Free Motion for Leave to Proceed in forma pauperis - District Court of Delaware - Delaware

, _ k` _ _ K Case 1 :07-cv-00749-JJF Document 25 Filed 12/28/2007 Page 1 of 2
I AO 2·t0(D£t..¤.wArLE F.E\"»'.0l1) _ - l I i '.
UNITED STATES DISTRI CTACOURT T" pp ‘ _1
_ DISTRICT OF DELAWARE
MARCUS MRM HJLL _ .
Plaintiff APPLICAHON TO PROCEED
‘ ‘ WITHOUT PRJEPAYMENT OF
V. D 1 FEES AND AFFLDAVIT
_ permeate; cass uumaeaz l PG ·€’J·C-#06 ani? ll E lf p
fp Nb!/`CUQY ?>Q#’"/\./{ /I _ declare that I am the (check appropriate box)
Petitioner B/Iovant I] Othe·r in the above-entitled proceeding; that in support of my
request to procee without prepayment of fees or costs under 28 USC §l9 15, I declare that I arn
una e to pay the costs of these proceedings and that I am entitled to the relief sought in the
com tn etition/rnotion.
e In support of this application, I answer the following questions under penalty of perjury:
1. Are you currently incarcerated? o (If "N0" go to Ques ‘ “ ·· 3.;; y_.;._.. , ___4_p__ _____ I
- -i`. l `_-’t tpop _
If "YES" state the place of your incarceratio . ` - -- ; l
. -. D. . :e· 5
Are you employed at the institution? EJ Yes 0 y 2 8 _.
J - - - .7 I _ il · l;§3·E'?’*¤" -· i—-a-- rr__
DQ YOU IBCCIVC Elly [email protected]€Hl`. from the Institution- lj YES NO n · -
r . "*~’—a ee·e .
Have the institution {ft/I out the certin`cate portion ofthis affkfavit and attach a /ed/ear sheet from in ` _
institution/sl of t-can- incarceration s/rowing at least the east SIX mont/rs’zi·oirsacrtons. Leda, er
s/teets are not reauired for cases fi/ed gurstranr to 28;USC §2254.
2. Are you currently employed? E Yes (Elf
a. elf the answer is "YES" state the amount of your talte—ho e salary or wages and pay period and
give the narne and address of your employer. fri?
b. If the answer is "NO" state the date of your last employment, the amount of your take-horne
- salary or wages and pay period and the name and address of your last employer. Aj
3. Ln the past 12 twelve months have you received any money from any ofthe following sources?
a. Business, profession or other self-employment E Yes
b. Rentpayrnents, interest or dividends [I Yes t
c. Pensions, annuities or li insurance payments K] Yes
cl. Disability or workers compensation payments . El Yes Q}? .·»
e. Gifts or inheritances C] Yes M
F. Any other sources H C] Yes No y
lf the answer to any ofthe above is "YES" describe each source of money and state the amount
received AND what you expect you will continue to receive. M ` ` M

( · _ Case 1:07-cv-00749-JJF Document 25 Filed 12/28/2007 Page 2 of 2
Q-- D0 Z-/Ol-1 hve ang cashor checking or savings accounts? Hi Yes [Q4! ‘ .
if "Yes" state the total amount S ` _ ' s ‘
I 5_ - DO you O·,~,·¤‘my real estate, stocks, bonds, securities, other financial in El5-ile; Oy `
other valuable properly? K] Yes r ‘o
1f"Yes" describe the property and state its value, '
6. - List the persons who are dependent on you for support, state your relationship to each person and
indicate how much you contribute to their support, OR state .\fOi\/E if applicable.
N ®~/di to Ropiaseal a .
2..} le ° /WOi’l~Q_t“?}?‘ ` .-
\
I declare under penalty of perjury that the above infomation is true and correct. _
. , c, ;L ‘ ~ . _. * .
Date: O Signature of`Applicant M K ‘ I; __; · . 4

. · Case 1:07-cv-00749-JJF Document 25-2 Filed 12/28/2007 Page 1 of 2
INMATE ACCOUNT STATEMENT
MARCUS BARNHILL 14-Dec-07 ;
NAME SCCCADMET DATE |
505585
DATE RELEASED I
A Type of DISBURSE Type of
DATE DEPOSITS De osit MENT Disburs. BALANCE i
$0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 T $0.00 $0.00
. $0.00 l $0-.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00 E
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00 ·
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00 .
$0.00 $0.00 $0.00 $0.00 A
$0.00 $0.00 $0.00 $0.00 $
$0.00 $0.00 $0.00 $0.00 T
$0.00 $0.00 $0.00 $0.00 I
. $0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00
TOTAL $0.00 $0.00 $0.00
$0.00
OPENING BALANCE
$0.00
ACCOUNT BALANCE
TYPE OF DISBURSMENTS -
R/B room/board owed from previous visits to SWRU
MED = Visits to medical
TRANS = transportation owed from previous visits - .
P2 = Pay to's submitted thru business office l
DG = Dollar General/commissary ‘
TRANSF Transfers to Other institutions
SP. COURT Superior Court
TYPE OF DEPOSITS
M/O = money orders received outside of institution
B/R = booking and receivng
CK = checks
CASH _
I /\/V = inmate wages
VIOLATlON OF PROBATION/SCCC

_. g Case 1 :07-cv-00749-JJF Document 25-2 Filed 12/28/2007 Page 2 of 2
REQUEST FORM
FOR
INMATE ACCOUNT ACTIVITY STATEMENT .
Inmate Name: (Boer tx IQQJQ lV\a_vgA5 rb SBI Number: C) CDS B 3S? S`
(Last) ' (First) (M.I.)
Housing Unit: *‘ pe A gl A
In accordance with Bureau of Prisons Procedure 5.4 entitled "In Forma Pauperis’”, please provide a
summary of my account transactions.
u rr a [ — A
- ...@,:;4__._C A!
Inmate Signature U ta f
Inmate Account Activity Statement will be processed • ¤ atter s ff verifies your legal documents are _
complete. `
Date received by business office: Z . U
[NMATE ACCOUNT STATEMENT
TO: Inmate Name: lgur K.,}-»( 9 Y gig ID
(Last) (First) (Ml.)
SBI Number: L)C2> Sc, $5 FSP E
Housing Unit: U 0~O -· Pu .) gp
I F R: U Inmate Account Technician U
DA:
RE: Summary Of Account
Attached is your account statement for the six month period of ¢D”€(L , 9*00 Z (
through .91 0-dc., , (94:07 . ·
Utilizing the c ion formula described in BOP Procedure 5.4, your average daily balance for this
period is $ . __
Attachment ’
‘• ‘

Case 1:07-cv-00749-JJF

Document 25

Filed 12/28/2007

Page 1 of 2

Case 1:07-cv-00749-JJF

Document 25

Filed 12/28/2007

Page 2 of 2

Case 1:07-cv-00749-JJF

Document 25-2

Filed 12/28/2007

Page 1 of 2

Case 1:07-cv-00749-JJF

Document 25-2

Filed 12/28/2007

Page 2 of 2