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

Case1:O7—cv-00209-GIVIS D0cument5 Filed 05/O4/2007 Page10f2
IN THE UNITED STATES DISTRICT COURT.
FOR THE DISTRICT.OF DELAWARE I
SHAWN WRIGHT, )
Plaintiff, i
v. i Civil Action No. 07-209-GMS
JAMES E. LIGUORI, LIGUORI, E
MORRIS AND YIENGST, )
Defendants. i
AUTHORIZATION _
I, Shawn Wright, Inmate Registration #40987050, request and
authorize the agency holding me in custody to disburse to the
Clerk of the Court the initial partial filing fee of $59.81 and
the subsequent payments pursuant to 28 U.S.C. § l9l5(b) and
required by the Court's order datad(Q%]é!£ ;; E; , 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.
Date: if ZOO'? , 2007.
"ignature of Plaintiff

I
I Am ci;] 1; 1
Case 1 :07-cv-OO209;GI\/IS Docu F||edp40-5/QA/ZQOZQ ;Page 2 of 2
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