Civil Cover Sheet: I. (A) Plaintiffs Defendants

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JS 44 (Rev.

12/12)

Case 1:13-cv-01717-CCC Document 1-1 Filed 06/24/13 Page 1 of 1

CIVIL COVER SHEET

The JS 44 civil cover sheet and the information contained herein neither replace nor supplement the filing and service of pleadings or other papers as required by law, except as provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is required for the use of the Clerk of Court for the purpose of initiating the civil docket sheet. (SEE INSTRUCTIONS ON NEXT PAGE OF THIS FORM.)

I. (a) PLAINTIFFS
Crawley, Todd, A.
(b)

DEFENDANTS
Harrisburg Area Community College Sygielski, John, J. (in his individual and official capacity) Heinle, Dennis, P. (in his individual and official capacity) County of Residence of First Listed Defendant Dauphin
(IN U.S. PLAINTIFF CASES ONLV

County of Residence of First Listed Plaintiff

Cumberland

(EXCEPT IN U.S. PLAINTIFF CASES)

NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF THE TRACT OF LAND INVOLVED.

(C) Attorneys (Firm Name, Address, and Telephone Number) Clark & Krevsky, LLC (Frank P. Clark) P.O. Box 1254, Camp Hill, PA 17001-1254 (717) 731-8600

Attorneys (IfKnown)

II. BASIS OF JURISDICTION (Place an -X" in One Box Only)


O 1

III. CITIZENSHIP OF PRINCIPAL PARTIES (Place an "X" in One Box for Plaintiff
(For Diversity Cases Only) and One Box for Defendant)

U.S. Government Plaintiff

M 3 Federal Question
(U.S. Government Not a Party)

PTF DEF

Citizen of This State Citizen of Another State Citizen or Subject of a Foreign Country

X1 02 03

III

Incorporated or Principal Place of Business In This State

PTF DEF 04 0 4

O 2 U.S. Government Defendant

0 4 Diversity
(Indicate Citizenship of Parties in Item III)

0 2 Incorporated and Principal Place of Business In Another State 0 3 Foreign Nation

u 5

05 0

06

IV. NATURE OF SUIT (Place an "X" in One Box Only)


oaNTRA'cr
O O O O O O O u O O O O 110 Insurance 120 Marine 130 Miller Act 140 Negotiable Instrument 150 Recovery of Overpayment & Enforcement of Judgment 151 Medicare Act 152 Recovery of Defaulted Student Loans (Excludes Veterans) 153 Recovery of Overpayment of Veteran's Benefits 160 Stockholders' Suits 190 Other Contract 195 Contract Product Liability 196 Franchise IIKAkv.PROPERTY O 210 Land Condemnation

..t....3:LHaS PERSONAL INJURY

FORE E 1 TURERENALTY 0 625 Drug Related Seizure of Property 21 USC 881 0 690 Other

PERSONAL INJURY

0 220 Foreclosure O 230 Rent Lease & Ejectment 0 240 Torts to Land 0 245 Tort Product Liability 0 290 All Other Real Property

0 310 Airplane O 365 Personal Injury 0 315 Airplane Product Product Liability Liability 0 367 Health Care/ O 320 Assault, Libel & Pharmaceutical Slander Personal Injury Product Liability 0 330 Federal Employers' O 368 Asbestos Personal Liability 0 340 Marine Injury Product 0 345 Marine Product Liability Liability PERSONAL PROPERTY 0 370 Other Fraud O 350 Motor Vehicle 0 355 Motor Vehicle u 371 Truth in Lending Product Liability O 380 Other Personal CI 360 Other Personal Property Damage Injury CI 385 Property Damage Product Liability O 362 Personal Injury Medical Mal ractice P ISONER PETITIONS - CIVIL RI 0 440 Other Civil Rights Habeas Corpus: 0 463 Alien Detainee 0 441 Voting 0 510 Motions to Vacate NI 442 Employment Sentence 0 443 Housing/ 0 530 General Accommodations O 445 Amer. w/Disabilities - O 535 Death Penalty Employment Other: O 446 Amer. w/Disabilities - O 540 Mandamus & Other O 550 Civil Rights Other u 448 Education O 555 Prison Condition 0 560 Civil Detainee Conditions of Confinement

BANKRI,JPTCY 0 422 Appeal 28 USC 158 0 423 Withdrawal 28 USC 157 PROPERTY -WIWI O 820 Copyrights 0 830 Patent 0 840 Trademark

OTHER STA -PIPITS

O 375 False Claims Act


O 400 State Reapportionment

Cl 410 Antitrust

J_

O O O O

430 Banks and Banking 450 Commerce 460 Deportation 470 Racketeer Influenced and Corrupt Organizations O 480 Consumer Credit

LABOR 0 710 Fair Labor Standards Act 0 720 Labor/Management Relations 0 740 Railway Labor Act 0 751 Family and Medical Leave Act 0 790 Other Labor Litigation u 791 Employee Retirement Income Security Act

SOCIAL SECURIT'Y , u 861 HIA (1395ff) O 862 Black Lung (923) 0 863 DIWC/DIWW (405(g)) u 864 SSID Title XVI 0 865 RSI (405(g))

"'"""PEDERA TAX suns 0 870 Taxes (U.S. Plaintiff or Defendant) 0 871 IRSThird Party 26 USC 7609

O 490 Cable/Sat TV u 850 Securities/Commodities/ Exchange O 890 Other Statutory Actions O 891 Agricultural Acts O 893 Environmental Matters O 895 Freedom of Information Act O 896 Arbitration O 899 Administrative Procedure Act/Review or Appeal of Agency Decision O 950 Constitutionality of State Statutes

1NIMIGItATION.
O 462 Naturalization Application u 465 Other Immigration Actions

V. ORIGIN (Place an "X" in One Box Only)


X

1 Original Proceeding

2 Removed from State Court

0 3 Remanded from Appellate Court

0 4 Reinstated or Reopened

5 Transferred from Another District


(specift)

6 Multidistrict Litigation

Cite the U.S. Civil Statute under whichyou are filing (Do not cite jurisdictional statutes unless diversity): False Claims Act, 31 U.S.C. 3729-3733 VI. CAUSE OF ACTION Brief description of cause: Defendants' violation of False Claims Act, PA Whistleblower Law, and retaliatory behavior toward Plaintiff CHECK YES only if demanded in complaint: DEMAND $ CHECK IF THIS IS A CLASS ACTION VII. REQUESTED IN UNDER RULE 23, F.R.Cv.P. 0 No )4 Yes JURY DEMAND: COMPLAINT:

VIII. RELATED CASE(S) IF ANY


DATE

(See instructions):

JUDGE SIGNATURE OF ATTORNEY OF RECORD

DOCKET NUMBER

06/24/2013
FOR OFFICE USE ONLY

CEvt-Lt>._,
AMOUNT APPLYING IFP

RECEIPT #

JUDGE

MAG. JUDGE

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