Free Complaint (Pro Se) - District Court of Delaware - Delaware

E Case li(lS-cv—OOO11-Gl\/IS Document5 Filed O9/O4/2007 Pagel of2
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UNITED STATES DISTRICT COURT FOR THE
EASTERN DISTRICT OF PENNSYLVANIA
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Plaintiff
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Def ant
COMPLAINT
1.) Fill in you address (street, city or town, state, and zip code):
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2.) Defendant’s address is (street, city or town, state, and zip code):
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3.) Statement of Qlaim:
Fill in the facts of your case, and state why you are tiling this lawsuit. Give names,
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Case 1 :08-cv—OOO11-GIVIS Document 5 Filed O9/O4/2007 PGQQ O
4.) Fill in what you are requesting in this case: q
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5.) If you tiled charges with the Equal Employment Opportunity Commission or with the
Pennsylvania Human Relations Commiss`0n, please zztach a copy ofthe Notice-of-
R1ght·to-Sue letter. [B I _
6.) If there is a right to jiyry trial in your type of case, do you want one?
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(Your Signature)
declare under penalty of perjury that the information filled in is true and co . »
A n ‘ 00 ritz; Y t
(Da ) ( our Signature)

Case 1:08-cv-00011-GMS

Document 5

Filed 09/04/2007

Page 1 of 2

Case 1:08-cv-00011-GMS

Document 5

Filed 09/04/2007

Page 2 of 2