Free Motion for Leave to Proceed in forma pauperis - District Court of Delaware - Delaware

Case 1 :06-cv-00034-JJF Document 1 Filed 01/17/2006 Page 1 of 3
~ ` AO 240 (Rem I0/03)
DELAWARE Rev. 4/D5
UNITED STATES DISTRICT COURT
DISTRICT OF DELAWARE
Piamnrr APPLICATION TO PROCEED
__ ___ V. ( WITHOUT PREPAYMENT OF
{Q JQ bg; Z Z . FEES AND AFFIDAVIT
Defendant(s) . P
CASE NUMBER: Q G ’ 3 'jt
I, gx err}; QZ KX pid. gig ` Q, are thatl am the (check appropriate box)
IDX Petitioner/Plaintiff/Movant El Other
in the above-entitled proceeding; that in support of my request to proceed without prepayment of fees or costs under
28 USC §l9l5, I declare thatl am unable to pay the costs of these proceedings and thatI am entitled to the relief
sought in the complaint/petition/motion.
as
In support of this application, I answer the following questions under penalty of perjury:
l. Are you currently incarcerated? El Yes No (If "No" go to Question 2)
If "YES" state the place of your incarceration e;_`fȤPI
Inmate Identification Number (Required): 4 g.;
A ;;
Are you employed at the institution? ou receive any payment from the institution?'“/€/
Attach a ledg er sheet iam the institution of your incarceration showing atleast the gast six months ’
transactions
l 2. Are you currently employed? El Yes M
a. If the answer is "YES" state the amount of your take-home salary or wages and pay period a
and give the name and address of your employer.
b. If the answer is "NO" state the date of your last employment, the amount of your take-home
. salary or wages and pay period and the name and address of your last employer. [jg Uiynétgf
3. In the past 12 twelve months have you received any money from any of the following sources?
a. Business, profession or other self-employment U Yes fic
b. Rent payments, interest or dividends El Yes Q/No
c. Pensions, annuities or life insurance payments El Yes Jo
d. Disability or workers compensation payments El Yes we
e. Gifts or inheritances El Yes o
f. Any other sources U Yes No
If the answer to any of the above is "YES" describe each source of money and state the amotuit
received AND what you expect you will continue to receive.

Case 1 :06-cv-00034-JJF Document 1 Filed O1/17/2006 Page 2 Of 3
COURT OF COMMON FLEAS CRIMINAL DOCKET Fage 1
( as Of 01/17/2006 )
State Of Delaware v. ERIC M WHITTLE DOB: II/20/1962
State's Atty: , Esq. AKA: ERIC WHITTLE
Defense Atty: JAMES A NATALIE , Esq. ERIC WHITTLE
Assigned Judge:
Charges: I
Ceunt DUC# Cr1m.Act1On# Descripticn Dispe. Dispe. Date
001 0309005188 MNO3094442 CRIM IMFERSON
002 0309005188 MN03094443 DR LIC SUSF/REV
003 0309005188 MNO3094444 INSURANCE CARD
004 0309005188 MNO3094445 DISREGARD DEVIC
005 0309005188 MN03094446 OFER UNREG Mv
Event :
NO. Date Event Judge
09/26/2003
CASE FILED ON 09/26/2003; ARREST DATE 08/22/2003
ARRAIGNMENT SCHEDULED FOR 12/01/2003
_ RELEASED/OWN RECOG. 0.00
12/03/2003 I
DEFENDANT PLED NOT GUILTY AND DEMANDED JURY TRIAL.
12/03/2003
JURY TRIAL SCHEDULED FOR 03/15/2004 AT 08:30 AM
03/15/2004
DEFENDANT FAILED TO AFFEAR, CAFIAS ISSUED
03/21/2005
CAFIAS RECALLED
03/21/2005
CAPIAS RETURNED ON 03/21/2005 AT 01:30 PM
O3/24/2005
UNSECURED BOND 1,000.00
04/25/2005
JURY TRIAL SCHEDULED FOR O4/25/2005 AT 08:30 AM
04/25/2005
DEFENDANT FAILED TO AFFEAR, CAFIAS ISSUED
04/25/2005
CAPIAS RECALLED —NO COST
04/25/2005
JURY TRIAL CONTINUED DEFENDANT·S REQUEST
04/25/2005
JURY TRIAL CONTINUED TO 08/08/2005 AT 08:30 AM
08/08/2005
DEFENDANT FAILED TO APPEAR, CAPIAS ISSUED
09/28/2005
»·*"4( /.4

_,·= Case 1 :06-cv—OOO34-JJF Document 1 Filed O1/17/2006 Page 3 of 3
COURT OF COMMON PLEAS CRIMINAL DOCKET Page 2
( as of O1/17/2006 )
State Of Delaware v. ERIC M WHITTLE DOB: 11/20/1962
State's Atty: , Esq. AKA: ERIC WHITTLE
Defense Atty: JAMES A NATALIE , Esq. ERIC WHITTLE
Event
N0. Date Event Judge
CAPIAS RETURNED ON 09/28/2005 AT 03:00 PM
09/29/2005
UNSECURED BOND 1,000.00
09/29/2005
JURY TRIAL SCHEDULED FOR 01/18/2006 AT 08:30 AM
*** END OF DOCKET LISTING AS OF 01/17/2006 ***
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