Free Complaint - District Court of Delaware - Delaware


File Size: 234.6 kB
Pages: 3
Date: December 19, 2005
File Format: PDF
State: Delaware
Category: District Court of Delaware
Author: unknown
Word Count: 443 Words, 2,920 Characters
Page Size: Letter (8 1/2" x 11")
URL

https://www.findforms.com/pdf_files/ded/35834/2-1.pdf

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— Case 1 :05-cv-00877-JJF Document 2 Fi-led 12/19/2005 Page 1 of 3
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(DeL Rnv.l2/98]
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF DELAWARE
(Name of Plaintiff or Plaintiffs) O 5 - 8 T 7
v. CIVIL ACTION NO. _
M
(Name of Defendant or Defendants) i -
COMPLAINT i ei'e_ ¥
1. This action is brought pursuant to V//l Clirwlf (gl wi
(Federal statute on which action is based)
for discrimination related to @152. LA·e!'( [ jurisdiction exists by virtue of
(ln what area did discrimination occur? e.g. race, sex, religion)
(Federal statute on whichjurisdiction is based) I K
2. Plaintiff resides at i G-L . Q; }"L‘~’ 4
(Street Address)
(4U¢).¤ gg; Hai, [22653-
(City) (County) (State) (Zip Code)
gg av,) ?<2»-r- 0 Mr .
Area Code) (Phone Number) I
3. Defendant resides at, or its business is located at ji ? 5 / *6C9"U·"O"’¢0@(·
(Street Address)
(gd,. [Z3-’6¢·{ .
(City) (County) (State) (Zip Code)
4. The alleged discriminatory acts occurred on , r (_ , lj @ , Z (9 D *5,1 .
(Day) (Month) (Year)
5. The alleged discriminatory practice K E EI is not continuing.

Case 1:05-cv-00877-JJF Document 2 Filed 12/19/2005 Page 2 of 3
6. P1aLntifr“(s)ii1ed charges with the 50106 #(182 ». 0/ 5*/Gb!
_ _ V (Aswy) _ __
T/tc @(2%. Lt g ,` Ewa sv, ..;»·c,rlQ.»0- E//Ja #,4. (grae. --·>¤ or
(Street Address) (City) (County) (St te) (Zip)
regarding defendant(s) alleged discriminatory conduct on: · /0 _ 0
(Date)
7. Attach decision of the agency which investigated the charges referred in paragraph 6 above.
8. Was an appeal taken from the agency's decision? Yes Hf No El
Ifyes, to whom was the appeal taken? @ { {M * li
9. The discriminatory acts alleged in this suit concem: (Describe facts on additional sheets if
necessary) __
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10. Defendant’s conduct is discriminatory with respect to the following:
A. Plaintiffs race
B. El Plaintiff s color
C. E! Plaintiff s sex
D. III Plaintiffs religion
E. El Plaintiff s national origin

. Case 1:05-cv-00877-JJF Document 2 Filed 12/19/2005 Page 3 of 3
11. Plaintiff prays for the following relief: (Indicate the exact relief requested)
;l A és-3* E Q S. ;
G,./vi Mggt, % L-Qigfgfg 527;:*;, Qjé
I declare under penalty of perjury that the foregoing is true and correct.
Dated:
7 ~ 7
j@*¤ r if
(Signature ofPlaintift)