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


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Pages: 2
Date: February 28, 2008
File Format: PDF
State: Delaware
Category: District Court of Delaware
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Word Count: 545 Words, 3,265 Characters
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AUTHORIZATION `_UE.I;e§¥%;@i‘”§T€G§il"@i
_O TIOTO
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I, Ivan L. Mendez, SEI # 453351, request and authorize the
agency holding me in custody to disburse to the Clerk of the
l Court all payments pursuant to 28 U,S.C. § 1915(b) and required
by the Court's Order dated{[2£j , 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. I 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 , EOOB.
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Case 1:07-cv-00831-JJF

Document 10

Filed 02/27/2008

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Case 1:07-cv-00831-JJF

Document 10

Filed 02/27/2008

Page 2 of 2