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O JS 44 (R ev.

2/08) 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 IN STR U C TIO N S O N THE R EV ER SE O F T HE FO R M .) NOTICE: Attorneys MUST Indicate All Re-filed Cases Below.
I. (a) PLAINTIFFS DEFENDANTS

(b) County of Residence of First Listed Plaintiff County of Residence of First Listed Defendant
(EX C EPT IN U .S. PLAIN TIFF C ASES) (IN U .S. PLAIN TIFF C ASES O N LY )

(c) Attorney’s (Firm N ame, Address, and Telephone N umber) N O TE: IN LAN D C O N D EM N ATIO N C ASES, U SE THE LO C ATIO N O F THE TR AC T
LAN D IN V O LV ED .

Attorneys (If Know n)

(d) Check County Where Action Arose: ’ M IAM I- D AD E ’ M ONROE ’ BR O W AR D ’ PALM BEA CH ’ M AR TIN ’ ST. LU C IE ’ IN D IAN R IV ER ’ O KEEC HO BEE
HIG HLAN D S

II. BASIS OF JURISDICTION (Place an “ X ” in O ne Box O nly) III. CITIZENSHIP OF PRINCIPAL PARTIES (Place an “X ” in O ne Box for Plaintiff
(For D iversity C ases O nly) and O ne Box for D efendant)
’ 1 U .S. G overnment ’ 3 Federal Q uestion PTF DEF PTF DEF
Plaintiff (U .S. G overnment N ot a Party) C itizen of This State ’ 1 ’ 1 Incorporated or Principal Place ’ 4 ’ 4
of Business In This State

’ 2 U .S. G overnment ’ 4 D iversity C itizen of Another State ’ 2 ’ 2 Incorporated and Principal Place ’ 5 ’ 5
D efendant of Business In A nother State
(Indicate C itizenship of Parties in Item III)

C itizen or Subject of a ’ 3 ’ 3 Foreign N ation ’ 6 ’ 6


Foreign C ountry
IV. NATURE OF SUIT (Place an “X ” in O ne B ox O nly)
CONTRACT TORTS F O R FE IT U R E /P E N A L T Y B A N K R U PT C Y O T H E R ST A T U T E S
’ 110 Insurance P E R SO N A L IN JU R Y P E R SO N A L IN JU R Y ’ 610 Agriculture ’ 422 Appeal 28 U SC 158 ’ 400 State R eapportionment
’ 120 M arine ’ 310 Airplane ’ 362 Personal Injury - ’ 620 O ther Food & D rug ’ 423 W ithdraw al ’ 410 Antitrust
’ 130 M iller Act ’ 315 Airplane Product M ed. M alpractice ’ 625 D rug R elated Seizure 28 U SC 157 ’ 430 Banks and Banking
’ 140 N egotiable Instrument Liability ’ 365 Personal Injury - of Property 21 U SC 881 ’ 450 C ommerce
’ 150 R ecovery of O verpayment ’ 320 Assault, Libel & Product Liability ’ 630 Liquor Law s P R O PE R T Y R IG H T S ’ 460 D eportation
& Enforcement of Judgment Slander ’ 368 Asbestos Personal ’ 640 R .R . & Truck ’ 820 C opyrights ’ 470 R acketeer Influenced and
’ 151 M edicare Act ’ 330 Federal Employers’ Injury Product ’ 650 Airline R egs. ’ 830 Patent C orrupt O rganizations
’ 152 R ecovery of D efaulted Liability Liability ’ 660 O ccupational ’ 840 Trademark ’ 480 C onsumer C redit
Student Loans ’ 340 M arine P E R SO N A L PR O P E R T Y Safety/Health ’ 490 Cable/Sat TV
(Excl. V eterans) ’ 345 M arine Product ’ 370 O ther Fraud ’ 690 O ther ’ 810 Selective Service
’ 153 R ecovery of O verpayment Liability ’ 371 Truth in Lending LABOR SO C IA L SE C U R IT Y ’ 850 Securities/C ommodities/
of V eteran’s Benefits ’ 350 M otor V ehicle ’ 380 O ther Personal ’ 710 Fair Labor Standards ’ 861 HIA (1395ff) Exchange
’ 160 Stockholders’ Suits ’ 355 M otor V ehicle Property D amage Act ’ 862 Black Lung (923) ’ 875 C ustomer C hallenge
’ 190 O ther C ontract Product Liability ’ 385 Property D amage ’ 720 Labor/M gmt. R elations ’ 863 D IW C /D IW W (405(g)) 12 U SC 3410
’ 195 C ontract Product Liability ’ 360 O ther Personal Product Liability ’ 730 Labor/M gmt.R eporting ’ 864 SSID Title X V I ’ 890 O ther Statutory Actions
’ 196 Franchise Injury & D isclosure Act ’ 865 R SI (405(g)) ’ 891 Agricultural Acts
R E A L P R O PE R T Y C IV IL R IG H T S P R ISO N E R PE T IT IO N S ’ 740 R ailw ay Labor Act F E D E R A L T A X SU IT S ’ 892 Economic Stabilization Act
’ 210 Land C ondemnation ’ 441 V oting ’ 510 M otions to V acate ’ 790 O ther Labor Litigation ’ 870 Taxes (U .S. Plaintiff ’ 893 Environmental M atters
’ 220 Foreclosure ’ 442 Employment Sentence ’ 7 9 1 E m p l. R et. Inc . S ecurity or D efendant) ’ 894 Energy Allocation Act
’ 230 R ent Lease & Ejectment ’ 443 Housing/ H abeas C orpus: Act ’ 871 IRS— Third Party ’
895 Freedom of Information Act
’ 240 Torts to Land Accommodations ’ 530 G eneral 26 U SC 7609
’ 245 Tort Product Liability ’ 444 W elfare ’ 535 D eath Penalty IM M IG R A T IO N ’ 900 Appeal of Fee D etermination
445 Amer. w /D isabilities - 462 N aturalization U nder Equal Access to Justice
’ 290 All O ther R eal Property ’ ’ 540 M andamus & O ther ’
Employment Application
446 Amer. w /D isabilities - 463 Habeas C orpus-Alien
’ ’ 550 C ivil R ights ’
O ther D etainee
465 O ther Immigration 950 C onstitutionality of State
’ 440 O ther C ivil R ights ’ 555 Prison C ondition ’ ’
Actions Statutes

V. ORIGIN (Place an “X ” in O ne B ox O nly) Appeal to District


Transferred from
’ 1 Original ’ 2 Removed from ’ 3 Re-filed- ’ 4 Reinstated or ’ 5 another district ’ 6 Multidistrict ’ 7 Judge from
Magistrate
Proceeding State Court (see VI below) Reopened (specify) Litigation
Judgment
a) Re-filed Case ’ YES ’ NO b) Related Cases ’ YES ’ NO
VI. RELATED/RE-FILED (See instructions
CASE(S). second page): JUDGE DOCKET NUMBER

Cite the U.S. Civil Statute under which you are filing and Write a Brief Statement of Cause (Do not cite jurisdictional statutes unless
diversity):
VII. CAUSE OF ACTION

LENGTH OF TRIAL via ______ days estimated (for both sides to try entire case)
VIII. REQUESTED IN ’ CHECK IF THIS IS A CLASS ACTION DEMAND $ CHECK YES only if demanded in complaint:
COM PLAINT: UNDER F.R.C.P. 23 JURY DEMAND: ’ Yes ’ No
ABOVE INFORMATION IS TRUE & CORRECT TO SIG N ATU R E O F ATTO R N EY O F R EC O R D D ATE
THE BEST OF MY KNOWLEDGE

F O R O FF IC E U SE O N L Y

AM O U N T R EC EIPT # IFP

Print Reset
JS 44 R everse (R ev. 02/08)

INSTRUCTIONS FOR ATTORNEYS COMPLETING CIVIL COVER SHEET FORM JS 44

Authority For Civil Cover Sheet


The JS 44 civil cover sheet and the information contained herein neither replaces nor supplements the filings and service of pleading 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. Consequently, a civil cover sheet is submitted to the Clerk of Court for each civil complaint
filed. The attorney filing a case should complete the form as follows:
I. (a) Plaintiffs-Defendants. Enter names (last, first, middle initial) of plaintiff and defendant. If the plaintiff or defendant is a government agency, use only
the full name or standard abbreviations. If the plaintiff or defendant is an official within a government agency, identify first the agency and then the official, giving
both name and title.
(b) County of Residence. For each civil case filed, except U.S. plaintiff cases, enter the name of the county where the first listed plaintiff resides at the time
of filing. In U.S. plaintiff cases, enter the name of the county in which the first listed defendant resides at the time of filing. (NOTE: In land condemnation cases,
the county of residence of the “defendant” is the location of the tract of land involved.)
(c) Attorneys. Enter the firm name, address, telephone number, and attorney of record. If there are several attorneys, list them on an attachment, noting
in this section “(see attachment)”.
(d) Choose one County where Action Arose.
II. Jurisdiction. The basis of jurisdiction is set forth under Rule 8(a), F.R.C.P., which requires that jurisdictions be shown in pleadings. Place an “X” in one
of the boxes. If there is more than one basis of jurisdiction, precedence is given in the order shown below.
United States plaintiff. (1) Jurisdiction based on 28 U.S.C. 1345 and 1348. Suits by agencies and officers of the United States are included here.
United States defendant. (2) When the plaintiff is suing the United States, its officers or agencies, place an “X” in this box.
Federal question. (3) This refers to suits under 28 U.S.C. 1331, where jurisdiction arises under the Constitution of the United States, an amendment to the
Constitution, an act of Congress or a treaty of the United States. In cases where the U.S. is a party, the U.S. plaintiff or defendant code takes precedence, and box
1 or 2 should be marked.
Diversity of citizenship. (4) This refers to suits under 28 U.S.C. 1332, where parties are citizens of different states. When Box 4 is checked, the citizenship of the
different parties must be checked. (See Section III below; federal question actions take precedence over diversity cases.)
III. Residence (citizenship) of Principal Parties. This section of the JS 44 is to be completed if diversity of citizenship was indicated above. Mark this section
for each principal party.
IV. Nature of Suit. Place an “X” in the appropriate box. If the nature of suit cannot be determined, be sure the cause of action, in Section VI below, is sufficient
to enable the deputy clerk or the statistical clerks in the Administrative Office to determine the nature of suit. If the cause fits more than one nature of suit, select
the most definitive.
V. Origin. Place an “X” in one of the seven boxes.
Original Proceedings. (1) Cases which originate in the United States District Courts.
Removed from State Court. (2) Proceedings initiated in state courts may be removed to the district courts under Title 28 U.S.C., Section 1441. When the petition
for removal is granted, check this box.
Refiled (3) Attach copy of Order for Dismissal of Previous case. Also complete VI.
Reinstated or Reopened. (4) Check this box for cases reinstated or reopened in the district court. Use the reopening date as the filing date.
Transferred from Another District. (5) For cases transferred under Title 28 U.S.C. Section 1404(a). Do not use this for within district transfers or multidistrict
litigation transfers.
Multidistrict Litigation. (6) Check this box when a multidistrict case is transferred into the district under authority of Title 28 U.S.C. Section 1407. When this box
is checked, do not check (5) above.
Appeal to District Judge from Magistrate Judgment. (7) Check this box for an appeal from a magistrate judge’s decision.
VI. Related/Refiled Cases. This section of the JS 44 is used to reference related pending cases or re-filed cases. Insert the docket numbers and the corresponding
judges name for such cases.

VII. Cause of Action. Report the civil statute directly related to the cause of action and give a brief description of the cause. Do not cite jurisdictional statutes
unless diversity. Example: U.S. Civil Statute: 47 USC 553
Brief Description: Unauthorized reception of cable service
VIII. Requested in Complaint. Class Action. Place an “X” in this box if you are filing a class action under Rule 23, F.R.Cv.P.
Demand. In this space enter the dollar amount (in thousands of dollars) being demanded or indicate other demand such as a preliminary injunction.
Jury Demand. Check the appropriate box to indicate whether or not a jury is being demanded.

Date and Attorney Signature. Date and sign the civil cover sheet.
CIVIL COVER SHEET

I. (a) PLAINTIFFS DEFENDANTS


United States ex rel.
Dr. Jorg Busse, Jennifer Franklin Prescott, Charlene E. Honeywell, John E. Steele, S. Polster Chappell,
Dr. J. Busse as Private Attorney General, Kenneth M. Wilkinson, Richard A. Lazzara,
J. Franklin Prescott as Private Attorney General, Jack N. Peterson, Beverly B. Martin, Ryan Barry,
State of Florida ex rel.

(b) County of Residence of First Listed Plaintiff


[United States ex rel.]

(c) Dr. J. Busse as Private Attorney General; J. Franklin Prescott as Private Attorney General

II. JURISDICTION
[1 UNITED STATES EX REL. PLAINTIFF]
2 U.S. Government Defendant

III. CITIZENSHIP (diversity only)

IV. NATURE OF SUIT


470 Racketeer Influenced and Corrupt Organizations
240 Torts to Land
370 Other Fraud (Personal Property)
220 Foreclosure
290 All Other Real Property
440 Other Civil Rights

V. ORIGIN
1 Original Proceeding

VI. CAUSE OF ACTION


Cite U.S. Civil Statute
18 U.S.C. §§ 1964, Civil RICO, Civil Rights Act
18 U.S.C. §§ 1961-1968
18 U.S.C. § 1341
4th; 7th; 14th; 1st U.S. Const. Amendments
42 U.S.C. §§ 1983, 1985 …

Brief description of cause:


Civil RICO, Racketeering, Obstruction of Justice, Extortion of Property and Money;
4th; 7th; 14th; 1st U.S. Const. Amendments; Public Corruption; Bribery; Fraud;
Property Seizure and Foreclosure Fraud

VII. REQUESTED IN COMPLAINT


Injunction; Triple Punitive Damages; Equitable Relief

$19,000.000.00

Jury Demand

VIII. RELATED CASE(S) IF ANY

DATE
07/27/2010 as Private Attorneys Gen /S/DR. JORG BUSSE /S/JENNIFER F. PRESCOTT

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