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Case 5:11-cv-00067-MFU Document 2 Filed 07/08/11 Page 1 of 1 Pageid#: 8

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 tCkï.1S44 tllev.I2/07) CIV IL CO VER SH EET
Th
b eJS44civilcoversheetandthzeain
yIogalrulesofcourt.Thisfornu
t
brmationcontainedhereintleitherreglacenorstlpplementthet-
ilingandseryiceofpl
eadingsorotherpapersasrqquiredbylaw,exceptasyroyijed
pprovedbytheJtldicialConterenceottheUnitedStatesinSeptemberl974.lsreqtliredfortheuseofthtClerkotCourtforthepurposeoflnitlatlng
theclvfldocketsheet. (SEEINSTRUCTIONSON THEREVERSEOFTHEFORM.)
1.(a) PLAINTIFFS DEFENDANTS
DANIEL PAYNE SHADW ELL DMV/DCSE

(b) countyot-iusidenceot-FirstListedPlaintiff PINELLAS,FL cotlntyot-ResidenceofFirstListedDetkndant FREDERICK,VA

(EXCEPTIN U,S.PLAINTIFFCASES) (IN U.S PLAINTIFFCASESONLY)
NOTE: IN LAND CONDEMNATION CASES.USE THE LOCATION OFTHE
LAND INVOLVED

(c) Attorney'stFil
.
m Name-Address.andTel
ephoneNtl
mber) Attorneys(Ii
-Klou'
ll
JOSH OURS,ERIK FISKE,KENNETH CUCCINELLI

II. BASIS O F JURISDICT IO N (pl

aoean''
x''inoneBoxonly) 111. C ITIZ ENSH IP O F PRINCIPA L PA RT IESIPI
aCean'x'
'inoneBoxforPlaintiff
(ForDiversityCasesOl1ly) andOneBoxforDefendant)
USGovernment 3 FederalQuesti
ol L'
tVO PTF DEF PTF DEF
Plaintiff (U.S.GovernlnelltNotaParty) CitizellofTllisState ID l X l lncorporatedorPrincipalPlace D 4 ID 4
I
ofBtlsinessInThisState

U.
SDe
.Governmelt
fendant '
4 Diversi
ty K.
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Citizel
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lot
llerState X2 IncoofrporatedandPrincipalPlace
BtlsinessInAnotherState
X
(llldicateCitizellsllipof'PartiesiI1ItelnlIl)
CitizelorStl
hi
ectofa Forei
glNation M 6
ForeiyI1Cotlnt
IV. NATURE O F SU IT placean-t
x--iI
)ollcBoxonl
CONTRACT TORTS FORFEITURE/ENALTY BANKRUPTCY OTHER STATUTES
C3 l!0 Insurance PERSONAL INJI.IRY PERSONAL INJURY O 6l0Agrictllture O 422Appeal28USC l58 O 400StateReapportionment
C1I20Marine O 3l0Airplane O 362Personallllitlr.y- O 620OtherFood& Drtlg ED 423W ithdrawal (D 4l0Antitrtlst
(D 130 MillerAct D 3I5Afrplalle Prodtlct
( Med.Malpractiee (D 625DrtlgRelafedSeiztlre 28 USC I57 (D 430Banksalld Bankfng
D l40Negotiablelnstrulnellt Liability 365Personallnitlry- ofProperty21USC88l O 450Colllmerce
O l50 RecoveryofOverpaylnellt O 320Assatllt.Libel& ProdtlctLiability (D 630 LiquorLaws PROPERTY RIGHTS O 460Deportation
&Enforcel
nentofltl
dgment Slalder (
7:
1 368AsbestosPersonal E
D 640R.R.&Trtl
ck O 820Copyrights X 470RacketeerIntltl
encedand
I
D I5lMedicareAct I
D 330FederalElnployers' lnjt
lryProdt
lcl I
D 650Ai
rlileRegs. I
D 830Patellt Con-t
lptOrgani
zations
O 152 RecoveryofDefatllted Liability Liability O 660Occtlpatiollal O 840Tradelnark C1 480ConstlmerCredit
SttldentLoalls O 340 Marille PERSONAL PROPERTY Safety/l-lealth D 490Cable/satTV
I
(ExcI.Veterans) O 345MarineProdtlct ED 370OtherFratld O 690Other D 810SelectiveService
(
O l53ReceveryofOverpayment Liability O 37ITrtlth iI1Lelldillg LAB R SOCIA SECURITY O 850 Sectlrities/commodities/
ofVeteran'sBenefits ID 350MotorVehi cle O 380OtherPersonal O 7l0FairLaborStandards E
D 86lI
-IIA (I395f1) Exchange
O l60Stockholdtrs'Stlits tD 355MotorVellicle Prepel'tyDalnage Act O 862BlackLtlllg(923) C1 875CtlstomerChallellge
C1l90OtherContract ProdtlctLiability O 385PropertyDamage ED 720Labor/Mgmt.Relations O 863DIWC/DIWW (405(g)) l2(JSC34l0
D 195ContractProdtlctLiability O 360OtherPersonal
I ProdtlctLiability O 730Labor/Mglnt.l
teporting O 864SSID TitleXVI O 890 OtherStatutory Actions
O l96Franchise I11'u & DisclostlreA(;t O 865RSl(405(')) O 89lAgrictllttlralAds
REAL PROPERTY CIVIL RIGHTS PRISONER PETITIONS O 740RailwayLaborAct FEDERAL TAX SUITS O 892 EconomicStabilization Act
D 2I0LaldCondemnation
I (D 44lVoting ED 5l0MotiollstoVacate D 790OtherLaborLitigation O 870Taxes(U.S.Plaintiff ED 893 EnvironlnentalMatters
ED 220Foreclostlre O 442Employment Sentellce O 79lEmpl.Ret.Inc. orDefendant) O 894EnergyAllocationAct
D 230RentLease& Ejectlnent O 443Hot
( lsins HabeasCorpus: Sectl
rityAct O 87llls---
l-
hirdParty ED 895Freedom oflnformation
ED 240Tol'tstoLalld Accolnmodatiolls O 530General 26 USC 7609 Act
C1245Tol4ProdtlctLiability O 444W elfare O 535Deatl!Pellalty IMM IGRATION O 900AppealofFeeDetenninatioll
C1290 AIIOtherRealProperty O 445Alner.w/Disabilities- O 540 Mandalntls& Otller O 462 NaturalizationApplication UllderEqtlalAccess
Employmellt (D 550CivïlRfghts (D 463 HabeasCbl-ptls- tgJtlstice
O 446Amer,w/Disabilities- O 555PrisonCollditioll AliellDetaillee X 950Coplstittltiollalityof
Other O 465OtherIlnmigratiol' StateStattltes
X 440OtherCivilRigllts Actiolls

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V I. CAUSE O F ACTIO N Briefdescriptionofcause: . .
tilA It D HNY Ii-lr IKANYUR IP lt5,UO UR 1 U RD U.I 'IN O l' Jt lIIIO NY I -o R I 'ItIJRHSY ALLO W tD .
VII. REQUESTED IN O CHECK IFTHISISACLASSACTION DEMAND$ CHECK YESonlyifdemandedincomplaint:
COM PLAINT: UNDER F.R.C.P.23 10,500,000.00 JI/RYDEMANIX V Yes O No
VlII.IRELATED
F A NY CASEIS) (Seeinstructiolts): JUDGE Sam uelG
W ilson . DOCKE,
.
FNUMBER 5:09CV00061
DATE SIGNATURE OFATTORNEY OFRECORD
07/05/2011
FOR OFFICE USE ONLY
+
RECEIPT # AMOUNT APPLYING lFP JuD tV,
GE P Y. .1MAG.JUDGE
Case 5:11-cv-00067-MFU Document 2-1 Filed 07/08/11 Page 1 of 1 Pageid#: 9
s:!1Wb7 9