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

Case 1:05-cv—00306-JJF Document 6-2 Filed 07/07/2005 Page 1 of 1
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF DELAWARE
IVAN L. MENDEZ, )
)
Plaintiff, )
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v. ) Civ. No. 05-306-JJF
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DELAWARE PSYCHIATRIC CENTER, )
)
Defendant. )
AUTHORIZATION
I, Ivan L. Mendez, SBI #453351, request and authorize the
agency holding me in custody to disburse to the Clerk of the
Court all payments pursuant to 28 U.S.C. § l9l5(b) and required
by the Court’s order dated , 2005.
This authorization is furnished in connection with the
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 5
to any other agency into whose custody I may be transferred. l
Date: , 2005.
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Ivan L. Mendez
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