NA FORM 13 040 (10-86

)
1 ATIONAL ARCHIVES AND RECORD S ADMINISTRATION
to wQom tQr.ar prrBrnt.a .aQall romr. CGrrrtiny:
of the authority vested in me by the Archivist of the United States, I certify on his behalf,
of the National Archives and Records Administration, that the attached reproduction(s) is
copy of documents in his custody.
SI GNATURE
NAME
·201 I
TITLE
NAME AND AD DRESS OF DEPOSITORY
Washington National Records Center
4205 Suitland Road /
Maryland 20746-8001
­
UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLUMBIA
)
JOHN AKWEI, )
)
Plaintiff, )
)
v. ) Civil Action No.
) (Stanley Sporkin)
NATIONAL SECUTIRY AGENCY, )
)
Defendant. )
)
---------------------------------)
MEMORANDUM OPINION AND ORDER
Plaintiff has brought this action se,
92-0449
ritE D
I DiSTRICT COURT
DiS ;Rlt. l OF COUJMBIA. .
alleging that
employees of the National security Agency have engaged in
harassment and criminal offenses directed toward him. He is
seeking damages. Plaintiff claims the harassment began when
certain individuals who are now employed by the NSA were students
with him ' at Northwood High School in Wheaton, Maryland. He then
describes a variety of instances of harassment, all of which
appear to be frivolous. For example, he alleges that in December
of 1981, he found a paragraph . of "graphitti" on a bus shel,ter at
the Silver Spring Metro station that "described the jacket I was
,
wearing in detail, and contained a paragraph of threats and
racial slurs directed at me personally." Complaint at 6. He
' also alleges that on 24, 1991 there was an "attempted
poisoning." His complaint includes a "List of Illegal Activities
Committed," one of which is "continuous attempts to damage mental
health since 1980."
The Court is unable to construe this complaint as stating
(N)

any identifiable legal cause of action. Accordingly, it will be
disJIlissed as frivolous pursuant to 28 U.S.C. § 1915(d).
It is this day of March, 1992, hereby
ORDERED that this complaint is dismissed.
stanley Spo
,
k'
,
j
United Court
2 .
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(4 , .
([ourt"
FEB 20 1992
----"<; ______ DISTRICT OF - _______________ ";'-----:---_.,--­
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APPLICATION TO PROCEr.u' w.,,,', ' -' WMt:; ,h
FORMA PAUPERIS, SUPPORTING
v.
DOCUMENTATION AND ORDER
I vr, lr AJ&I/
CASE NUMBER:
J-T, G-eo')e G--. Mell-kflllJ d.
o
755 -low
92-0449
1,_____J--'o'-'hu..N _(.:.... A_K_,_""'_, ' :..::-_" . __ _e._t_____---#. declare that I am the (check approPriate box)
D movant (filing·28 U.S.c. 2255 motion)
.
.
o respondent/defendant
,

in the above-entitled proceeding; that, in support of my request to proceed without being i
requil1!d to prepay fees, cost or give security therefor, I state that because of my poverty, I
am unable to pay the costs of said proceeding or give security therefor; that I believe I am
entitled to relief. The nature of my action, defense, or other proceeding or the issues I intend
to present on appeal are briefly stated 'as follows: ,
fltc/YI r Je/e,.;jl1,,15,
W ( I "Z. e J N,.1'1 Nk I "Uf': J-y Aj e,JCY ofh c. e. S ",,,,J te.fOil rc eS
to Cc,J}"-tlJ i!4J,Q i f /-I.e-If' \IV. II 1I1,1I-11r My
eMIJ II YIt'! e.v.f- I
In flIrthef support of this application, I answer the following qu.estions.
1. Are you presently employed? NoD
a. If the answer is "yes," state the amount of your salary or wages per month, an<;i
give the name and address of your employer. (list both gross and net salary) .
-1t1" ·,...JJ,/90 "
5 5:r B iJ.i' I""e.ss Ce,.J.J,- e,-S - /800-0R Q c k 11" I! e Pk flD " [(Vi. lIe
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b. If the answer is "no," state the date of last employment and the amount of the
salary and wages per month which you received.
2. Have you received within the past twelve months any money from any of the follow­
ing sources? ' /
a, Business, profession or other form of self-employment Yes No 0
b. Rent payments, interest or dividends? Yes 0 No
c. Pensions, annuities or life insurance payments? Yes 0 No
d. Gifts or inheritances? Yes 0 No
e. Any other sources? Yes 0 No
.'
00-217
R8\!.3JlIl
FPI·LEX
UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLUMBIA
P1aintiff(s)
92-0449
vs. Civil Action No.
Defendant(s)
Dear
In the above entitled cause, please be advised that on
Judge
endorsed thereon as follows:
"Leave to file without prepayment of costs
As a result of the Judge's ruling, your case has been filed
and assigned to Judge

SPURKfN,
J. SS
All subsequent correspongence or pleadings must bear the civil action
number referred to above, followed by the initials of the Judge assigned
, to your case. The Judge's initials can be found on the line
following their name as shown above.
NANCY MAYER-WHI'IT INGION, cr.ERK
. By:
Deputy Clerk
, Jl.II
.f-: '.
~ .. ~ ' .
"t--.' " i ~ ~ ~
UNITED STATES DISTRICT COURT
FORTIIE DISTRICT OF COLUMBIA
'"
.
F
.,
"
,
JOHN S. AKWEI
R19 MALTA LANE
WHEATON, MARYLAND 20901
301-593-4855
vs.
NATIONAL SECURITY AGENCY
FT. GEORGE G. MEADE, MARYLAND 20755-6000
FfS ? 0 1992
CLEFl!<, u,s, GIS:-f.lICT GOlhil
DiSTRICT OF COLUMEllil
Civil Action No.
92-C4.49
COMPLAINT FOR DAMAGES (Criminal Offenses and Harassment)
1. This Court Has Jurisdiction Pursuant to the Fact that the Defendant is a Federal Agency.
2. Plaintiff is a Private Citizen of the United States and a Resident of the State of Maryland.
3. The Defendant, N.S.A. , is a Federal Agency and is Responsible for the Activities of
Agents Utilizing its Offices and Equipment.
4. Criminal Offenses and Harassment by these Employees of the National Security Agency
are Not Covered by Executive Order 12333.
5. ( Documentation of Criminal Activity against Plaintiff by Employees of the National
Security Agency, see page 2. )
1
LIST OF ILLEGAL ACTIVITIES COMMITTED.(By persons whom are former
acquintances now employed hy the N.S.A.)
use of N.S.A. offices and equipment in order to harass, attack and attempt
to disrupt Plaintiffs' life to the point of suicide or mental incapacity.
eyidence to obtain authorization to use N.S.A. offices, personnel
resources, and equipment. Actiyities not sanctioned by Exec. Order 12333.
Using N.S.A. resources to preyent employment. disrupt freindships and
associations over a ten year period to keep Plaintiff from being successful in life.
Attempted Set-Ups to inYQlye Plaintiff in contriyed crimes. (None of which were
successful.)
Inyasion of Privacy. surveillance . Search and Seizure.
( Home break-ins since 1980.)
False accusations of criminal activities in order to harass. Harassment by
falsifying FBI stake out of apartments (1990 -1991). Verbally threatening with
physical harm.
Verbal harassment at home and work. Threats in writing
Auemptini to incite violence and antaeonism towards the Plaintiff.
oyer 24 chemicals and druiS to harass and incapacitate.
Attempted poisoning. Threatening injection of hlood containing fatal diseases.
Interrogation while asleep. Keeping Plaintiff out of R.E.M. sleep.
Illegal use of N.S.A. equipment such as telephone wire-tapping, remote
personal-computer tampering and sabotage, and remote physiological devices.
Continuous attempts to damage mental health since 1980.
Endange;ing health by causing Plaintiff to be prescribed
potentially harmful, unneeded psychiatric medicine every day for six years.
Theft of property (Theft of clothing, Damage to clothing, $300 cash stolen)
Intercepting mail, disrupting mail delivery, intercepting telephone calls. Threats
of murder over an R months duration. Attempting to prevent Plaintiff from going
to authorities.
False police call to house ( can be verified with Montgomery County police).
Harassment every day from 511/91 to present. 214 consecutive days of harassment
as ()f 11/29/91. N.S.A. offices eQuipment used.
2
·
' .
National Security Agency Employees or acquaintances whom are
actively involved in criminal a-ctivities or whom participated in
criminal activities at tbeir request.
MR. KINNECOME (Retired N.S.A. agent)
KAREN KINNECOME
MARY KINNECOME
MARYANN KINNECOME
SUSAN KINNECOME
PAT (LAST NAME UNKNOWN)
ALLISON (LAST NAME UNKNOWN)
JEFF SULLIVAN
ONI SULLIVAN
PAUL JOHNSON
S'IEVE JOHNSON
MICHEAL (ALIAS)
MARISSA (ALIAS)
GREG ABATE
STEVE ABATE
PAUL STETIER
(Paul Stetter can be identified by Howard County or Montgomery
County Police) .
Persons whom participated in Criminal activity and barassment,
thougb not necessarily employed by tbe N.S.A.
JEFF NAIMIAN
MIKE PRIME
SUSAN PRIME
STEVE ABATE
GREG DAY
GLENN (LAST NAME UNKNOWN)
JEFF SULLIVAN
ONI SULLIVAN
EDDIE STEW ART
CARLOS (LAST NAME UNKNOWN)
ANDY (LAST NAME UNKNOWN)
MARTY ENGELS
MIKE MAYO
MARC BERMAN
TASOKARRAS
RESIDENTS OF 814 MALTA LANE, SILVER SPRING, MARYLAND
ALL ABOVE PERSONS WERE EITHER NORTHWOOD HIGH SCHOOL GRADUATES OR
LIVE IN THE MALTA LANE/ LUXFORD TERRACE/ KEMP MILL NEIGHBORHOOD OF
WHEATON, MARYLAND,
( Further information on these persons supplied on request)

3
\
/
/'
YERSONS THAT CAN VERIFY THAT I WAS UNDER SURVEILLANCE
(ALL OF THESE PERSONS WERE FALSELY TOLD THAT I WAS UNDER INVESTIGA nON FOR
CRIMINAL ACTIVITIES)
RESIDENTS OF APT. #5, 5407 HAMILTON STREET, HYATTSVILLE, MARYLAND
AT THE TIME OF 4/91
BRIAN MILLAR
OF A V WASHINGTON, INC. FAIRFAX, VIRGINIA
RESIDENTS OF 8556 FREYMAN DRIVE, CHEVY CHASE" MAR YLAND
AT THE TIME OF 1/91
N.I.H TEMPORARY WORKER FROM TEMPWORLD, ROCKVILLE AROUND THE TIME OF
1/3/91.
Authorities Contacted
Local Police called Three (3) times
FBI notified four (4) times
Filed with Allan C. Kornblum at the Department of Justice 202-514-2882
Filed with Joan Russo at Sen, Barbara Mikulski's State Office 301- 345-5517
Filed ~ i t h the Select Committee on Intelligence 202-224-4654
Inspector General's Office at the N.S.A. at Fort Meade notified 1111/91
rJO
?(t
5
)
I, John S. Akwei, am a private citizen who has no record of criminal
activity, or activity that would endanger National Security, yet I have been the
subject of ten years of unwarranted criminal offenses and harassment by
former acquintances, whom I have known in the past, who are presently
employe-es of the National Security Agency.
These events began ten years ago when I was acquainted with persons
who are now employees of the N.S.A. as students at Northwood High School in
Wheaton, Maryland. Only oyer the last six months have I gained enough
evidence to file a lawsuit aeainst the N.S.A.
This harassment was brought on by personal antagonism towards me
during High School, and has led to a history of illegal activities and abuse of
authority by aforementioned employees of the NATIONAL SECURITY AGENCY.
None of these activities are sanctioned by Executive Order 12333.
Authorization to commit these acts against me was obtained by falsifying
evidence and lying to superiors at the N.S.A and at other agencies.
National Security Agency Employees or acquaintances whom are actively
involved in criminal activities against Plaintiff or whom participated in criminal
activities at the request of the N.S.A. Employees.
MR. KINNECOME (Retired N.S.A. agent)
KAREN KINNECOME
MARY KINNECOME
MARYANN KINNECOME
SUSAN KINNECOME
PAT (LAST NAME UNKNOWN)
ALLISON (LAST NAME UNKNOWN)
JEFF SULLIVAN
ONI SULLIVAN
PAUL JOHNSON
STEVE JOHNSON
MICHEAL (ALIAS)
MARISSA (ALIAS)
STEVE ABATE
GREG ABATE
PAUL STETTER
(Paul Stetter can be identified by Howard County or Montgomery
County Police)
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I
TIlE FOLLOWING PAGE EXPLAINS MY BACKGROUND AND RELATIONSHIP WIlli TIlE
EMPLOYEES OF TIlE N.S.A. AND OTIIER PERSONS WHO ARE RESPONSIBLE FOR 11IE
AffiREMENTIONED CRIMINAL OFFENSES AND HARASSMENT..
I, John S. Akwei, attended Northwood High School in Wheaton, Maryland from 197&
to 1981.
I participated in the Northwood Cross-Country and Track teams and lived in the
Loxford terrace neighhorhood of Montgomery County, Maryland with several persons who
would I ater become employeeR of the N.S .A.
Among those persons are Mary Kinnecome, Susan Kinnecome, Pat (last name
unknown), Allison {last name unknown). Other persons who are involved in the Criminal
Offenses and ten years of Harassment are leff Naimian, Steve A hate, Greg Ahate, Micheal
Prime, Susan Prime, Jeff Sullivan, Glenn (last name unknown). All of whom are now
employed by the N .S.A.
The persons and motives hehind this Criminal Activity have hecome apparent to me
only since around June, 1991 due to these persons persuing a policy of leaving no
physical evidence.
The following is a partial list of instances of criminal activity and harassment which has
led to this complailtt.
1. Six months after the graduation day ceremonies at Northwood High School, on
Decemher, 1981, I found a paragraph of Graphitti, written in magic marker. at a hus
shelter at the Silver Spring Metro station that I waited at every morning. The Graphitti
described the jacket that I was wearing in detail, and contained a paragraph of threats and
racial slurs directed at me personally.
Apparently this graphitti was meant as a warning hy the memhers of the
aforementioned group of people that they intended to keep track of my activities hecause
of a personal d i ~ l i k e for me.
2. From Septemher, 1983 to December 1983 I was suhjected to verbal harassment and
surveillance at Montgomery College in Takoma Park, Maryland and at home.
:3. From January. 19&4 through July, 1984 I was threatened, harassed, and under
surveillance while living at an apartment in Takoma Park. I was also prevented from heing
employed at several places hy the misuse of authority hy the aforementioned persons.
4. From luly, 19&4 to March, 1987 I was tracked, occasionally threatened, and
prevented from heing employed hy these persons.
5. During the first six: months ~ f 1988 I was prevented from attaining steady
employment hy these persons.
6. From May, 19&8 to Octoher, 1990 I was closely monitored, hy the aforementioned
former acquaintances whom were now employees of the N.S.A and the C.I.A. They used
N.S.A. facilities and equipment to monitor me at work and at home. This included using
false identities and using adjacent apartments for surveillance and harassment.
7. From Octoher, 1990 to present I have heen suhjected to intense and completely
unwarranted harassment, hreak-ins, intimidation, threats, and coercion hy these persons
,whom attained the authority to do this from senior agents at the N.S.A. and have falsified
evidence to ohtain authorization. On 12/24/91 there was an attempted poisoning.
They have actively attempted to prevent roe from going to authorities.
L.
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r", JS,44 -pijlt· "', "'t and the informat i on contai ned herein nei ther replace nor supplement the filing and service of pleadi ngs or other pap rs except as proVi ded by local
riliet.of Ipproved by the Judici al Conference of the United StItes in September 1974. is required for the use of the Clerk of Court for the purpose of init iating the civil dcx:ket
sheet . (SE E INSfM:IcrrlONS ON THE REVERSE OF THE FORM.)
I (a) PLMmFFS
" /I'
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,",,'r- y_ .. -­
.. . .. ' .. PP.iPAYYnf'D

'"lMma
(b) COUNT Y OF RESIDENCE OF FIRST LISTED PLAINTIFF SlS<),o(.,:;,g
(EXCEPT IN U.S. PLAINTIFF CASES)
(c) AiTORNEYS (FIRM NAME, ADDRESS, AND TELEPHONE NUMBER) .
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.
DEFENDANTS
rUt
92-0449
COUNTY OF RESIDENCE OF FIRST LISTED DEFENDANT _____ _ _ _
(IN U.S. PLAINTIFF CASES ONLY)
NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF THE
TRACT OF LAND INVOLVED
ATIORNEYS (IF KNOWN)
II. BASIS OF JURISDICTION (PLACE AN )( IN ONE BOX ONLY) III. CITIZENSHIP OF PRINCIPAL PART1ES IPLACE AN x IN ONE BOX
(For Diversity Cases Only)
FOR PlAINTIFF AND ONE BOX FOR DEFENDANT)
o 1 U.S. Government o 3 Federal Question
Plaintiff (U.S. Government Not a Party) PTF DEF PTF DEF
Citizen of Thla State 01 01 Incorporat.ctor 1Irtno.... It'- 04 04

U.S. Government o 4 Diversity
, . of Bualne.. In Thill sc.te
Defendant (Indicate Citizenship 01
Citizen of Another Stat. 02 02 Incorporated -.d PrlncIpIII PIKe 05 05
Parties in Item III)
of Bualneaa In Ano1fler sc.ta
Citizen or Subjac:t of a 03 03 Foreign Nllllon 06 06
Foreign Country
IV. CAUSE OF ACTION (CITE THE U S. CIVIl STATUTE UNDER WHICH YOU ARE FlUNG ANO WRITE A BRIEF STATEMENT OF CAUSE.
00 NOT CITE JUAISplCTIONAl STATUTES UNLESS DNERSITY. )
V. NATURE OF SUIT (PLACE AN x IN ONE BOX ONLY)
CONTRACT TORTS FORfEITURE !PENALTY BANKRUPTCY
o 110 Insurance PERSONAL INJURY PERSONAl INJURY
. AgriculllJre
0422 Appeal
o 120 Madne o 310 AIrplane
o 362 Per.onol Injury-
o 620 Other Food & Orug
28 uSC '58
o 130 Miller ACI o 315 Airp/one P,oduct
o 625 Drug Related SeiZure 01
o 423 Withdr.wal
Property 2t USC 881
o 140 Negotiable Instrument uabiity
o 365 PersoNIlnjuty­
28 USC 157
o 150 Recovery of Overpaymen. o 320 ubel &
o 830 liquor Laws

0640 R.R & Trocl<
& En'orcement 01 Slander
o 368 -.,.,. P8rwonoI
PROPERTY RIGHTS
JoOgr.l ent 0 330 Federal Employe'"
Injury Product
o 650 Airline Regs
o 820 Copyrigh's
0151 MedicaIe ..;C1 Liability
uabilty
o 660
o 152 Recovery 01 Delaulted 0 340 loIarine
n etylHeakh 0830 Pal.nl
Studenl Loans o 345 Marine ProduCt
PERSONAL PROPERTY 690 Other o 840 lhldemark
(ExC I Vetefans) uabiity iJ 370 Other Fraud
LABOR

o 153 Recovery of Overpayment o 350 Molor Vel" clo
o 371 Trulh in Lending
o 710 Fair Labor Standa,ds
o 861 HIA (139511)
of Veleran"s Benefits
o 355 Motor Vehicle o 380 Other Personal
o 862 iliaci< u.ng (923)
[J 160 Sl ockho4ders' SUits Product Uabtlity
Property Damage Act
rJ 190 Other Contract o 360 Othe' Personal
o 385 p,operty Damage '0720 Labor/Mgml. o 863 DIWC/ OIWW (405(91)
o 195 Contract Proc1uct Injury Product u-.y ReCalions o 864 5510 Title XVI
o 730 Labor/ Mgm•. o 865 RSI (405(g»
REAL PROPERTY
CIVIL RIGHTS PRISONER PETITIOfIS
Reporting &
Oisclosure Act
U 210 Land Condemnation
0 441 Voting o 740 R..lway L.bor FEDERAL TAX SUITS
o 220 Foreclosure
o 442 Employmen.
L 510 Motfons 10 Vacate
Act
Senlence o 870 Taxes (U.S Plainhn
LJ 230 Rent Lease & Electment o 443 Housing/
Habeas Corpus ·
o 790 Othor Labor
or Defendant)
Littgatjon
o 240 Torts 10 Land Accommodalions
C530 Gener al
o 791- Empl. Rot. Inc.
0871 IRS - Third Party
o 245 Tort Product liability
Won.ro
C 535 Death Penal ty
26 USC 7609
o 290 All ()(her Real Property «0 Other CIVIl Rights
Security Act
C 540 Malldamus & Other
C 550 OIhe,
VI. ORIGIN (PLACE AN x IN ONE BOX ONLY)
Original
Proceeding
o 2 Removed from
State Court
o 3 Remanded from
Appellale Court
o 4 Reinstated or
Reopened
Transhmed from
o 5 another district
(specify)
o 6 .Multidistrict
Litigation
OTHER STATUTES
04005'.'.
R8AppOrtionme1'l1
o 410 Anti.rust
o 430 Banks and Banking
0450 Commerce/ ICC Rates/ et
o 4410 Deportation
o 470 Rackel.., Influenced and
COfl'up( Organizations
o 810 SefOClNe Service
o 850 Securities/ Comrnodi fies/
Exchange
lJ 875 Customer Challenge
12 USC 3410
o 891 AQri<u_ura/ Acts
o 892 Economic Stabihzation
Act
o 893 Environmental Malt8fs
o 894 Energy Allocation Act
o 895 Freedom of
InfofmatHm >\ct
o 900 Appeal of Fee Detem" "stio
Under EQuill 10
Juslice
o 950 Constitutionality 0 1
Stale Statutes
o 890 Other S.alulory
Acti ons
Appeal 10 Dlstflct
o 7 ,Iudge from
Magistrate
Judgment
VII. REQUESTED IN CHECK IF THIS IS A CLASS ACllON DEMAND $
Check YES only if demanded in complaint:
o UNDER FR.CP 23
COMPLAINT: JURY DEMAND: 0 YES <\g:NO
.
VIII. RELATED CASE(S) (See Instructions)
JUDGE ____________ DOCKET NUMBER_____ _____ _
IF ANY'
{
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DATE SIGNATURE. OF ATIORNEY OF RECORD '
en... s
UNITED STATES DISTRICT COURT
JS44
CIVIL COVER SHEET
(Rev. 07(89)
rhe JS-44 civil cover sheet Ind the inform.don conuined herein neither replace nor supplement the filing and seNt« of pleadings or other as required by law, except as provkted by toea'
rules of coun. This form. approved by the Judicial Conference of the United States in September 1974. is required fOf' the use of the Cieri< of Coun for the purpose of initiating the ciyil docket
sheet . (SEE INSTRUCTIONS ON THE REVERSE OF THE FORM.)
(a) PLAINTIFFS .
JJ.,) 5.
--g t 9 ;"v1 tJ- I LiJ-oJ-{.
S;I,,0':'
WIJ'
(b) COUNTY OF RESIDENCE OF FIRST LISTED PlAINTIFF
(EXCEPT IN U.S. PLAINTIFF CASES)
DEFENDANTS .
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COUNTY OF RESIDENCE OF FIRST LISTED DEFENDANT
(IN U.S. PLAINTIFF CASES.QNLy)
NOTE: IN LAND CONDEMNATION CASES. USE THE LOCATION OF THE
TRACT OF LAND INVOLVED
-l(
(c) ATTORNEYS (FIRM NAME. ADDRESS. AND TELEPHONE NUMBER) ATTORNEYS {(F KNOWN)
II. BASIS OF JURISDICTION (PlACE AN)II; W ON£ aox ONLY)
o 1 U.S. Government
Plaintiff
o 2 U.S. Government
Defendant
o 3 Federal Question
(U.S. Government Not a Party)
o 4 Diversity
(Indi<:«te Citizenship 01
Parties in Item III)
III. CnlZENSHIPOF PRINCiPAL PARTIeS (PlACE AN ... COIEaox
(For Diversity Cases Only) . FOA PlNNT1Ff' "'0 COlE BOX FOR oeFE"OAHTj
PTF DEF PTF DEF
Citizen of Thl. State 01 01 Incorporated (N Princlp81 Place 04 04
of Business In Thl. State
Citizen of Another State 02 02 IncorporatecI and Princlp81 PIece OS 05
of Business In Another State
Citizen or Subject of • 03 03 foreign Netlon 06 06
Foreign Country
IV. CAUSE OF ACTION (CITE THE u.s.CIVIl STAture _ 'MilCH YOU 1#1£ F1UHG NjQ WRITE A IIRIEF STATEUeIT OF CAUSE.
00 NOT CITE JURISOICTIONAL STATUTES UNl£SS 0fVERSrTY.)
V. NATURE OF SUIT (PLACE AN x IN ONE BOX ONLy)
CONTRACT TORTS FORF£ITIIRE /PENAllY BANKRUPTCY JlIHEfl STATUTU
01101_ . !=! Ii!':l Agriculture PERSONAL INJURY PERSONAL INJURY 0400 $We
0422 Appal
o 620 OIher Food & Drug RNpportionment 0120_
281JSC 158
o 362 P.nonaI Injury-
o 625 Drug Related Seizure 01 0410_
o 130 MiUer Ad o 315 Airplane

o423w_
Property 21 USC 881
o 430 Banks and Banking liabiity o 14n Negotiable Instrument 28 USC 157
o 365 P.nonaI Injury-
o 630 liquor Laws
o 320 Assau•. Libel & o 450 Commerce/ICC Retes/otc.
o 150 Recovery 01 Overpayment Product lJabIIi1y
o 640 R.R & Trud<
PROPERTY RlGKTS Slender & Enforcement of o 460 Deportation
o368_oo_al
0650 Airline Regs
Judgr._, 0470 RacI<_1_and
Injury Product
o 820 CopytigItts
0660 CX:ional Corrupt Organiutions o 151 Medic,". kI
0830 Patent
o etylHeal1h
0340 Marine o 152 Recovery 01 Defauho<! o 810 Selective Ser<ice
0840_ 690 0tI1et PERSONAL PROPERn'
Studt!nt loans
o 850 Securities/Commodihes/
o 370 Oth... Fraud (E)(CI . Veterans) Liabiity LABOR Exchange SOCIAL SECURITY
0350 __
o 371 TruIh In len<jng o 1 53 Recovery 01 Ov0<p8yment
o 875 Custome< Challenge
0861 HIA (139511)
of Veteran's Benefits o 710 Fair Labor Standards
0355 Mccor_
D 380 Other P.nonaI
12 USC 3410
o 862 _ Lung (923)
Ad Proc>e<ty Damege o 160 StOOd,oIde,.· Suit.
Produd liabiity o 891 Agricultural Ads
D 720 Labor/Mgmt o 863 DIWCIDIWW 1405(g))
o 360 Other PO<SOn8I
o 385 Proc>e<ty Demage o 190 Other Co<>trect
o 892 Economic S_18tion
Relark>ns
Injury
Product Liability o 884 SSlD Tille XVI
o 195 Co<>trac1 Product Liabiity Ad
0730 Labor/Mgmt.
o 865 ASI (405(g))
o 893 Enwonmental Maners
Reporting &
REAL PROPERTY
CIVIL RIGKTS o 894 Energy Allocation Ad PRISONER PETITIONS
OisOosure Ad
o 895 Freedom of
FEDERAL TAX SUITS o 21 0 Land CondemnallOn
o Railway LWar 0441 Voting
o 510 Mohons to Vacate
Informalion Ad
o 220 FOIeclOsu(e
o 442 Employment
Sentence o 870 Taxes (U.S. Plainliff
o 900 Awealo1 Fee Detetn.;naho

o 230 Rani Lease & EjeC1menl
o 443 Housing/
Habeas Corpus ' or Defendant)
Under EQual Access 10
o 240 To<ts 10 Land AccommodattQos
o 871 IRS - Third Party Justice 0530
o 245 ro<t Product 0444 We".re 26 USC 7609
o 950 Conslilutionahly 01 C 535 Dealh Penalty
o 290 All OIhe( Real PrQPefty o 440 Other Ovil Roghts
Stale Sialuies
' . ',. 4....'. c::; 540 Mandamus & Other
o 890 Ofher StalVlory
C 550 Oohe'
Acllons
,
Appeal 10 D,slncl
VI. ORIGIN (PLACE AN x IN ONE BOX:0NLY)
Transferred from o 7 .Iudge tram
o 1 OrigInal o 2 Removed from o 3 Remanded from o 4 Reinstal ed or o 5 o 6 Mullodistnct Maglslrale
ProceedIng Siale Coun
1}pp:lla!e
Litigation Judgmenl
': 4 .
VII. REQUESTED IN CHECK IF THIS IS A CLASS' ACTION Check YES only Ii demanded rn cOmplam/. ,.
COMPLAINT:
o UNDER F RCP 23
JURY [)EMAND: 0 YES &;::;0
- '.'
VIII. RELATED CASE(S) (See Inslruclions)'
____________________
IF ANY
, .t ['1 .! . . _.' -, . . :
J'PI ·I FX 319 1
DATE SIGNAl.l.JRE OF ATTORNEY OF RECORD
..
'.
, \
from
'.ilasl'.kgtnn Records r•. '
Record Group No ••.Q.?'. 1.. ..................... .
W021- DL/-()DD5 2.0
Aooession Nt> ............................Box No .•...
-
, .
.. .

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