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

Case 1:07-cv-00392-SLR Document 9 Filed 07/25/2007 Page 1 of 1
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT O F DELAWARE
SALIH HALL, KENNETH M. SMITH, )
and LLOYD DIXON, III, )
Plaintiffs, ;
v. g Civil Action No. 07-392-SLR
GOVERNOR RUTH ANN MINNER, g ·- ·· -- -.»I _
Josspn Banu sloerwnivres T. ) - _, M E _,,_,,_,,_,, Q
VAUGHN, CARL C. DANBERG, and ) - ·
` RENATA HENRY, ` g -
D“S““"`S‘ ) ry ii
AUTHORIZATION ED 5 mhz- r ‘I‘· · ·····
I, Kenneth M. Smith, SBI #193906, request and authorize the agency holding me
in custody to disburse to the Clerk ofthe Court the initial partial tiling fee of $20.79 and
the subsequent payments pursuant to 28 U.S.C. § 19‘l5(b) and reouired by the Court’s
order dated June 29, 2007.
This authorization is furnished to the Clerk of Court in connection with the Hiing
of a civil action, and I understand that the filing fee for the complaint is $350.00. t also
understand that the entire filing- fee may be deducted from my trust account regardless .
ofthe outcome of my civil action. This authorization shall apply to any other agency ,
into whose custody I may be transferred. n l
oare; 7- gi 5 -— , 2007.
Sig nature of Plaintiff l