Free Authorization Form (PLRA) - District Court of Delaware - Delaware

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Case 1:08-cv-00368—GIV|S Document 10 Filed 07/09/2008 Page 1 of 2
I I L {E 0 ;
IN THE UNITED STATES DISTRICT COURT I JU W A Y
? L — 0 3338 ¤ §
FOR THE DISTRICT OF DELAWARE f g
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’ U.S.QiSl*`CT CQLJRI QF 1
DONALD L. SHEPHERD, ) 1 {;;g"sr-;jj;‘,;g$r¤_»,¤¤·.¤;g if
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Plaintiff, )
)
v. ) Civil Action No. OB-368-GMS
)
CARL DANBERG, COLLEEN BELL, )
OFFICER/LT. DEIFO, OFFICER/LT. )
SENATO, OFFICER/ LT. SEBATO, )
TRACY WILKINS, and }
PERRY PHELPS. )
)
Defendants. )
AUTHORIZATION
I, Donald L. Shepherd, SBI #l24625, request and authorize
the agency holding me in custody to disburse to the Clerk of the
Court the initial partial filing fee of $18.32 and the subsequent
payments pursuant to B U.S.C. § l9l5(b) and required by the
Court’s order dated , 2008.
This authorization is furnished to the Clerk of Court in
connection with the filing of a civil action, and I understand
that the filing fee for the complaint is $350.00. I also
understand that the entire filing fee may bo deducted from my
trust account regardless of the outcome of my civil action. This
authorization shall apply to any other agency into whose custody
I may be transferred.
nate; 7[ {é[;;)X , 2008.
Signature of Pfaintiff

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Case 1:08-cv-00368-GMS

Document 10

Filed 07/09/2008

Page 1 of 2

Case 1:08-cv-00368-GMS

Document 10

Filed 07/09/2008

Page 2 of 2