Deli
Member
Ninth Judicial Circuit
"Equal Justice Under Law"
SC-100
Plaintiff (list names): Pepe Hernandez.
Case Number (for clerk):
One.
The Plaintiff (the person, business, or public entity that is suing) is: Pepe Hernandez
Name:Pepe Hernandez
Phone: 517789
Street Address (Street, City, State, Zip): Ace Street, House - 3.
Mailing Address (if different):
If more than one Plaintiff, list next Plaintiff here:
Name:
Phone:
Street Address (Street, City, State, Zip):
Mailing Address (if different):
Two.
The Defendant (the person, business, or public entity being sued) is: Los Santos Police Department.
Name: P. Smiths, and D. Kristoff.
Phone: 911
Street Address (Street, City, State, Zip): Pershing Square.
Mailing Address (if different):
If more than one Defendant, list next Defendant here:
Name:
Phone:
Street Address (Street, City, State, Zip):
Mailing Address (if different):
Three.
The Plaintiff claims the Defendant owes $400k
[*=left]Why does the Defendant owe the Plaintiff money? I saw my friend being yelled at by the cops, so I walked over there, and began to take pictures. The cops quickly glanced in my direction withdrawing their stun guns, then aiming at me with them.. I was quickly tazed and brought to the ground, seconds later I received another blow from a stun gun in my back. I believe that this scene was a behavior of police brutality.
[*=left]When did this happen? (Date): 12/12/13
[*=left]If no specific date, give the time period: Date started: INSERT HERE Through: INSERT HERE
Four.
List the evidence you have regarding the claims listed in three.
- Evidence 4.1
- Detail the items/pictures name
- http://i.imgur.com/QLI0Mcr.png
- Description of the evidence presented.
- Evidence 4.2
- Detail the items/pictures name
- http://i.imgur.com/4nPjIST.png http://i.imgur.com/TtgwBxX.png
- Description of the evidence presented.
Five.
You must ask the Defendant (in person, in writing, or by phone) to pay you before you sue. Have you done this?
[*=left][X] Yes ---------- [] No
Five.I understand that by filing a claim in court, I have no right to appeal this claim.
I declare, under penalty of perjury under California State law, that the information above and on any attachments to this form is true and correct.
Date: 12/12/13 Pepe Hernandez Pepe Hernandez
Date: 12/12/13 Los Santos Police Department Los Santos Police Department