Free Order on Motion for Miscellaneous Relief - District Court of Connecticut - Connecticut

l . Case 2:90-cr-00018-AHN Document 228 Filed O4/O3/2006 Pa·g?gLgé¢}g>@ @0
UNITED STATES DISTRICT COURT 1
DISTRICT OF CONNECTICUT {
UNITED STATES OF AMERICA, : I' _ i I
v. ‘ : i
Frank A Pugliano, : i
0 R D E R I an jdt;. i
Plaintiff having filed a Motion to Examine Judgment Debtor l
and for a hearing on defendant's ability to pay the judgment 1
rendered against defendant, it is hereby: E
ORDERED that the defendant, Frank A Pugliano, appear before G
the District Court in gQfo£o{1inT-Number i at BRN? oJ2.‘T' E
$·,;.._,.
Connecticut on the_i£[E?day of @; { , 2006, at ;Q;§p
o'clock in the.¥%VlE»noon, and then and there be examined under
oath concerning his assets and his ability to pay the judgment.
The Court may make such orders at the hearing or thereafter that
it determines to be reasonably calculated to facilitate payment
of the judgment. It is further ORDERED that defendant bring with
him and produce at the hearing all documents sought by
plaintiff's Request for Production served on or about February 3, `
2006, as well as a completed copy of the financial statement I
attached hereto as Exhibit "A" to facilitate the Court's l
examination of the defendant. 1
l The defendant is advised that failure to appear before the
Court at the scheduled time and place and produce the
aforementioned documents as ordered above, may subject the
defendant to being held in Contempt of Court and having a Capias
issued for the arrest of the defendant.
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f . · Case 2:90-cr-00018-AHN Document 228 Filed O4/O3/2006 Page 2 of 4
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E Dated this jd day of , 2006r I
ai: , Ccrmecticut.
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UNITED ATES JUDGE
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l · I Case 2:90-cr-00018-AHN Document 228 Filed O4/O3/2006 Page 3 of 4 `
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FINANCIAL AFFIDAVIT(please type or print)
` `
SECTION I. PERSONAL DATA
Mr. Mrs. Ms. Miss.
last name first middle initial social security date of birth
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complete address (including city/state/zip code) home phone work phone
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_. ,__ _,_. .,_ __ _,, L,. _.,, __ _,_.._h _,,__ _,,._.. l
Martial status (please check) License No. l
single married widowed divorced __ separated I
name of spouse social security number date of birth
age(s) of dependents (if older than 21 please list dependant‘s name and reason for dependency) [
SECTION `ll. HISTORY OF EMPLOYMENT l
name/address of current employer occupation years/months employed [
SPOUSE EMPLOYMENT ’
name/address of current employer occupation years/months employed
AVERAGE MONTHLY HUSBAND WIFE MONTHLY AMOUNT
INCOME EXPENSES
MONTHLY GROSS SALARY RENTJ MORTGAGE
before a roll deductions PAYMENT
DEDU
FEDERALISTATEILOCAL UTILITIES/HEAT
INCOME TAXES
masmm _Q
TOTAL DEDUCTIONS MEDICAL (NON
REIMRURSABLE
NET TAKE HOME PAY AUTO REPAIR! l
OTHER LIVING
EXPENSES
Combined monthly income: How much of the balance can you apply
to your debt to the U.S. on a monthly basis? $ 1
lf total monthly expenses exceed monthly income,
Total monthly expenses: how do you pay the difference? ·
_ "Exhibit A·· `

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{ ‘ ` Case 2:90-cr-00018-AHN Document 228 Flled O4/O3/2006 Page 4 of 4 {
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SECTION III ASSETS
NAME/ADDRESS OF BANK INSTITUTION: Q
Do you own: (please circle)
` 1. U.S. savings bonds? Yes No
bank account balance: 2. stocks and other bonds? Yes No {
‘ checking savings other {
3. Do you own any property? Yes No {
(if not continue)
complete address of property: {
cash value of furniture l
and household goods: $
(current value) $ {
automobile(s): (estimate value of each vehicle)
make year model
trailerfboats/campers (resale value):$
I.
2.
SECTION IV. INSTALLMENT CONTRACTS/OTHER DEBTS {
**Show here all debts which ou arc re uircd to a in rc ular monthl installments. Do not include livin ex >enscs.** {
NAME OF CREDITOR PURPOSE OF DEBT ORIGINAL UNPAID BALANCE AMOUNT DUE AMOUNT
AMOUNT OF DEBT MONTHLY PAST DUE
'"'NOTE: IF REPAYMENT OF DEBT IS NOT ON A MONTHLY BASIS, PLEASE EXPLAIN WHEN PAYMENT IS DUE°'*
Have you ever been in bankruptcy? If yes, date discltarged location ofeourt (cityfstate) docket number
Are you currently in the military? yes no
Ifapplicable, what is your present unit assigned? total years active duty
*"*PLEASE USE ADDITIONAL SHEETS, IF NECESSARY TO SUPPLY ANY OTHER PERTINENT INFORMATION ABOUT YOUR FINANCIAL STATUS."** `
With knowledge of the penalties for false statements provided by 18 ll.S.C. § 100t, $250,000 fine and tive years imprisonment and with knowledge that thls tinanclal
statement Is submitted by me to affect actlon bythe Department of Justice, I certify that I believe the above statement is true and that lt is a complete statement of all
Income and assets, real and personal, whether held in my name or be any other.
I I hereby certify that this financial statement ls made to affect action by the Department uflustice regarding a debt of $47,922.00 as of March 20, 2006; which I
acknowledge is due and owing to the United States.

signature of debtor date signed J
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