Case 1:07-cv-00777—G|\/IS Document 6 Filed 12/14/2007 Page 1 of 2
IN THE UNITED STATES DISTRICT COURT 1
FOR THE DISTRICT OF DELAWARE E
-
MARQUIS MASON, ) g
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Plaintiff, ) 1
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v. ) Civil Action No. 07-777-GMS
RAPHEAL WILLIAMS, SUPERVISOR ) F l L § y
JILL WALTERS, AND MEDICAL ) ‘ ;- ~ ..~ ~- »-—-—- ·~~ ` A
coMMITTE > g 3 f { j
1 Q DEC 14 2007 Q 1
Defendants. ) ; f g f y
ca n I E 2:
AUTWRIZATION y __ .,.. I .. FST G ..,... . _L._ _ I 1
QD scanned g?
I, Marquis Mason, SBI #506146, request and authorize the
agency holding me in custody to disburse to the Clerk of the 1
Court the initial partial filing fee of $41.13 and the subsequent l
payments pursuant to 28 U.S.C. § l915(b} and required by the i
Court's order dated , 2007.
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.
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Date: \i2,7 \i" , 2007.
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Signature of Plaintiff
Case 1:07-cv-00777#G|\/IS D0cument_6 Filéd 12/14/2007 P·ag(e20f2
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Case 1:07-cv-00777-GMS
Document 6
Filed 12/14/2007
Page 1 of 2
Case 1:07-cv-00777-GMS
Document 6
Filed 12/14/2007
Page 2 of 2