Free Order of 9th Circuit - District Court of Arizona - Arizona

il UNITED STATES COURT OF APPEALS I L E D
FOR THE NINTH CIRCUIT JAN 3 1 zggg
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ALLACE LEEROY CORNELLIER, I No. 05-17166
Petitioner - Appellant, D.C. No. CV-04-00724-PGR
` District of Arizona,
V- A J W _ _. . - . F- rn. i A ~
fl SANDRA WALKER; et al., A
ORDER
Defendants - Appellees.
Appellant Allace Leeroy Cornellier, prison identification number 040553,
has been granted leave to proceed in fonna pauperis in this appeal and has
completed and filed the required authorization form directing the appropriate
prison officials to assess, collect, and forward to the district court the tiling and
docketing fees for this appeal pursuant to 28 U.S.C. § l915(b)(l) and (2). This
5 ” I `7E;§C§{he;·}-iby aééiégi iiiiiiiimnig rs; arzo pa-eL{srirhc g{s;t;4Riji ri; I I if
average monthly deposits to the prisoner’s account; or (B) the average monthly
balance in the prisoner’s account for the six-month period immediately preceding
the tiling of the October 20, 2005 notice of appeal. .
The Clerk shall serve this order and appellant’s completed authorization
form on the Attorney General for the State of Arizona, 1275 West Washington
Case 2:04-cv-OO724—PGR—JJl\/I Document 49 Filed O2/O9/2006 Page 1 of 3

it 05- 1 7 1 66
Street, Phoenix, Arizona 85007, Attention: Jan Dyer, who shall notify the U
appropriate agency or prison authority responsible for calculating, collecting, and
forwarding the initial payment assessed in this order and for assessing, collecting,
and forwarding the remaining monthly payments ofthe fee to the district court for
,,_ ,___ ,_, ____,t,his_app,e,aL 2_&LJsSt.!.`..§Tl9rLS(b)(2). be accempan%ed—r·=—~ ·r ’
l by the district court and appellate docket numbers for this appeal and a record of
previous payments made for this appeal.
l The Clerk shall also serve a copy of this order on the clerk and the financial
unit of the district court. A ` A
All pending motions will be addressedby separate order. C
For the Court: A
l CATHY A. CATTERSON —
Clerk of the Court
9th Cir. R. 27-7
General Orders/Appendix A
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Case 2:04-cv-OO724—PGR—JJI\/I Document 49 Filed O2/O9/2006 Page 2 of 3

· PRISONER AUTHOIUZATION FORM
I, am the appellant in Qgrnelligr v. walker, et
g_l_, docket number Q5-] fl 1§§ . D A
_ I understand that I am required by statute to pay the full amount of the $255
docketing and filing fees for this appeal, regardless of my forma pauperis status,
-»--- - regardless.offFfé"dilsposition df hereby ku
officials at this institution to assess, collect, and forward to thedistrict comt the
l full amount of these fees, in monthly increments based on 20 percent of the
average of deposits to or balance in my prison trust account. I tmderstand that I l
am not responsible for payment when there are no deposits or funds in my trust I
account, but that payments will resume when such deposits are made or ftmds are .
otherwise available. ?
NAME Q [(41;;; é,·¤J¢'L&£'-{ya.
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<%;(;<; _%\·%’5»i'g2§ébl DOCKET NO. Q6-Wg; 6 p - _
GO 4]*,; Qgf PRISONER I.D. NO. 0 gd $5*3
It PRISON FACILITY fj .?§’Y,'€,,E_’.`Z‘,," ’°‘“ M
i' ADDRESS gt Q. gee esac
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` DATE Jpqiuuggrdh éé ZOQQ
PRO SE .U`NIT I
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