swanson v. mjj prods and timbaland - chicago copyright infringement lawsuit

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1 \ 1 3 c v ^ ^ Louis Wi ll acy (SBN 186 356) LOUI SWI LLACY, ESQ 360 Grand Avenue, Suite 250 Oakland, California 94610 TEL: (415) 670-9400 Fax:(415)952-9310 [email protected] Attorney for Plaintiff SIDNEY EARLSWANSON UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA T p  n b SIDNEY EARL SWr ANSON, an individual, £J CV14 0 1 97 5  Mm(ZT5y ^ ^ Case No. v .> Plaintiff. vs MJJ PRODUCTI ONS, INC. , a California corporation; SONYMUSICHOLDINGS INC. , a Delaware corporation; TIMOTHY ZACHERY MOSLEY, an indi vi dua l; CORY ROONEY. an individual; and DOES 1 thr oug h 10,inc lus ive, Defendants. / COMPLAINT F OR COPYRIGHT INFRINGEMENT DEMAND FOR JURY TRIAL Plaintiff SIDNEY EARL SWTANSON, for his Complaint agains t Defendants, and each of them, alle ges as foll ows: P.ARTIES 1. Plaintiff SIDNEY EARL SWANSON ( SW.ANSON ) isan individual reside nt of THfe State o f California. COMPLAINT FOR COPYRIGHT INFRINGEMENT with DEMAND FOR JURY TRIAL

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    Louis Willacy (SBN 186356)LOUIS WILLACY, ESQ360 Grand Avenue, Suite 250Oakland, California 94610TEL: (415) 670-9400Fax:(415)[email protected]

    Attorney for PlaintiffSIDNEY EARL SWANSON

    UNITED STATES DISTRICT COURT

    CENTRAL DISTRICT OF CALIFORNIA

    T!p

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    SIDNEY EARL SWrANSON,an individual,

    J)CV14 01 975'Mm(ZT5y^"^ Case No. v .>

    Plaintiff.vs.

    MJJ PRODUCTIONS, INC., a Californiacorporation; SONY MUSIC HOLDINGSINC., a Delaware corporation; TIMOTHYZACHERY MOSLEY, an individual; CORYROONEY. an individual; and DOES 1through 10, inclusive,

    Defendants./

    COMPLAINT FOR COPYRIGHTINFRINGEMENT

    DEMAND FOR JURY TRIAL

    Plaintiff SIDNEY EARL SWTANSON, for his Complaint against Defendants, and each ofthem, alleges as follows:

    P.ARTIES

    1. Plaintiff SIDNEY EARL SWANSON ("SW.ANSON") isanindividual resident ofTHfe State of California.

    COMPLAINT FOR COPYRIGHT INFRINGEMENT with DEMAND FOR JURY TRIAL

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    2. Defendant MJJ PRODUCTIONS, INC. ("MJJ PRODUCTIONS") is acorporationorganized and existing under the laws ofthe State ofCalifornia, with its principal place of

    business located in North Hollywood. California, within this district.

    3. Defendant SONY MUSIC HOLDINGS INC. dba SONY MUSIC

    ENTERTAINMENT and/or EPIC RECORDS ("SONY") isa corporation organized andexisting under the laws of the State ofDelaware, with its principal place ofbusiness located in

    New York, New York.

    4. Upon information and belief, Defendant TIMOTHY ZACHERY MOSLEY

    professionally known as TIMABALAND ("TIMBALAND"). is an individual resident of theState of California.

    5. Upon information and belief, Defendant CORY ROONEY ("ROONEY"), whosefull name is Mark Rooney, is an individual resident of the State of New York.

    6. The names, residences and capacities of the Defendants named herein as DOES 1

    through 10 areunknown to Plaintiff at this time. Plaintiff is informed andbelieves, and thereon

    alleges, that each ofthe fictitiously named Defendants is in some way liable, jointly andseverally, toPlaintiff for the damages alleged herein, either together with, or independently of,

    each other Defendant. At such time as the fictitiously named Defendants are identified, Plaintiff

    will amend this Complaint to state each of their true names, capacities and residences.

    7. At all material times, each Defendant acted as the agent and/or principal ofeach

    other Defendant and each is equally liable for the wrongful acts of the other.

    JURISDICTION AND VENUE

    8. Subject matter jurisdiction is invoked pursuant to 28 U.S.C. 1331 and 1338because this action is based on federal copyright law.

    COMPLAINT FOR COPYRIGHT INFRINGEMENT with DEMAND FOR JURY TRLAL

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    9. Venue is proper in tins district pursuant to 28 U.S.C. 1391(b)(2) because theinfringement occurred in this district and pursuant to 28 U.S.C. 1391(b)(3) because at least onedefendant resides in this district.

    GENERAL AVERMENTS

    10. Swanson is the owner ofthe copyright in the composition and sound recording

    copyright entitled "Come Home On the Move" (the "Infringed Composition") written bySWANSON, U.S. Copyright Registration No. PAu002712187, dated September 11, 2002.

    Attached hereto as Exhibit "A" is atrue and correct copy of the composition and sound recordingregistration for the Infringed Composition.

    11. On or about May 2014, Defendants SONY and MJJPRODUCTIONS released for

    sale and distribution the sound recording "Chicago," ("Defendants' Sound Recording") featuredas the second track on Xscape, the posthumous album offamed singer-performer Michael

    Jackson, which has achieved tremendous financial success.

    12. Defendants TIMBALAND and ROONEY are two of the artists credited with

    creating the Defendants' Sound Recording.

    13. Defendants' Sound Recording is, and continuously has beensince it was first

    released, offered for sale in vanous media. It continues to this day to beoffered for sale on CDs

    and available for downloading from iTunes, Amazonmp3.com, eMusic.com as well asother

    internet music providers. On information and belief, Defendants' Sound Recordine still

    generates substantial income for all Defendants at this time.

    14. On information and belief. Defendants copied and incorporated substantial,

    original portions ofthe Infringed Composition in Defendants' Sound Recording. The portions of

    the Infringed Composition which have been copied into Defendants' Sound Recording are

    COMPLAINT FORCOPYRIGHT INFRINGEMENT with DEMAND FOR JURY TRIAL

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    numerous. There is a substantial similarity between the Infringed Composition and Defendants'

    Sound Recording due to Defendants' copying.

    15. Defendants' copying, duplication, use, performance and exploitation ofthe

    Infringed Composition in Defendants' Sound Recording constitute infringement of

    SWANSON's copyright in the Infringed Composition.

    FIRST CLAIM FOR RFI TFF

    COPYRIGHT INFRINGEMENT

    16. Plaintiff repeats and incorporates byreference the allegations contained in

    Paragraphs 1 through 15 above, as though fully set forth.

    17. Plaintiff is, and at all material times hereto has been, the owner ofthe copyright in

    the Infringed Composition and is entitled and authorized to protect his composition against

    copyright infringement, including the enforcement of copyright actions. Plaintiff secured the

    exclusive rights under U.S.C. 106, among others, to "reproduce the copyrighted work in copiesorphonorecords," "toprepare derivative works based upon tire copyrighted work," "todistribute

    copies orphonorecords of the copyrighted work to the public bysale orother transfer of

    ownership, or by rental, lease, or lending," and to "perform the copyrighted work publicly."

    18. Plaintiff did not authorize Defendants to copy, reproduce, perform, or use the

    Infringed Composition in Defendants' Sound Recording, or at all. Defendants did not seek or

    obtain any permission, consent or license from Plaintiff for the copying, reproduction,

    performance or use ofthe Infringed Composition in Defendants' Sound Recording or in any uses

    thereof that were made or authorized by Defendants, or at all.

    19. Defendants, and each ofthem, have infringed, and are continuing to infringe

    upon. Plaintiffs copyright in the Infringed Composition by copying, preparing a derivative

    COMPLAINT FOR COPYRIGHT INFRINGEMENT with DEMAND FOR JURY TRIAL

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    work, reproducing and using, and causing, contributing to, and panicipating in the unauthorized

    copying, preparing a derivative work, reproduction and using, ofthe Infringed Composition in

    Defendants' Sound Recording and causing the same to be publicly distributed in retail stores, on

    the internet, by digital download and otherwise.

    20. Defendants never paid Plaintiff for the use of the Infringed Composition.

    Defendants have infringed on Plaintiffs exclusive rights by:

    (a) Reproducing Plaintiffs copyrighted work in copies orphonorecords inviolation of 17 U.S.C. 106(1);

    (b) Preparing derivative works based on Plaintiffs copyrighted work in violationof 17 U.S.C. 106(2);

    (c) Distributing copies or phonorecords of Plaintiffs copyrighted work and

    derivative work to the public bysale or other transfer ofownership, orby

    rental, lease, or lending in violation of 17 U.S.C. 106(3);

    (d) Performing Plaintiffs copyrighted work or a derivative thereof publicly inviolation of 17 U.S.C. 106(4); and

    (e) Performing Plaintiffs copyrighted work and derivative work publicly bymeans of a digital audio transmission in violation of 17 U.S.C. 106(6).

    Defendants failed to properly attribute the authorship of Defendants' Sound

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    Recording to Plaintiff.

    23. Defendants' acts of infringement were done, and now continue to be done with

    knowledge that such actions constitute an infringement of Plaintiffs exclusive rights and are,

    therefore, willful. At a minimum, Defendants acted in reckless disregard ofPlaintiffs copyright,

    COMPLAINT FOR COPYRIGHT INFRINGEMENT with DEMAND FOR JURY TRIAL

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    24. As a result of their actions. Defendants, and each of them, are liable to Plaintiff

    for willful copyright infringement under 17 U.S.C. 501. Plaintiff suffered, will continue tosuffer and is entitled to recover from Defendant, substantial damage to his professional

    reputation and goodwill, aswell as losses in an amount yetascertained, but which willbe

    determined according toproof, pursuant to 17 U.S.C. 504(b). In addition to Plaintiffs actualdamages. Plaintiff is entitled to receive the profits made by Defendants from their wrongful acts,

    pursuant to 17 U.S.C. 504(b).

    25. As a direct and proximate result of Defendants' infringement, Plaintiffhas

    incurred attorneys' fees and costs, in an amount according to proof, which are recoverable under

    the provisions of 17 U.S.C. 505.

    WHEREFORE, Plaintiffprays for judgment against Defendants, and each of them,jointly and severally as follows:

    1. For damages insuch amount as may be found, or as otherwise permitted by law;

    2. Foranaccounting of Defendants' profits attributable to their infringements of

    Plaintiffs' copyright in the Infringed Composition;

    3. For a preliminary and permanent injunction prohibiting Defendants, and theirrespective agents, servants, employees, officers, successors, licensees and assigns,

    and all persons acting in concert or participation with each or any of them, from

    continuing to infringe Plaintiffs' copyright inthe Infringed Composition;

    4. For Plaintiffs' attorneys' fees, costs, and disbursements in tins action; and

    COMPLAINT FOR COPYRIGHT INFRINGEMENT with DEMAND FOR JURY TRIAL

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    ^ For such other remedies under the copyright laws of the United States and'or as the

    Court deems reasonable and just.

    Respectfully submitted.A

    aw WAhrLouis WillacyLOUIS WILLACY. ESQ.360 Grand Avenue, Suite 250Oakland. CA 94610(415)670-9400Fax:(415)952-9310louisin.'wi llacv.com

    Attorney for Plaintiff, Sidney Earl Swanson

    COMPLAINT FOR COPYRIGHT IN'FRINGF.MEXT with DEMAND FOR JURY TRIAL

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    DEMAND FOR JURY TRIAL

    Plaintiff. Sidney Earl Swanson. hereby demands a trial by jury in the above matter.Dated: September 16. 2014

    LOUIS WILLACY. ESQ./

    By IAaw'ALOUIS WILLACY

    Attorney for Plaintiff Sidney Earl Swanson

    /' / i i /I21/1i/i

    COMPLAINT FOR COPYRIGHT INFRINGEMENT witii DEMAND FOR JURY TRIAL

  • EXHIBIT A

  • 9/10/2014. . ^M cocatalog.loc.gov/cgi-bin/Pwebrecon.cgi ^^Type of Work: Music

    Registration Number / Date:PAU002712187 / 2002-09-11

    Title: Songs by Sidney : vol. 1.

    Description: Compact disc.

    Notes: Music only.

    Copyright Claimant:Sidney E. Swanson

    Date of Creation: 1995

    Rights and Permissions:Rights & permissions info, on original appl. in CO.

    Variant title: Songs by Sidney : vol. 1

    Names: Swanson, Sidney E.

    http://cocatalog.loc.gov/cgi-bin/Pwebrecon.cgi -;/1

  • UNITED SlQs DISTRICT COURT, CENTRAL DISTRICT OF AfORNIACIVIL COVER SHEET

    I. (a) PLAINTIFFS ( Check box if you are representing yourself ["JSIDNEY EARLSWANSON, an individual

    (b) County of Residence of First Listed Plaintiff(EXCEPT INU.S. PLAINTIFF CASES)

    (c) Attorneys {Firm Name, Address and Telephone Number) If you arerepresenting yourself, provide the same information.Louis Willacy (SBN 186356)LOUIS WILLACY, ESQ.360 Grand Avenue, Suite 250, Oakland, CA 94610Telephone: 415.670.9400 Facsimile: 415.952.9310

    DEFENDANTS (Check box if you are representing yourself [~J )SONY MUSIC HOLDINGS INC., a Delaware corporation; MJJ PRODUCTIONS, INC., aCalifornia corporation; TIMOTHY ZACHERY MOSLEY, an individual; CORY ROONEY, anindividual:and DOES 1 through 10, inclusive.

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

    Attorneys [Firm Name, Address and Telephone Number) If you arerepresenting yourself, provide the same information.

    II. BASIS OFJURISDICTION (Place an Xinone box only.)

    I 11. U.S. GovernmentPlaintiff

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

    III. CITIZENSHIP OF PRINCIPAL PARTIES-For Diversity Cases Only(Place an Xin one box for plaintiff and one for defendant)

    PTF DEF PTF DEFCitizen of This State 1 1 '"corporated or Principal Place [-] 4 Fl 4of Business in this State

    Citizen ofAnother State r~]

    3 [] 3 Foreign Nation

    [J 2 Incorporated and Principal Place D 5 D 5of Business in Another State

    6 6| | 2. U.S. Government

    Defendant| 14. Diversity (Indicate Citizenship

    of Parties in Item III)

    IV. ORIGIN (Place an Xin one box only.)

    Citizen or Subject of aForeign Country

    1. OriginalProceeding

    2. Removed fromState Court

    3. Remanded fromAppellate Court

    4. Reinstated orReopened

    5. Transferred from AnotherDistrict (Specify!

    6. Multi-| | District Litigation

    V. REQUESTED IN COMPLAINT: JURY DEMAND: |x] Yes No (Check "Yes" only if demanded incomplaint.)CLASS ACTION under F.R.Cv.P. 23: [J Yes [x] No QMONEY DEMANDED IN COMPLAINT: $ proven attrialVI. CAUSE OF ACTION (Cite the U.S. Civil Statute under which you are filing and write abrief statement of cause. Do not cite jurisdictional statutes unless diversity.)Copyright infringement under17U.S.C. 106and 501 basedon Defendants' unauthorized useofPlaintiffs composition.

    VII. NATURE OF SUIT (Place an Xin one box only).OTHER STATUTES

    375 False Claims Act 400 State

    Reapportionment 410 Antitrust[~J 430 Banks and Banking 450 Commerce/ICC

    Rates/Etc.

    I | 460 Deportation 470 Racketeer influ

    enced &Corrupt Org.

    | | 480 Consumer Credit 490 Cable/Sat TV

    850 Securities/Com- modities/Exchanger-, 890 Other StatutoryII Actions 891 Agricultural Acts 893 Environmental

    Matters

    895 Freedom of Info.Act

    896 Arbitration

    899 Admin. Procedures| | Act/Review of AppealofAgency Decision

    950 Constitutionality ofState Statutes

    FOR OFFICE USE ONLY:

    CONTRACT

    | | 110 Insurance 120 Marine 130Miller Act 140 Negotiable

    Instrument

    150 Recovery of|I Overpayment &Enforcement ofJudgment

    [7J 151 Medicare Act152 Recovery of

    [~J Defaulted StudentLoan (Excl. Vet.)

    153 Recovery ofI | Overpaymentof

    Vet. Benefits

    160 Stockholders'Suits

    rj 190 OtherContract

    195 ContractProduct Liability

    [~J 196FranchiseREAL PROPERTY

    [J 210LandCondemnation

    | | 220 Foreclosure230 Rent Lease &

    REAL PROPERTY CONT.

    240Torts to Land|~J 245TortProduct

    Liability[~J 290All OtherReal

    PropertyTORTS

    PERSONAL INJURY

    310 Airplane 315 Airplane

    Product LiabilityrI 320 Assault, Libel&ll Slander 330 Fed. Employers'

    Liability 340Marine

    345 Marine ProductLiability

    350Motor Vehicle355 Motor VehicleProduct Liability

    360 Other Persona IInjury

    362 Personal Injury-Med Malpratice

    365 Personal Injury-Product Liability367 Health Care/

    II Pharmaceutical Personal Injury

    Product Liabilityrn 368AsbestosI I Personal Injury

    itv

    Ejectment

    Case Number^pcrnr

    IMMIGRATION

    462 NaturalizationApplication

    465 OtherImmigration Actions

    TORTSPERSONAL PROPERTY

    370OtherFraudI I 371 Truth inLending

    380 Other Personal Property DamageII 385 Property Damage"I Product Liability

    BANKRUPTCY

    ii 422 Appeal 28USC158

    423 Withdrawal 28USC157

    CIVIL RIGHTS

    440OtherCivil Rights 441 VotingI | 442 EmploymentII 443Housing/'' Accommodations

    445 American with Disabilities-

    Employment 446 American with

    Disabilities-Other

    ri 448 Education

    ofTf 5CV-71 (06/14) CIVIL COVER SHEET

    PRISONER PETITIONS

    Habeas Corpus:I I 463 Alien Detainee 510 Motions to Vacate

    Sentence 530General 535Death Penalty

    Other:

    540Mandamus/Other 550Civil Rights1I 555 Prison Condition

    560 Civil DetaineeLJ Conditions of

    ConfinementFORFEITURE/PENALTY

    !_. 625 Drug RelatedI I Seizure ofProperty 21

    USC 881 690 Other

    LABOR

    710 Fair Labor StandardsAct

    I| 720 Labor/Mgmt.L-' Relations

    740Railway Labor Act 751 Family and Medical

    Leave Act

    rI 790 Other LaborII LitigationII 791 Employee Ret. In

    Security Act

    PROPERTY RIGHTS

    [x] 820Copyrights 830 Patent 840Trademark

    SOCIAL SECURITY 861 HIA(1395ff) 862Black Lung (923) 863DIWC/DIWW (405 (g)) 864SSID Title XVI 865RSI (405 (g))

    FEDERALTAX SUITS

    r-, 870 Taxes (U.S. Plaintiff orII Defendant)r-i 871 IRS-Third Party 26 USC

  • UNITED STS DISTRICT COURT, CENTRAL DISTRICT OF ^FORNIACIVIL COVER SHEET

    VIII. VENUE: Your answers to the questions below will determine the division of the Court to which this case will be initially assigned. This initial assignment is subjectto change, inaccordancewiththe Court's General Orders,upon reviewbythe Courtofyour Complaintor Noticeof Removal.

    QUESTION A: Was this case removedfrom state court?

    Yes [x] No

    If"no," skip to Question B. If"yes,"check thebox to the right that applies, enter thecorresponding division in response toQuestion E, below, and continue from there.

    STATE CASE WAS PENDING IN THE COUNTY OF: INITIAL DIVISION IN CACD IS:

    |~J Los Angeles, Ventura, SantaBarbara, or San Luis Obispo Western

    QUESTION B: Is the United States, orone of its agencies or employees, aPLAINTIFF in this action?

    Yes [x] No

    If"no," skip to Question C. If"yes," answerQuestion B.l, at right

    QUESTION C: Is the United States, orone of its agencies or employees, aDEFENDANT in this action?

    Yes [x] No

    If"no," skip to Question D. If"yes," answerQuestion C.l, at right.

    [~J Orange| | Riversideor San Bernardino

    B.1. Do 50% or more of the defendants who reside inthe district reside in Orange Co.?

    checkone of the boxes to the right ""'T'

    B.2. Do 50% or more of the defendants who reside inthe district reside in Riverside and/or San BernardinoCounties? (Consider the two counties together.)

    check one of the boxes to the right .

    C.I. Do 50% or more of the plaintiffs who reside in thedistrict reside in Orange Co.?

    check one ofthe boxes to the right m^'

    C.2. Do 50% or more of the plaintiffs who reside in thedistrict reside in Riverside and/or San BernardinoCounties? (Consider the two counties together.)

    check one ofthe boxes to the right m^r

    Southern

    Eastern

    YES. Yourcase will initially be assigned to the Southern Division.[~J Enter "Southern" inresponse to Question E, below, andcontinue

    from there.

    [~J NO. Continue to Question B.2.

    YES. Yourcase willinitiallybe assigned to the Eastern Division. Enter "Eastern" in responseto Question E, below, and continue

    from there.

    NO. Your case will initially be assigned to the Western Division. Enter "Western" in response to Question E, below, andcontinue

    from there.

    YES. Yourcase will initiallybe assigned to the Southern Division. Enter "Southern" in responseto QuestionE, below, and continue

    from there.

    NO. Continue to Question C.2.

    YES. Yourcase willinitiallybe assigned to the Eastern Division.I I Enter"Eastern" in response to Question E, below,and continue

    from there.

    NO. Yourcase willinitiallybe assigned to the Western Division.[~J Enter "Western" in responseto Question E, below, and continue

    from there.

    QUESTION D: Location of plaintiffs and defendants?A.

    Orange County

    B.

    Riverside or SanBernardino County

    Los Angeles, Ventura,Santa Barbara, or SanLuis Obispo County

    Indicate the location(s) in which 50% or more of plaintiffs who residein this districtreside. (Checkup to two boxes, or leave blank ifnone of these choices apply.)Indicate the location(s) in which 50% or more of defendants who reside in thisdistrict reside. (Check up to two boxes,or leave blank ifnone of these choicesapply.)

    D.I. is there at least one answer in Column A?

    Yes px] NoIf"yes,"your case will initially be assigned to the

    SOUTHERN DIVISION.

    Enter "Southern" in response to Question E, below, and continue from there.If"no," go to question D2 to the right "^

    QUESTION E: Initial Division?

    Enter the initial division determined by Question A, B,C, or D above:

    QUESTION F: Northern Counties?

    D.2. Is there at least one answer in Column B?

    [X] Yes NoIf"yes," your case willinitiallybe assigned to the

    EASTERN DIVISION.

    Enter "Eastern" in response to Question E, below.If"no,"your case willbe assigned to the WESTERN DIVISION.

    Enter "Western" In response to Question E, below.

    INITIAL DIVISION IN CACD

    EASTERN

    I

    Do 50% ormore ofplaintiffs ordefendants in this district reside in Ventura, Santa Barbara, orSan Luis Obispo counties? [H Yes No

    CV-71 (06/14) CIVIL COVER SHEET Page 2 of 3

  • UNITED 5H DISTRICT COURT, CENTRAL DISTRICT OFMFORNIACIVIL COVER SHEET

    IX(a). IDENTICAL CASES: Has this action been previously filed in this court?

    Ifyes, list case number(s):

    [x] NO YES

    IX(b). RELATED CASES: Is thiscase related (as defined below) to anycases previously filed in this court?Ifyes, list case number(s):

    NO YES

    Civil cases are related when they:

    Q A. Arise from the sameor closely related transactions, happening, or event;[] B. Call for determination ofthe sameorsubstantially related or similar questions of law andfact; orQ C. For otherreasons would entail substantial duplication of labor ifheard by different judges.Check all boxesthat apply. Thatcases may involve the same patent, trademark,or copyright isnot, in itself, sufficient to deem casesrelated.

    X. SIGNATURE OF ATTORNEY(OR

    IGNATURE OF ATTORNEY | r I SELF-REPRESENTED LITIGANT): L-VL) t Q> V\J \L- L^H< W^ DATE: September 16,2014

    Notice to Counsel/Parties: The submission of this Civil Cover Sheet is required by Local Rule 3-1. This Form CV-71 and the information contained hereinneither replaces norsupplements the filing andservice of pleadings orother papersas required bylaw, exceptas provided bylocal rules ofcourt. Formore detailed instructions, see separate instruction sheet (CV-071 A).

    Keyto Statistical codes relating to Social Security Cases:

    Nature of Suit Code Abbreviation Substantive Statement of Cause of ActionAll claims forhealthinsurance benefits(Medicare) underTitle 18,PartA, of the Social Security Act, as amended. Also,include claimsby hospitals, skilled nursing facilities, etc., for certificationas providers of servicesunder the program.(42U.S.C1935FF(b))

    All claimsfor "Black Lung"benefits under Title4, Part B, of the FederalCoalMineHealth and SafetyActof 1969.(30U.S C.923)

    All claims filed byinsured workers fordisability insurance benefitsunderTitle 2 of the Social Security Act, as amended; plusall claimsfiledforchild's insurance benefits based on disability. (42 U.S.C. 405 (g))

    All claimsfiledforwidows or widowers insurance benefits based on disabilityunder Title2 of the SocialSecurityAct, asamended. (42 U.S.C. 405 (g))

    All claims forsupplemental securityincome payments based upon disability filed underTitle 16ofthe Social Security Act, asamended.

    861

    862

    863

    863

    864

    865

    CV-71 (06/14)

    HIA

    BL

    DIWC

    DIWW

    SSID

    RSI All claimsfor retirement (old age) and survivorsbenefits under Title2 of the SocialSecurityAct, as amended.(42 U.S.C. 405 (g))

    CIVIL COVER SHEET Page 3 of 3