bti?m was Flamth 1?65?qut?45auouw?ar/ Le, neuar
beta} ?SCor46c?1L03rke, Ce?) LT Knapp
n6, Ah}; I ?knoU win .3: was being. final. in 
Jreld Hm no.2, cKrw?fp +013 he. (pair 
bw?d?kna?o Come, back +0 ?:kaok an m)
ask/A Mm LC kg, (100% lease 100550 ?Hmc 
(109% Upton mgr-n1 W4 was awn} 4., mu) m;
km ,0 me) no?krep Jada {)E?aces m5 0. av ?34 Herman
m4 9W9, Ceil?w?hePceces a. a: 1er?Manama):ng m3 
LT S?v?w Neck can he: anc?, LT?mj 
wry-k (epotfis erAPnj I [1:55 can ?mam Vixen
5an 0am back \m cm War in; ckeck am Mug 
3: ?x hl?t?lck Jm LEN-W44 n1 erw Pigs on moo/1&1
46ch Hm MA are: Mag :?revm
Km $054 know who 0\ L?R?'n?ov r5 never
?rmed We, akcwef. 
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Hn gm was :nwskamjrs LT. knapp
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6 wk WW Menla? MAM  Jul 'In maid/1+5,
He 9M in fesirainJrs because Le jail/He \m ($54401 ?nals

Case Document 1 Filed 09/02/14 Page 9 of 18

1V. STATEMENT 0F. Lm Conjrm? 3

am Mked 004, Me mum ramp We, back in can
\wur 4-0 Ckeck (30?an reskam-ks EXPIGSAQA Es Hm
 was+McgaLy and 4% reg?)! Wedgie Usean
reeirman 1 km]; $264 submel Hank 
Waggon Em 61%me Ms 
5mg 6 Lake ma?a-C. reskain15$a ed
of\ bakmwo?j a?k?cl D: km!) ?link a?  
2012? 10M  QSCQ ?ame
$13996?! Fejmlol m. le?m Mon/can
$6191 l?lloll 01st Cami Ha??ca? @90an
Pl 2515a \mse? 44w. up on M?fs??ec?m? and 
know} MA mi 4M1 c2st LT. app hf wad 964 
dome: cam! 0\ cup Some, waiverxkn Midi me, no (ml
WaWai  ?a LT. know/Y) Crane back 0} koof? ?40
an ex (mt/WA 4?0 %a4"14:6 exceeds
lick/N?  ma Jinner an 6 20!; can land/1 can 7/2012,
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0k Ar?mk 69%: ha no OMA 521%?  g?
5662 m; 00 ?McKay Sea/H? 102611 card  $04 ?of: 
{Sewage 4} n1 3 w: me chainww?o (/66 6
$1 Urine) inn?{A Qece? em me, Cir 
(4664456 Hemg]: ml Add? W1de 

 

Case Document 1 Filed 09/02/14 Page back  my cell, Due ?Lo 
+m4m:nj (sea 04444464 ?001 +116.
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MAM Seen it CM-
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back WM (1 em Cowlon \sn  \?goT

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amped 4+1: grader i W49 }n orqu 642ko @04- 4146 dict/tn

$601058 ??104qu cal/IA LT $4740? 4; 
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[o?S?Z??lZs ch me reqson QHA chc?ts?we J:ch: was
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Case Document 1 Filed 09/02/14 Page 11 of 18

0F CLAIM 

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5:94} a, 20!? LT?ax/loraclon WNW @hccn?T?meQJJ
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\ndcle' 1?6 ZTascw?or W554i an me?,

(See o?mye/A  iD fee  $6,03ch {to
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?Tn {?664-Valx?is 66. gxcess?we, $0ch qu 

?jams; 

 

Case Document 1 Filed 09/02/14 Page 12 of 18

C5)

  76am Unbiak?l M?f Qi??'rml??d Rglr??
AS a;  mfiinj SquE. ate?eq  MR 441856
$606316. owe. because a 3% on 3:0? m?olr rig/om
M1 man Q, ma?, Leznj I
Ta?miniS  Mae?god Teen/?Viva 0!!?ch 9
Vans were, Placed on v46. 50"?   (31/46 
gar rte, 41> wcaVGWeY  (1 Am Caron/IA my
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Case Document 1 Filed 09/02/14 Page 13 of 18

 STRIEHENTOF CLAY ViolmLeAm Amime 
7 ?gigoli Carl?s/1  
. Aer?ecl 777F116 Dr; 96705 ..
. . 9W6 em M, ?d?oq! Fedorc1$ wWe mam 
reskqu. an?jcs We CHARM Dxlreolor 0H
1%:ij U.&R.Dm05jas ream; e.qu cml?/ 4/116 nurse?
magi We made tamer eycheckeJ an me. and 
NHR Task/Q?th  Mg: Dr.p.?7es 
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ma (Core We me maAI?cq? q?Herm?on.
MM :x 90% @2461; pan numerous ?52k
COINS See Halc?lcq? c154 r17! Waist?
av an Wrai?' my 92K {Bar Helica? 
no kd?a 2.245 jM/exh HY wow/145 Leeiccl
UP on e?m wan, [Lean/x was ale/[RC3 meAm?. 
0mm :ckaveh'j )oakt'nj @00st on Iowa oCm/
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We can; [awake roblens. :?c?vc wr?chnanws 
66?va 4?6 Oh 

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numms acas?on? Scream?n - ele? ?1 ?meH/ws

:1 can?: 6  lama: 69?? (l3 go?aih?s

MC

 

FOREVER

  

 

N. \xJoz??MJqum Ma
W50 1

 

ns-?3783?
DATE AUG 28 
THE ENCLOSED LETTER WAS THROUGH
sr-e?rcw FOR TO

{j
I


 

glam? (Serif.



 

  .wa- LE NEITHER OPENED NGR
a - a  w: .: RAISES A on
avg; w; ages-e mas HAS JURIS-
5 [a DH, Ma?  EWSH 7O RETURN THE 
 [2.9 A Fm FLtai?tvi'H ENFORMAHON 09 u:
 EVE ?3 T?iE'rmiiLn? CORRESPONDENCE FOR
.0, 8 8 SE -  NGTOANOTHEJEDDRESSEE. PLEASE RETURN
if; 2 a of) y; sr'TzosunE TO THERBOVE ADDRESS~mm-wf -



 

 

Case Document 1 Filed 09/02/14 Page 15 of 18

:m 

j: $46.1 UP  Ganjrwem X?qv?
.EICCUSQA    
Me, 0t.? \Decaqz  pokes: 1? been?Hrwo/?lu 
 Cause er? \jdn ?lach Ln 41? no,_ 
.  Wagon an rj ?e mei?cq?empfx ?uqer

scam

. $9,qu ~Qr?n menlgg yr?bknfi

 

Case Document 1 Filed 09/02/14 Page 16 of 18

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Cami Jcemshecassary, f,

 

 

Case Document 1 Filed 09/02/14 Page 17 of 18

 

 

 

 

 

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Case Document 1 Filed 09/02/14 Page 18 of 18

 

 

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