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

Case 1:08-cv-00072-JJF Document 7 Filed O3/28/2008 Pagei of2
Case 1:08-cv-00072-JJF Document 6 Filed O3/24/2008 Page? of 5
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IN THE UNITED STATES DISTRICT COURT Ie fe o,3%
EoE THE DISTRICT OF DELAWARE
RAYMOND E. BLAKE, i
Plaintiff, g
V. i Civil Action Na. oo-72-JJE
ooooras NEAL, JAY J. KING, i
WILLIAM BAKER, TRAVIS LOWE, i
Defendants. ;
AUTHORIZATION
I, Raymond E. Blake, SBI # 377092, request and authorize
the agency holding me in custody to disburse to the Clerk of the
Court the initial partial filing fee of $53.33 and the
subsequent payments pursuant to 28 U.S.C. 5hI9I5(b) and required
by the Court's order dated ‘”@Gl;j[ gl? , 20OB.
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; [lf]Q¢"’Ch I.9~:?"H/I , zoos.
, ‘ I
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Case 1 :08-cv-00072-JJF Document 7 Filed O3/28/2008 Page 2 0f 2
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Case 1:08-cv-00072-JJF

Document 7

Filed 03/28/2008

Page 1 of 2

Case 1:08-cv-00072-JJF

Document 7

Filed 03/28/2008

Page 2 of 2