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

Case 1 :08-cv-00396-SLR Document 5 Filed 07/31/2008 Page 1 of 2
IN THE UNITED STATES DISTRICT COURT
FOR THE DIS`|'RICT OF DELAWARE
BERNARD F. WOODS, )
I
Plaintiff, )
I
v. ) Civ. No. 08-396-SLR
I
BRIAN GRANT, MARK GRAJEWSKI, ) . . .... . .
TERRY OCONNOR, AND TRAVIS ) F | gw § D
MCDERMOTT, ) i
I . .
) JUL 31 2008 .
Defendants. )
U.S. DISTRIET COURT
AUTHORIZA'I'ION DISTRICTOF DELAWAR .
gg) SC<1m
I,Bernard F. Woods, SBI #215300, request and authorize the agency holding me
in custody to disburse to the Clerk of the Court the initial partial filing fee of $17.47 and
the subsequent payments pursuant to 28 U.S.C. § 1915(b) and required by the Court’s
order dated {zifljlld L2 M , 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 forthe complaint is $350.00. I also
understand that the entire tiling 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 be transferred.
Date: Oyctjy X2. M , 2008.
7;) / __.. /7 l ¢
,Jz;mzz¢g { T ,»y,;z<>; zz
Signature of Plaintiff

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Case 1:08-cv-00396-SLR

Document 5

Filed 07/31/2008

Page 1 of 2

Case 1:08-cv-00396-SLR

Document 5

Filed 07/31/2008

Page 2 of 2