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

Case 1:07-cv-00257-JJF DOcument8 Filed 06/07/2007 Page1 0f2
IN THE UNITED STATES DISTRICT COURT
ROR THE DISTRICT OF DELAWARE
DANIEL M. WOODS )
)
Plaintiff, )
)
v. ) Civil ActiOn NO. 07-257-JJP
)
BOARD OF PAROLE, )
COMMISSIONER STANLEY TAYLOR, )
EX—WARDEN PATRICIA CARR, )
WARDEN RAPHAEL WILLIAMS. ) pp _V
WARDEN D.C.C. THOMAS CARROLL, ) ;··"T *·I §j§g‘@E@‘””“`§ ‘‘‘‘
RECORDS SUPER CINDY WRIGHT, ) Q _,,. .rArsA.EL;La1 §
BRENDA CALLOWAY, L. SULLIVAN, ) § ‘ Q
V. HAYES, P. RITER, ) { I JUNl.§2mH E
C. ESCHERICH, ELW JANE DOE, ) i C` I, I i
>
. ¤~»3h¥mx LJ. é
D€f€IldE.I.1’1*CS. E `-’
AUTHORIZATION
I, Daniel M. WOOdS, SBI #l64728 , request and authcrize the
agency hOlding me in custOdy tO disburse tO the Clerk Of the
COurt the initial partial filing fee Of $9.02 and the subsequent
payments pursuant tO 28 U.S.C. § l9l5(b) and required by the
COurt’ s Order dated 5[ 25-( 02 , 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 acccunt regardless Of the OutcOme Of my civil acticn. This
authcrizaticn shall apply tO any Other agency intO whOse custcdy
I may be transferred.
Date: Q I/·~Q? , 2007.
O ,_ Lg
Signature Of Plaintiff I

Case 1 :07-cv—00257-JJF Document 8 Filed 06/07/2007 Page 2 of 2
77 _ E,
J 7 @5
2/ X ¤ :
I il igg 7 iQ %
» K @7 7 { i
,7 _q,0,a Q % 7
-. 7 $7 me-ee \h 7% 7
.7 ` $$25; } * \ Nr; - 75
u 7 7 7777 7 xw 7
2%
(ll V
7 X 7 ‘ _ __ 7p
` ‘ 7 ¤ ` ‘ 0 - 7
°¤ 7 7‘
“ . E
.L _ i J 5
» · \ £ i
z 7 é
7g ~ \>
if-5 § 7 . —
, z*}1`T· ` 7
:¤ P Q 7 . 7
Q 2 7% 7 s
its 7;% aa. ;
EP ` T
we a 7. 7