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Derrick's Incarceration

LOUISIANA ACLU COMPLAINT
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DOC RULES FOR ADULT INMATES
DOC -- DISCIPLINARY REPORT
DOC INCIDENT REPORT
INITIAL ARP FORM
FIRST STEP RESPONSE
SECOND STEP RESPONSE TO SECRETARY OF DOC
RISK REVIEW FORM
PAROLE
LOCATE INMATE
CLEMENCY APPLICATION / RULES
DOC HEADQUARTERS CONTACT NUMBERS
RISK REVIEW
FURLOUGHS / FUNERALS
PLACEMENT / TRANSFER OF INMATES
WORK RELEASE -- SELECTION -- JAIL / DOC
DOC INSTITUTIONS (PRISONS)
LOUISIANA ACLU COMPLAINT
COURT / JAIL LISTING BY PARISH
DOC ARP (GRIEVANCE) PROCESS
MOTIONS
TITLE 42 U.S.C. 1983
APPELLATE FORMA PAUPERIS
FORMA PAUPERIS
LAWS BEFORE INMATE FILING: CARP /PLRA
ACTUAL BLANK IJR -- PETITION FOR JUDICIAL REVIEW

Mail to: ACLU of Louisiana FOR ACLU USE ONLY:
Protecting Our Rights Type of Complaint:
P. O. Box 56157Recommendation:
New Orleans, LA 70156 Disposition/Date:

IMPORTANT: Before completing, please read the entire form carefully. TYPE or PRINT CLEARLY.
Sign and date the last page.

Complainant Information

Name: Last First M.I.
Address: City: State: ZIP:
Day Phone: ( ) Night Phone: ( )
email address __________________________________________

Respondent Information – My complaint is against the following:

Name: Last First M.I.
Company/Government Agency (if applicable):
Address: City: State: ZIP:
Phone: ( ) Fax: ( )
Date of Act giving rise to this complaint:
May we contact this person? Yes No
If more than one respondent, please provide the information on a separate sheet.

Have you filed a complaint with any other agencies? Yes No
If yes, please describe and include dates:

Are you represented by an attorney in this matter? Yes No
If yes, Attorney's Name: Last First M.I.
Address: City: State: ZIP:
Phone: ( ) Fax: ( )

Has a criminal or civil lawsuit been filed against you or on your behalf? Yes No
If yes, Case Title: Case Number: Date Filed:
Court: Judge:
Opposing Attorney: Current Status of Case:

Description of Complaint: Please type or print clearly.
Describe the events* that led you to file this complaint. If there is not sufficient space, please attach an additional page to complete your explanation. DO NOT SEND ORIGINALS OR ADDITIONAL DOCUMENTATION. The ACLU is not responsible for the maintenance or return or any documentation we receive.
* Include pertinent facts, such as date, person, place, summary and what was said or done to you or to the hurt person.















Are you willing to serve as a plaintiff in litigation if needed? Yes No
I hereby certify that I have read the information contained in this complaint form
and that all of the information I have given is accurate and complete to the best
of my knowledge and belief. I understand that by accepting this complaint, the ACLU
is not undertaking legal representation of me, and that the ACLU is not responsible
for ensuring that any statute of limitations or prescriptive period is met in my case.
I hereby authorize the ACLU to use this information in any manner it deems necessary.
SIGNATURE: DATE:
(signed)


(printed)

I CAN VOTE WHEN I AM RELEASED AND I WILL!!!!!