( Fon THE N1NTH.c1RcU1T F | L E D
NOV U 3 2006
KERRY ALLYNN CHASE, N0. 06-16110 GATHY A. csmanscu. ctsnu (
U.S. COURT or APPEALS
Plaintiff- Appellant, D.C. No. CV-04-00056-NVW l
District of Arizona, - .
v. Phoenix A
rf"` " D BRIAN COX, sued in his individual & n if if 0-ch VB. wu-`M if
official capacity; et al., ORDER
Defendants - Appellees.
Appellant Kerry Allynn Chase, prison identification number 166870, has
been granted leave to proceed in forma 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 Hling and docketing fees for
this appeal pursuant to 28 U.S.C. § l91§(b)(l) and (2). This court (hereby assesses _ .. -
an initial filing fee of 20 percent of the greater of (A) the average monthly deposits l
to the prisoner’s accotmt; or (B) the average monthly balance in the prisoner’s
account for the six-month period immediately preceding the filing of the June 12, _
2006 notice of appeal.
S:\MOATT’\Clrkords\10.06\lcw\06—16110.wpd A
Case 2:04-cv—OOO56-NVW—LOA Document 124 Filed 11/O7/2006 Page 1 of 3
r 06-16110 A . in A - i
p The Clerk shall serve this order and appellant’s completed authorization
i ‘ form on the Attorney General for the State of Arizona, 1275 West Washington
Street, Phoenix, Arizona 85007, Attention: Jan Dyer, who shall notify the
appropriate agency or prison authority responsible for calculating, collecting, and
forwarding the initial payment assessed in this order and for assessing, collecting,
*2: wi.;-;&E‘§iadii@he remain; sicliriiryigamenig er1Léirseit0lrg`HiSsT§§§iT§§T if A it it `
this appeal. See 28 U.S.C. § 1915(b)(2). Each payment should be accompanied
by the district court and appellate docket numbers for this appeal and a record of
previous payments made for this appeal.
The Clerk shall also serve a copy of this order on the clerk and the iinancial
unit of the district court.
For the CQ; s
J i _ __ _ r KathrynE..White.r. . ( -- -
‘ - Motions Attorney/Deputy Clerk
S 9th Cir. R. 27-7
General Orders/Appendix A _ _
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Case 2:04-cv-OOO56-NVW—LOA Document 124 Filed 11/O7/2006 Page 2 of 3
* PRISONER AUTHORIZATION FORM
I, EQLWMM dt—\F1’$E R , am the appellant ‘
I » [Print Name] i ‘
in C/\:\Pi$’E v. Co E , docket no. O Q -
Hel IO . I
‘ p I understand that I am required by statute to pay the full amotmt of the
I $25%*55 deetstiae aaaiiliag f<=¤Sf<¤· ¤¤iSa·;2selrtéa¤a¤i2e_@a°,et¤Y ia f¤¤¤¤ In I
pauperis status, and regardless of the disposition of this appeal. I P ‘
I hereby authorize the prison officials at this institution to assess, collect,
and forward to the district court the full amount of these fees, in monthly
‘ increments based on the average of deposits to or balance in my prison trust ·
account. `
/ I understand that I am not responsible for payment when there are no
deposits or funds in my trust account, but that payments will resume when such
I I deposits are made or funds are otherwise available. glp? é§%%§géi§_;},IE(§-EH?
. ` OCT 2 3 2006
q Q FILED
I , __, IISIEUEEEUIB E - -R , R R *‘ R R ¤Gc=r
Prisoner I.D. No.: A,QQ$P\€=»é>(rS?‘O D E mat R ‘
_ Docket No.: OQ ~· WJ ' O _ R R
Address: Dh\’¢·L&uJt5 ?··O.·i$¤ IC 3300
tguéggtg Q2, *3939% n
R MOATr·
Date: a ` /D;"’ h ,2OOf °°l2"?U¤6
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