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

Case 1:05-cv-00763-GI\/IS Document 1-2 Filed 11/O2/2005 Page 1 0f 2
DELAWARE C ORRE C TIONAL CENTER
SUPPORT SER VICES OFFICE
MEMORANDUM
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TO: gjflwttk \/LLM gig; se1#.-_3‘;f(OO’jYp
FROM: Stacy Shane, Support Services Secretary
RE: 6 Months Account Statement
DATE.- ©C,j_i;bg A ’1 ,;;Qg*_,g”#;
Attached · of you; ininate accountstatge(Fg¢e§J{€Q;thT..mo}nths-ot ` s_ __ _
T he following indicates the average daily balances. I - - _
MONTH AVERAGE DAILYBALANGE T 1
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Q'; Mg gg ct? *1 Q3
55/ t
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Average daily balances/6 months: / I O
Attachments
CC: File
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_ Case 1:05-cv-00763-Gl\/IS Document 1-2 Filed 11/O2/2005 Page 2 of 2
I CERTIFICATE
(Incarccratcd applicants only)
_ (T0 be COIN l?{,’i'(’£1'.IJ`l' Jfre itisrifrtrirm ri `iii·c·rrrr:r¤r:tram

I certify that the applicant named herein has the sum o€S on account hisfher credit at (name
\ , I
of institution) ° ,- CN /'/I .
I hirther certify that the applicant has the following securities to liisltlier credit; _ 2
I Further certify that during the past six months the applicants average monthly balance was S i L 2 O
and the average monthly deposits were S &\ [
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io\”t lm I l
Date ignature o€Atitl rizcd Officer
(NO TE THE REQUIRE MENTTIV I TE M I FOR THE ITVM4 TE TO OBTAIN AND A T TA CH LEDGER
SHEETS OEACCOUNT TRANSACTIONS OVER THE PAST SIX MONTH PERIOD. LEDGER SHEETS
ARE NOTREQUIRED FOR CASES FILED PURSUANT TO 28: USC [$2254)