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

Case 1:06-cv-00046-JJF Document 7 Filed O2/27/2006 Page1 of3
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF DELAWARE
RICARDO A. DE LOS SANTOS MORA, )
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Plaintiff, P
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v. ) Civil Action No.O6—O46—JJF
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DELAWARE POLICE DEPARTMENT, ) _ _W__ “m“whm_
U.S- ATTORNEY, E ) F g } Q g) I
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Defendants. D i f
FEB 27 2006
AUTHORIZATION w_mWmnMMwmm“j _ __
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I, Ricardo A. De Los Santos Mora, Inmate Reg. ID# 27615083
request and authorize the agency holding me in custody to
disburse to the Clerk of the Court the initial partial filing fee
of $20.43 and the subsequent payments pursuant to 28 U-S.C. §
l9i5(b) and required by the Court*s order dated
gu;-- 2, _ , 2000.
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 $250.00. I also i
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 E
custody I may be transferred. {

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