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Plaintiff (list names): Dillon Anderson II
Case Number (for clerk):
One.
The Plaintiff (the person, business, or public entity that is suing) is: Dillon Anderson II
Name: Dillon Anderson
Phone: # 859077
Street Address (Street, City, State, Zip): Grove Street, Los Santos
Mailing Address (if different):
If more than one Plaintiff, list next Plaintiff here:
Name:
Phone:
Street Address (Street, City, State, Zip):
Mailing Address (if different):
Two.
The Defendant (the person, business, or public entity being sued) is:
Name: Altha Jarry III (#1500) of the LSPD
Phone: Unknown or 911
Street Address (Street, City, State, Zip): Police Plaza, Los Santos
Mailing Address (if different):
If more than one Defendant, list next Defendant here:
Name:
Phone:
Street Address (Street, City, State, Zip):
Mailing Address (if different):
Three.
The Plaintiff claims the Defendant owes $2,000,000
Four.
List the evidence you have regarding the claims listed in three.
Five.
You must ask the Defendant (in person, in writing, or by phone) to pay you before you sue. Have you done this?
Six.
I understand that by filing a claim in court, I have no right to appeal this claim.
I declare, under penalty of perjury under San Andreas State law, that the information above and on any attachments to this form is true and correct.
Date: 28/02/14 Dillon Anderson II Dillon Anderson II
Date: INSERT 2ND PLAINTIFFS NAME 2ND PLAINTIFFS NAME
Plaintiff (list names): Dillon Anderson II
Case Number (for clerk):
One.
The Plaintiff (the person, business, or public entity that is suing) is: Dillon Anderson II
Name: Dillon Anderson
Phone: # 859077
Street Address (Street, City, State, Zip): Grove Street, Los Santos
Mailing Address (if different):
If more than one Plaintiff, list next Plaintiff here:
Name:
Phone:
Street Address (Street, City, State, Zip):
Mailing Address (if different):
Two.
The Defendant (the person, business, or public entity being sued) is:
Name: Altha Jarry III (#1500) of the LSPD
Phone: Unknown or 911
Street Address (Street, City, State, Zip): Police Plaza, Los Santos
Mailing Address (if different):
If more than one Defendant, list next Defendant here:
Name:
Phone:
Street Address (Street, City, State, Zip):
Mailing Address (if different):
Three.
The Plaintiff claims the Defendant owes $2,000,000
[*=left]Why does the Defendant owe the Plaintiff money? In a recent commission with the LSPD and unknown street gangs the officer in question deemed it fit to shoot at my vehicle (Civilian) with a lethal use of force (MP5) in order to get me to leave the scene (which I was doing) The officer committed criminal damage and endangered my life.
[*=left]When did this happen? (Date): 28/02/15
[*=left]If no specific date, give the time period: Date started: INSERT HERE Through: INSERT HERE
Four.
List the evidence you have regarding the claims listed in three.
- Evidence 4.1
- Detail the items/pictures name
- Video recording
- The recording would show the scenes before hand and the moment the vehicle was shot at.
- Evidence 4.2
- Detail the items/pictures name
- Pictures
- These would show the damages done to the vehicle
Five.
You must ask the Defendant (in person, in writing, or by phone) to pay you before you sue. Have you done this?
[*=left][X] Yes ---------- [] No
Six.
I understand that by filing a claim in court, I have no right to appeal this claim.
I declare, under penalty of perjury under San Andreas State law, that the information above and on any attachments to this form is true and correct.
Date: 28/02/14 Dillon Anderson II Dillon Anderson II
Date: INSERT 2ND PLAINTIFFS NAME 2ND PLAINTIFFS NAME
