Free Authorization Form (PLRA) - District Court of Delaware - Delaware

Case 1:07-cv—OO847-JJF Document 6 Filed O1/22/2008 Page 1 of 1
IN THE UNITED STATES DISTRICT COURT ii I L
I Ii 1 I
FOR THE DISTRICT OF DELAWARE { _ (_ { i
JM 532 2006
I .,,1a_ %
cHRIsTopHER BLAIR, > L"`"'Li`§?T>?éYi?¤EcIccIIRI
) ‘ Udliiilii -.--..1
Plaintiff, > ```'
)
v. ) Civil Action No. 07-847-JJF
)
)
TAMMY MANN, 1
)
Defendants. )
AUTHORIZATION
1, Christopher Blair, SBI #477186, request and authorize the
agency holding me in custody to disburse to the Clerk of the
Court the initial partial filing fee of $28.81 and the subsequent
payments pursuant to 28 U.S.C. § l915(b) and required by the
Court’s order dated Z-* 5 , 2008.
This authorization is furnished to the Clerk of Court in
connection with the filing of a civil action, and I understand
that the filing fee for the complaint is $350.00. 1 also
understand that the entire filing fee may be deducted from my
trust account regardless of the outcome of my civil action. This
authorization shall apply to any other agency into whose custody
I may be transferred.
Date; I" /5 ,2008. -
_ I Signature of glaintiff f

Case 1:07-cv-00847-JJF

Document 6

Filed 01/22/2008

Page 1 of 1