Onionhead Complaint - ATL

Case 1:14-cv-03673-KAM-JO Document 1 Filed 06/11/14 Page 1 of 9 PageID #: 1

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JS 44 (Rev. 1/2013) CIVIL COVER SHEETThe 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 asprovided 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 thepurpose of initiating the civil docket sheet. (SEE INSTRUCTIONS ON NEXT PAGE OF THIS FORM.)

I. (a) PLAINTIFFS DEFENDANTS

(b) County of Residence of First Listed Plaintiff County of Residence of First Listed Defendant(EXCEPT IN U.S. PLAINTIFF CASES) (IN U.S. PLAINTIFF CASES ONLY)

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

(c) Attorneys (Firm Name, Address, and Telephone Number) Attorneys (If Known)

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

1 U.S. Government 3 Federal Question PTF DEF PTF DEFPlaintiff (U.S. Government Not a Party) Citizen of This State 1 1 Incorporated or Principal Place 4 4

of Business In This State

2 U.S. Government 4 Diversity Citizen of Another State 2 2 Incorporated and Principal Place 5 5Defendant (Indicate Citizenship of Parties in Item III) of Business In Another State

Citizen or Subject of a 3 3 Foreign Nation 6 6 Foreign Country

IV. NATURE OF SUIT (Place an X in One Box Only)CONTRACT TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES

110 Insurance PERSONAL INJURY PERSONAL INJURY 625 Drug Related Seizure 422 Appeal 28 USC 158 375 False Claims Act 120 Marine 310 Airplane 365 Personal Injury - of Property 21 USC 881 423 Withdrawal 400 State Reapportionment 130 Miller Act 315 Airplane Product Product Liability 690 Other 28 USC 157 410 Antitrust 140 Negotiable Instrument Liability 367 Health Care/ 430 Banks and Banking 150 Recovery of Overpayment 320 Assault, Libel & Pharmaceutical PROPERTY RIGHTS 450 Commerce

& Enforcement of Judgment Slander Personal Injury 820 Copyrights 460 Deportation 151 Medicare Act 330 Federal Employers Product Liability 830 Patent 470 Racketeer Influenced and 152 Recovery of Defaulted Liability 368 Asbestos Personal 840 Trademark Corrupt Organizations

Student Loans 340 Marine Injury Product 480 Consumer Credit (Excludes Veterans) 345 Marine Product Liability LABOR SOCIAL SECURITY 490 Cable/Sat TV

153 Recovery of Overpayment Liability PERSONAL PROPERTY 710 Fair Labor Standards 861 HIA (1395ff) 850 Securities/Commodities/ of Veterans Benefits 350 Motor Vehicle 370 Other Fraud Act 862 Black Lung (923) Exchange

160 Stockholders Suits 355 Motor Vehicle 371 Truth in Lending 720 Labor/Management 863 DIWC/DIWW (405(g)) 890 Other Statutory Actions 190 Other Contract Product Liability 380 Other Personal Relations 864 SSID Title XVI 891 Agricultural Acts 195 Contract Product Liability 360 Other Personal Property Damage 740 Railway Labor Act 865 RSI (405(g)) 893 Environmental Matters 196 Franchise Injury 385 Property Damage 751 Family and Medical 895 Freedom of Information

362 Personal Injury - Product Liability Leave Act Act Medical Malpractice 790 Other Labor Litigation 896 Arbitration

REAL PROPERTY CIVIL RIGHTS PRISONER PETITIONS 791 Employee Retirement FEDERAL TAX SUITS 899 Administrative Procedure 210 Land Condemnation 440 Other Civil Rights Habeas Corpus: Income Security Act 870 Taxes (U.S. Plaintiff Act/Review or Appeal of 220 Foreclosure 441 Voting 463 Alien Detainee or Defendant) Agency Decision 230 Rent Lease & Ejectment 442 Employment 510 Motions to Vacate 871 IRSThird Party 950 Constitutionality of 240 Torts to Land 443 Housing/ Sentence 26 USC 7609 State Statutes 245 Tort Product Liability Accommodations 530 General 290 All Other Real Property 445 Amer. w/Disabilities - 535 Death Penalty IMMIGRATION

Employment Other: 462 Naturalization Application 446 Amer. w/Disabilities - 540 Mandamus & Other 465 Other Immigration

Other 550 Civil Rights Actions 448 Education 555 Prison Condition

560 Civil Detainee - Conditions of Confinement

V. ORIGIN (Place an X in One Box Only) 1 Original

Proceeding 2 Removed from

State Court 3 Remanded from

Appellate Court 4 Reinstated or

Reopened 5 Transferred from

Another District(specify)

6 MultidistrictLitigation

VI. CAUSE OF ACTIONCite the U.S. Civil Statute under which you are filing (Do not cite jurisdictional statutes unless diversity): Brief description of cause:

VII. REQUESTED IN COMPLAINT:

CHECK IF THIS IS A CLASS ACTIONUNDER RULE 23, F.R.Cv.P.

DEMAND $ CHECK YES only if demanded in complaint:JURY DEMAND: Yes No

VIII. RELATED CASE(S) IF ANY (See instructions): JUDGE DOCKET NUMBERDATE SIGNATURE OF ATTORNEY OF RECORD

FOR OFFICE USE ONLY

RECEIPT # AMOUNT APPLYING IFP JUDGE MAG. JUDGE

Case 1:14-cv-03673-KAM-JO Document 1-1 Filed 06/11/14 Page 1 of 2 PageID #: 10

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CERTIFICATION OF ARBITRATION ELIGIBILITY

Local Arbitration Rule 83.10 provides that with certain exceptions, actions seeking money damages only in an amount not in excess of $150,000,exclusive of interest and costs, are eligible for compulsory arbitration. The amount of damages is presumed to be below the threshold amount unless acertification to the contrary is filed.

I, ______________________, counsel for __________________, do hereby certify that the above captioned civil action isineligible for compulsory arbitration for the following reason(s):

monetary damages sought are in excess of $150,000, exclusive of interest and costs,

the complaint seeks injunctive relief,

the matter is otherwise ineligible for the following reason

DISCLOSURE STATEMENT - FEDERAL RULES CIVIL PROCEDURE 7.1

Identify any parent corporation and any publicly held corporation that owns 10% or more or its stocks:

RELATED CASE STATEMENT (Section VIII on the Front of this Form)

Please list all cases that are arguably related pursuant to Division of Business Rule 50.3.1 in Section VIII on the front of this form. Rule 50.3.1 (a)provides that A civil case is related to another civil case for purposes of this guideline when, because of the similarity of facts and legal issues orbecause the cases arise from the same transactions or events, a substantial saving of judicial resources is likely to result from assigning both cases to thesame judge and magistrate judge. Rule 50.3.1 (b) provides that A civil case shall not be deemed related to another civil case merely because the civilcase: (A) involves identical legal issues, or (B) involves the same parties. Rule 50.3.1 (c) further provides that Presumptively, and subject to the powerof a judge to determine otherwise pursuant to paragraph (d), civil cases shall not be deemed to be related unless both cases are still pending before thecourt.

NY-E DIVISION OF BUSINESS RULE 50.1(d)(2)

1.) Is the civil action being filed in the Eastern District removed from a New York State Court located in Nassau or SuffolkCounty:_________________________

2.) If you answered no above:a) Did the events or omissions giving rise to the claim or claims, or a substantial part thereof, occur in Nassau or SuffolkCounty?_________________________

b) Did the events of omissions giving rise to the claim or claims, or a substantial part thereof, occur in the EasternDistrict?_________________________

If your answer to question 2 (b) is No, does the defendant (or a majority of the defendants, if there is more than one) reside in Nassau orSuffolk County, or, in an interpleader action, does the claimant (or a majority of the claimants, if there is more than one) reside in Nassauor Suffolk County?______________________

(Note: A corporation shall be considered a resident of the County in which it has the most significant contacts).

BAR ADMISSION

I am currently admitted in the Eastern District of New York and currently a member in good standing of the bar of this court.Yes No

Are you currently the subject of any disciplinary action (s) in this or any other state or federal court?Yes (If yes, please explain) No

I certify the accuracy of all information provided above.

Signature:____________________________________________


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MarziliaTypewritten Text








MarziliaTypewritten TextEDNY Revision 1/2013

AO 440 (Rev. 06/12) Summons in a Civil Action

UNITED STATES DISTRICT COURTfor the

__________ District of __________

))))))))))))

Plaintiff(s)v. Civil Action No.

Defendant(s)

SUMMONS IN A CIVIL ACTION

To: (Defendants name and address)

A lawsuit has been filed against you.

Within 21 days after service of this summons on you (not counting the day you received it) or 60 days if youare the United States or a United States agency, or an officer or employee of the United States described in Fed. R. Civ.P. 12 (a)(2) or (3) you must serve on the plaintiff an answer to the attached complaint or a motion under Rule 12 ofthe Federal Rules of Civil Procedure. The answer or motion must be served on the plaintiff or plaintiffs attorney,whose name and address are:

If you fail to respond, judgment by default will be entered against you for the relief demanded in the complaint. You also must file your answer or motion with the court.

CLERK OF COURT

Date:Signature of Clerk or Deputy Clerk


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AO 440 (Rev. 06/12) Summons in a Civil Action (Page 2)

Civil Action No.

PROOF OF SERVICE(This section should not be filed with the court unless required by Fed. R. Civ. P. 4 (l))

This summons for (name of individual and title, if any)

was received by me on (date) .

I personally served the summons on the individual at (place)on (date) ; or

I left the summons at the individuals residence or usual place of abode with (name), a person of suitable age and discretion who resides there,

on (date) , and mailed a copy to the individuals last known address; or

I served the summons on (name of individual) , who is designated by law to accept service of process on behalf of (name of organization)

on (date) ; or

I returned the summons unexecuted because ; or Other (specify):

.

My fees are $ for travel and $ for services, for a total of $ .

I declare under penalty of perjury that this information is true.

Date:Servers signature

Printed name and title

Servers address

Additional information regarding attempted service, etc:


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check1008: Brief Description: Religion based hostile work environment,failure to accommodate,termination, retaliation & constructive dischargecheck1007: check 1000: 440check1005: 440Text1: check1004: Demand: Method:

Place Served: Text2: Text3: Text4: s/ Sunu P. Chandy, US EEOCcheck1001: 440Text5: Organization: County_2: YesPlaintiff address: United States Equal Employment Opportunity CommissionAttn: Sunu P. Chandy, Senior Trial Attorney - Legal Unit 33 Whitehall Street, 5th FloorNew York, New York 10004Button: SaveAs: Print1: Reset:

Date: 06-11-2014County_of_Residence_of_Fi: Suffolk County Unexecuted Reason: check1009: 440DOCKET_NUMBER: Attorneys: David Sutton Esq. PC1205 Franklin Ave., Suite 320Garden City, New York 11530Plaintiff: United States Equal Employment Opportunity CommissionLegal Unit, 33 Whitehall Street, 5th Floor, New York, New York 10004

CHECK_IF_THIS_IS_A_CLASS: Other: JUDGE: Place Served2: FirmName: United States Equal Employment Opportunity Commission, Legal Unit, Attn: Sunu P. Chandy, 33 Whitehall Street, 5th Floor, New York, NY 10004 / 212-336-3706Defendant: United Health Partners of America, Inc. / Cost Containment Group160 Eileen WaySyosset, New York 11790

Left With2: Server Address: Date_Today2: 7: District: YesService Fee: Total Fee: 0Additional information: Basis of Jurisdiction: 1.U.S. Plaintiff

Served On: 9: 8: Travel Fee: Date_Served: Date_Received: 17: 18: 15: 16: 13: 14: I: Sunu P. Chandy Defendant2: 11: 12: counsel for: US EEOCV: Origin: 1

Date_Served1: or Suffolk County: CauseofAction: Title VII of the Civil Rights Act of 1964 and Title I of the Civil Rights Act of 1991Defendant address: United Health Programs of America, Inc. Cost Containment Group160 Eileen WaySyosset, New York 11790 Date_Served2: Civil action number: 14-cv-3673

Server Signature: b_County_of_Residence_of: Nature of Suit: 442

Sig: /s Sunu P. Chandy, US EEOC Legal Unit Date_Today: CHECK_YES_only_if_demand1: Yes

Organization2: 10: Left With: County: NoDist: Info: Eastern District of New York

Server Name: Deputy Clerk Signature:

Onionhead Complaint - ATL

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