Fill and Sign the Now Comes the Plaintiff and Would Show Unto This Honorable Court the Following in Form

- 1 - IN THE UNITED STATES DISTRICT COURT FOR THE _________________ DISTRICT OF _________________ ________________ DISTRICT ) ) ) Petitioner/Plaintiff, ) ) ) NO. Vs. ) ) ) Respondent/Defendant ) ) COMPLAINT Now comes the Plaintiff and would show unto this Honorable Court the following in support of its complaint: 1. The plaintiffs are residents of ______________, _________________; 2. The defendant is a corporation chartered in and registered to do business in the State of ________________; 3. The Plaintiff was an employee of the defendant at the defendant's______________, ______________________; 4. This action is brought under Federal question jurisdiction 28 USCS 1311; 5. This action is also brought under 29 USCS Section 2601, the Family Leave Act, 42 USCS Section 12101 et seq., the Americans with Disability Act; 42 USCS Section 2000e-2. et seq. Title VII of The Civil Rights Act of 1964 and the 14th Amendment to the United States Constitution. 6. ( Insert Facts) 7. The plaintiff has been damaged as follows: (List damages) IN THE UNITED STATES DISTRICT COURT FOR THE _________________ - 2 - WHEREFORE, the plaintiff prays that the proper process issue to the defendant and that upon a hearing upon this Court grant a judgment for the plaintiff and against the defendant for any and all actual, special, compensatory, and punitive damages to which this Honorable Court deems the plaintiff to be entitled, and for attorney fees, interest, court costs and any and all further relief under the applicable statutes me ntioned above to which this Honorable Court deems the plaintiff to be entitled. The plaintiff further prays for any and all such other and further relief which this Court may grant and which this Court feels the plaintiff to be entitled. Plaintiff dem ands that jury try its cause. Respectfully submitted, ___________________________