Free Motion for Leave to Proceed in forma pauperis - District Court of Delaware - Delaware

Case 1:08-cv-00156-JJF D0cument1 Filed O3/19/2008 Page1 0 p
N IN THE UNITED STATES DISTRICT COURT 0 BJ- . 5 6
. FOR THE DISTRICT OF DELAWARE [
Verlin J. Alexander, I
Plaintiff, `
v. ' Civil Action No. T0 be provided
Several Unknown Named ATF, °
U.S. Marshal, and FBI Agents, : Declaration in Support of Motion
and _ to Proceed in Forma Pauperis
Several Unknown Named Delaware ° . . .,.. .1l .._.. “..,m.,
State Police and Delaware 2 V"` ; , Q {E {
Probation and Parole Agents, _ Z ‘m°Wf;mEN£pwj i
D . ° l 1 i
efendants . 5 6%/ E i
` LA .‘—-. F`; E0 2008 g
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‘J€ 0??*?CTCOORT g
- .Q.tj Q-? ”____:
I, Verlin J. Alexander, am the plaintiff in the above titled
case. In support of my motion to proceed without being required to prepay
fees or cost or give security therefore, I state that because of my poverty
I am unable to pay the cost of said proceedings or to give security therefore
and I believe that I am entitled to redress.
I declare that the responses which I have made below are true.
1. If you are presently employed, state the amount of your salary wage
per month, and give the address of your employer: Not Applicable
2. If you are not presently employed, state the date of your last employment
and amount of your salary that you received and how long you were at that
employment: December 2006, approximately 1 year, $7.50 HR. 40 HR. Week
3. Have you received in the past 12 months, any money from any of the
following sources:
A. Bussiness, proffesion or form of self-employment? No
p B. Rent payments, interest or dividends? No
H L C. Pensiods, annuities, or life insurance payments? No
D. Gifts or inheritances? No
E. Any form of public assistance? No
F. Any other source? No
p If the answer is yes to any of the above sources, describe each source
of money, and amount received in past 12 months: Not Applicable

Case 1 :08-cv-00156-JJF Document 1 Filed O3/19/2008 j Page 2 of 2
A. Do you have any cash in a checking or savings acount? No
5. Do you own any type of real estate, stock, bonds, note, automobiles,
'or any other valuable property? No
6. List persons who are dependant upon you for support: Not Applicable
7. If you live in a rented apartment or other rented building, state the
amount of rent you pay: Not Applicable
8. State any special financial circumstances which the court should consider
in this application: The plaintiff is an indigent inmate within a state
correctional facility
I understand that a false statement or answer to any questions
in this declaration will subject me to the penelties of perjury.
I DECLARE UNDER THE PENELTY OF PERJURY THAT THE FOREGOING IS
TRUE AND CORRECT.
Signed this TH day of ·!ZZQRG}1l , 2008.
Verlin . Alexander
" —
e of Birth
Social Security Number ll

Case 1:08-cv-00156-JJF

Document 1

Filed 03/19/2008

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Case 1:08-cv-00156-JJF

Document 1

Filed 03/19/2008

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