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

Case 1:08-cv—00397-JJF Document 10 Filed 07/15/2008 Page 1 of 3
Case 1:08~ov—003Q7~JJF" Document 9—2 Fééed O?/10/2008 Page 1 ex'2
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF DELAWARE
DANIEL M. WOODS, )
)
Plaintiff, )
)
v. ) Civil Action No. 08-397-JJF
)
FIRST CORRECTIONAL MEDICAL )
INC., CORRECTIONAL MEDICAL )
SERVICES INC., L.P.N. LISA )
SUGER, NURSE QUANNY, R.N. ) *Wwm_NmmmM“_MML .,.. i
JAMILLA MCKENZIE, NURSE VERIA, ) { F I L F' G i
NURSE RICHARD, JOHN DOE, ) i _,;..L.1
JANE DOE, RONNIE MOORE, ) { E 1 Q
INVESTIGATOR BRENDA LUCAS, ) g { JUL li egg 2 {
DELAWARE CORRECTIONAL CENTER, ) i l V KJ Q 1
DR. NIEZ, AND JOHN/JANE DOE ) E · ww*mwC§@C;;_J g
DIRECTOR OF MEDICAL AT DCC ) E USyg@gQ@RT i
2°O7·2OO8· ) ,.E‘?.’E’*f-?;i.?§l;fQ‘i5,’?i€...-.........J
*
)
Defendants. )
AUTHORIZATION
I, Daniel M. Woods, SBI #164728 , request and authorize the
agency holding me in custody to disburse to the Clerk of the
Court the initial partial filing fee of $10.33 and the subsequent
payments pursuant to 28 U.S.C. § 19I5(b) and required by the
Court’s order dated 7 ’\O {O`§ , 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 be deducted from my
trust account regardless of the outcome of my civil action. This

Case 1:08-ov—00397-JJF Document 10 Filed 07/15/2008 Page 2 of 3
Cassewl:08-cv*00397~JJF Document9~»2 Fi1ed0?/10/2008 F°age2of2
authorization shall apply to any other agency into whose custody
I may be transferred.
Date: { { fO_-Z' @@3 , 2008.
1. o .o,.__ xr
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»/’ ,, . X,
[ _»'V _f,.“-/‘ Signature of Plaintiff
2 ,

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Case 1:08-cv-00397-JJF

Document 10

Filed 07/15/2008

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Case 1:08-cv-00397-JJF

Document 10

Filed 07/15/2008

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Case 1:08-cv-00397-JJF

Document 10

Filed 07/15/2008

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