Free Order (PLRA) for Pay Authorization - District Court of Delaware - Delaware

Case 1:05-cv-00630-KAJ Document 7-3 Filed 10/21/2005 Page 1 of 1
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF DELAWARE
FAMOUS B. RHOADES, )
Plaintiff, i
v. i Civil Action No. 05-630 JJF
CORRECTIONAL OFFICER CARLTON g
ADAMS, CORPORAL W. CAMPBELL, )
JOSEPH BELANGER - SHIFT )
COMMANDER, AND LIEUTENANT )
LARRY SAVAGE — DISCIPLINARY )
HEARING OFFICER, )
Defendants, i
AUTHORIZATION
I, Famous B. Rhoades, request and authorize the agency
holding me in custody to disburse to the Clerk of the Court the
initial partial filing fee of $3.33 and the subsequent payments
pursuant to 28 U.S.C. § l915(b) and required by the Court’s order
dated QC;QbQI 2] , 2005.
This authorization is furnished in connection with the l
filing of a civil action, and I understand that the filing fee
for the complaint is $250.00. I also understand that the entire
filing fee may be 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 he transferred.
Date: , 2005.