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

~ " Case 1:08-cv-00090-JJF Document 1 Filed O2/12/2008 Page 1 of 4
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UNITED STATES DISTRICT COURT
DISTRICT OF DELAWARE
Of tb W cbr Ie. ;i;tr"fx
mtimrr APPLICATION TO PROCEED
V. WITHOUT PREPAYMEN T OF
l )f l"£ SQ; [ bt I H ljlQ5 FEES AND AFFIDAVIT
Defendantts)
t CASE NUMBER: .i
~0e·90 1e.1e M
_,_.i
I, l i] Q Fig l, ly ( I Y] C]; 2 declare that I am the (check appropriate box) I
° ° PetitionerlPlaintifflMovant ° ° Other .
in the above-entitled proceeding; that in support of my request to proceed without prepayment of fees or costs under
28 USC §_l9l 5, I declare that I am unable to pay the costs ofthese proceedings and that I am entitled to the relief
sought in the complaintlpetitionlmotion.
In support of this application, I answer the following questions under penalty of peij ury:
I. Are you currently incarcerated? ° Yes (If "I\lo" go to Question 2) .
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If "YES" state the place of your incarceration 'Q
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Inmate Identification Number (Required); {;E¥§
sa
Are you employed at the institution'? _ Do you receive any payment from the institution? G,
_ * ,.. to
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Atmel: nr ledger slice! li·or;··r the fmrrflzriion ofvozrr inccrrcertilfonsl1oi»1·fn·g ui least the gms! six monrl2.s·'
xmnmerions
2. Are you currently employed? ° No
a. Ifthe answer is "YES" state the amount ofyour take—home salary or wageks and pay period a
and give the name and address ofyour employer. _, I ‘ · I € |H’qC(]r .
is \ aq;. <;c> t~¤<>¤`vl*l·’1 ei we mcievei tara e»r;~+·>~rcl,‘¤€» lqq
b. Ifthe answer is "NO" state the date ofyour last employment, the amount ofyour take-home
salary or wages and pay period and the name and address of your last employer.
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 · · Yes
b. Rent payments, interest or dividends • · Yes
e. Pensions, annuities or life insurance payments • · Yes _ • No
d. Disability or workers compensation payments · • Yes _` _ •
e. Gifts or inheritanees · · Yes é· No)
f Any other sources • • Yes
lfthe answer to any ofthe above is "YES" describe eaeh source ofmoney and state the amount
received AND what you expect you will continue to receive.

Case 1 :08-cv-00090-JJF Document 1 Filed O2/12/2008 Page 2 of 4
AO 2-16 Reverse (Rev. 10/ G3)
DELAWA.R.E!{_Ev. lalfz '
4. Do you have any cash or checking or savings accounts? · •No
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If "Yes" state the total amount $ . Calf-ieclél · 50 mgo Vcfw
5. Do you own any real estate, stocks, bonds, securities, other tinancial instruments, automobiles or other
valuable property?
· ‘ Ya
lf "Yes" describe the property and state its value. I
6. List the persons who are dependent on you for support, state your relationship to each person and
indicate how rnuch you contribute to their support, OR state NONE if applicable.
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I declare under penalty of perjury that the above information is true and correct.
DATE SIGNATURE OF APPLICANT
NOTE TD PRISONER: A Prisoner seeking to proceed without prepayment of fees shall submit an affidavit
stating all assets. ln addition, a prisoner must attach a statement certified by the appropriate institutional
officer showing all receipts, expenditures, and balances during the last six months in your institutional accounts.
lf you have multiple accounts, perhaps because you have been in multiple institutions, attach one certified
statement of each account.

v ., Case 1:08-cv-00090-JJF Document 1 Filed O2/12/2008 Page 3 of 4
In The
United States
District Court
of
"Delaware"
J & J Mobile Home Park Civil Act. No.
v. "Federal Question(s)"
28 U.S.C. Section 1331.
Section 1446. Section 1343.
Theresa Thomas
=l<>l<>l==l=>l=>l<>l<>l<¤l<¤l=>l==l¤>l<>l<¤l<>l<=l==I<>l=>l<¤l<=l==l=>l<>l¤¤l<>l<=l=>l=>l=>l=>l<>l<¤l<>l=>l=>l=>l<>l<=l<>l=>l=>l<>l<=l<=l<>l<>l=>l=>l==l<=l<>l=>l=>l=>l<=l<>l=>l<>l=>l==l<
"Motion To Proceed" — IFP / In forma pauperis,
At all constitutional deliberate "speed,."
In the interest of Justice,. By virtue,. As a Matter of Law,.
I, Ms. Theresa- Thomas cannot be illegally compelled to, be a involuntary
. - participant,. In any inferior unconstitutional, {State} leveled de facto
court - setting(s) / hearing(s),.
As a Matter of law,. This Manifest / Fully vehemently
Constitutional "Motion" to proceed;
"I FP" shall be , "Granted" As a Matter of, "Equal - Justice" under the
law,.

Case1:08-cv-00090-JJF D0cumeht1 Filed 02/12/2008 Page40f4
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A s!/ D m \.4/MTL he
Theresa Thomas

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