Fill and Sign the Complaint American Disabilities Act Form

IN THE UNITED STATES DISTRICT COURT FOR ( Insert Court and Division ) ________________________ VS. ________________________ JURY DEMANDED COMPLAINT NATURE OF THE ACTION 1. This is an action for declaratory, injunctive, and monetary relief brought by Plaintiff, ____________, by and through his attorneys of record, ______________ and _______________, against his former employer, ________________, and its successors and assigns. Plaintiff's Complaint asserts, as more specifically set forth below, that he was subjected to disability discrimination in the form of disparate treatment and harassment, in violation of the Americans with Disabilities Act, 42 U.S.C. § 12101 et. seq. JURISDICTION 2. Jurisdiction of this Court is invoked pursuant to 28 U.S.C. §§ 1331 and 1343. 3. The employment practices alleged to be unlawful were committed within the jurisdiction of the United States District Court for the ____________________________________. 4. Plaintiff filed a timely charge of discrimination with the EEOC, a copy of which is attached hereto as Exhibit "A" and is incorporated as if fully set forth herein. Plaintiff received a Notice of Right to Sue attached hereto as Exhibit "B." 5. The EEOC issued a cause determination, attached hereto as Exhibit "C." THE PARTIES 6. Plaintiff, ___________ , is an adult ( Insert gender ) citizen of the United States and resident of _________ , _________________. 7. Defendant, __________________, is a _______________________ in good standing in the State of __________________. 8. Upon information and belief, Defendant's registered agent for service of process is ___________, ________________, ( Insert city, state, and zip code ). - 1 - STATEMENT OF FACTS 9. ( Insert Statement of Facts) ____________________________________ 10. __________________________________________________________ LEGAL CLAIMS 11. Plaintiff incorporates Paragraphs 1 through 10 above as though specifically set forth herein and as causes of action would state that Defendants' actions and conduct described above constitute unlawful discrimination on the basis of disability in violation of the ADA, 42 U.S.C. § 12101 et. seq. (harassment and disparate treatment due to Plaintiff's disability and his son's disability). PRAYER FOR RELIEF Wherefore, in consideration of the foregoing, Plaintiff prays that the court, after service of this action upon Defendants, direct the clerk to set this matter for trial. Plaintiff further requests a jury to hear this cause, and upon a hearing and verdict thereon, prays for the court to issue a judgment: 1. Finding that Defendants' actions constitute unlawful discrimination in violation of the statutes cited herein. 2. Reinstating plaintiff with full back pay and benefits in an amount to be determined at trial. 3. Awarding full back pay and benefits in an amount to be determined at trial. 4. Awarding Plaintiff front pay and benefits in an amount to be determined at trial. 5. Awarding Plaintiff actual and compensatory damages (including damages for emotional distress) in an amount to be determined at trial. 6. Awarding Plaintiff punitive damages in an amount to be determined at trial. 7. Awarding Plaintiff prejudgment interest. 8. Awarding Plaintiff costs and reasonable attorney's fees pursuant to the statutes cited herein, and as otherwise allowable. 9. Awarding Plaintiff such other and further relief as the court deems just and proper. Respectfully submitted, __________________________ - 2 - - 3 -