Complaint (Eastern District)

COMPLAINT. This form is used in the United States District Court for the Eastern District of Texas, seeking judicial review of a decision made by the Commissioner of the Social Security Administration. The Plaintiff, who is adversely affected by the decision, provides personal details and information about the decision being challenged. The Plaintiff has exhausted administrative remedies in this matter and this Court has jurisdiction for judicial review pursuant to 42 U.S.C. 495(g). The Plaintiff shall effect proper service of process by serving a copy of the summons and complaint upon the local United States Attorney, the Attorney General of the United States, and the Secretary of Health and Human Services within 120 days from the date of filing this complaint according to Rules 4(j) and 4(m) of the Federal Rules of Civil Procedure and Local Court Rule CV-4. www.FormsWorkflow.com