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


File Size: 44.1 kB
Pages: 1
Date: July 2, 2008
File Format: PDF
State: Delaware
Category: District Court of Delaware
Author: unknown
Word Count: 245 Words, 1,502 Characters
Page Size: 614 x 792 pts
URL

https://www.findforms.com/pdf_files/ded/40167/10.pdf

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IN THE UNITED STATES DISTRICT co T
Eoa THE DISTRICT os DELAWARE
TVAN L. MENDEZ, >
Plaintiff, i
v. i Civil Action No. 08-243-JJF
LATISHA M. REED, i
Defendants. i
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. § 1915(b) and required
by the Court’s order dated , 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: , 2008.
.
.00 i liirl W lfln 4 Signature of Plaintiff
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Case 1:08-cv-00243-JJF

Document 10

Filed 07/02/2008

Page 1 of 1