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

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X Cas:e€:08~cv—G02<%4~J.§? iQ>c><:z.1me¤i6 Fiied 06/24/2018 Pageébfé
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FOR THE DISTRICT OF DELAWARE
1vAN L. MENDEZ, >
Plaintiff, i
v. i Civil Action No. 08-244-JJF
COUNSELOR LINDA KEMP, i . E iii, _ i O
LT. SEACORD, FIRST ) ~ ·I I` ·‘’‘ll ‘ I
CORRECTIONAL MEDICAL, WARDEN ) _ I I
Defendants. ) i N v_V_ W_ww,TLwL..Li .....
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AUTHORIZATION ¢D gfanFwJ
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. § l915(b) and required
by the Court's order dated %S>§§ 2 I ()§& , 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 authorization shall apply to any other agency into whose
custody I may be transferred.
Date.: Z I , 2008.
‘;X3§@ E KET ES ,K l
Signature of Plaintiff
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Case 1:08-cv-00244-JJF

Document 9

Filed 07/02/2008

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