Free Motion to Produce - District Court of Arizona - Arizona

Tiiiiiii Cii.21..w?1;.:; MUNEHTTEIT STATES DISTRICT COURT
A _ ‘ DISTRICTLOF ARIZONA
Fennando» GonazalezeBarrera --
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REQUEST TO PROCEED
v. IN FORJWA PA UPERIS I
` United Stated Of America

District Court Of Arizona Q
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- ‘ z z—·Barrer.a · - “
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I, _F@r¤&¤d¤ G¤1'L§§ _}_§.Z‘BaI Hara , (win: or type your name) am the plaintiff lpetitioner
in the above entitled case and I hereby request to proceed informa pauperis and without being —
required to prepay fees or costs or give security. I state that because of my poverty I am unable to
pay the costs of said proceeding or to give security therefor, and that I believe I am entitled to
redress.
1. If you are presently employed:
a) give the name and address of your employer
b) state the amount of your eamings per month
Northeast 0hioCorrectiona1Center


2. If you are NOT PRESENTLY EMPLOYED: _
a) state the date of start and termination of your last employment
b.) state your earnings per month
YOU MUST ANSWER THIS QUESTION EVEN IF YOU ARE IN CARCERATED.
‘
3. Haveyou received, within the past twelve months, any money from any source? If so, name
the source and the amount of money you received.
N o t

a) Are you receiving any public benetits? E1 No. I] Yes, $ .
b) Do you receive any income from any other source? E] No. El Yes, $ .
Case 2:02-cr-00900-JAT Document 251 -2 Filed 08/29/2007 Page 1 of 2

· 4. I Do you have any money, including any money in a checking or savings account? If so, how
. much? _
5. Do you own any apartment, house, or building, stock, bonds, notes, automobiles or other
property? If the answer is yes, describe the property and state its approximate value.
El No. Ei Yes, _ . ‘
6. List the person(s) that you pay money to support and the amount you pay each month.

7. Do you pay for; rent or for a mortgage? If so, how much each month?
Not: 4

8. State any special financial circumstances which the Court should consider.



I understand that the Court shall dismiss this case if I give a false answer to any questions in this
declaration. In addition, if I give a false answer I will be subject to the penalties for perjury.
I declare under penalty of perjury that the foregoing is true and correct. I °
signed this g 3 day Or__ ;_. .9.S/ , 720*2
date p month year
_a.¤... .,—.. .4L.—.. _
MISTYL. KIMMELL
Notary Public
rev. 3/2006 in and for the State of Ohio .
My Commission Expires
June 6, 2010 __
Case 2:02—cr—00900 1 -2 Filed 08/29/2007 Page 2 of 2 2 .
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Case 2:02-cr-00900-JAT

Document 251-2

Filed 08/29/2007

Page 1 of 2

Case 2:02-cr-00900-JAT

Document 251-2

Filed 08/29/2007

Page 2 of 2