CACI No. 3001

Factual Elements (42 U.S.C. § 1983)

[Name of plaintiff] claims that [he/she/ nonbinary pronoun] was deprived of

[his/her/nonbinary pronoun] civil rights as a result of an official [policy/

custom] of the [name of local governmental entity]. To establish this claim,

[name of plaintiff] must prove all of the following:

1. That the [name of local governmental entity] had an official [policy/

custom] [specify policy or custom];

2. That [name of offıcer or employee] was an

[officer/employee/[other]] of [name of local governmental entity];

3. That [name of offıcer or employee] [intentionally/[insert other

applicable state of mind]] [insert conduct allegedly violating

plaintiff’s civil rights];

4. That [name of offıcer or employee]’s conduct violated [name of

plaintiff]’s right [specify right];

5. That [name of offıcer or employee] acted because of this official

[policy/custom].

New September 2003; Revised December 2010; Renumbered from CACI No. 3007

and Revised December 2012