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Case 1:07-cv-OO797—G|\/|S“"· Document 5 File /27 7 Pa e 1 0f4
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Case 1:07-cv-00797—Gl\/IS Document 5 Filed 12/27/2007 Page 2 of 4
- ` { Case 1:07—cv—00797—GMS Documenté. Filed 12/20/2007 Page 1 of 2 i
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF DELAWARE
BRANDON GIPSON, l
Plaintiff, g
U v. g Civil Action No. 07-797-GMS
RAPHAEL WILLIAMS, AND g
JILL WATERS,
Defendants. g
U FILING EEE ORDER
l. The plaintiff Brandon Gipson, SBI #479470, a prg sg
litigant who is presently incarcerated, has filed this action
pursuant to 42 U.S.C. § 1983 without prepayment of the filing
fee. - - _
2. Consistent with 28 U.S.C. § l9l5(a)(l),the
plaintiff submitted an affidavit stating_that he has no assets
with which to prepay the filing fee. Based on the plaintiff’s
affidavit, his request to proceed in fgrma pauperis is granted.
3. Notwithstanding the above, pursuant to 28 U.S.C. §
l9l5{bl(l), the plaintiff shall·be assessed the filing fee of
$350.00. In order to determine the schedule of payment of the
filing fee, the plaintiff shall submit to the Clerk of Court, a
certified copy of his trust fund account statement (memorandum or
institutional equivalent, with attachments) showing all deposits,
eggenditures and balances during the six—month period,
immediately preceding the filing of the complaint, obtained from
the appropriate official at the institution at which the

Case 1:OIecv-00757-gMS`Docu-mem I f_Page“S.of4_— ...» “
. ·· I Case1:07—cv~00797—GMS Documenw Filed 12f20l2007 Page.? o§2
plaintiff is confined. FAILURE OF THE PLAINTIFF TO RETURN THE
REQUESTED INFORMATION WITHIN 30 DAYS FROM THE DATE THIS ORDER IS
SENT SHALL RESULT IN DISMISSAL OF THIS ACTION WITHOUT PREJUDICE.
4. Unless the Court determines from the plaintiff’s
financial information that he has no assets whatsoever, an
initial partial filing fee of 20 percent (20%) of the greater of
the plaintiff’s average monthly deposit or average monthly
balance in the trust fund account shall be required to be paid
before the court reviews the complaint. NOTWITHSTANDING ANY
PAYMENT MADE, THE COURT SHALL DISMISS THE CASE IF THE COURT
DETERMINES THAT THE ACTION IS FRIVOLOUS OR MALICIOUS, EAILS TO
STATE A CLAIM UPON WHICH RELIEF MAY BE GRANTED, OR SEEKS MDNETARY
RELIEF AGAINST A DEFENDANT WHO IS IM UNE FROM SUCH RELIEF.
5. Pursuant to 28 U.S.C. § l9l5(g), if the plaintiff
has had three or more actions dismissed by the Court on the
grounds that they were frivolous, malicious, or failed to state a
claim upon which relief may be granted, then the Court shall deny
the plaintiff leave to proceed in fgrma pauperis in all future
suits filed without prepayment of the filing fee, unless the
Court determines that the plaintiff is under imminent danger of
serious physical injury.
DATED: y` United States Distr ' .. L
E D
_ 2 DEC 2 U EGE?
Bti-t%¥‘E‘é%E$9E§E

Case 1 :07-cv-00797—Gl\/IS Document 5 Filed 12/27/2007 Page 4 of 4
EAD 85 (Rev, 8/98) Notice, Consent, and Order of Reference — Exercise of Jurisdiction by a United States Magistrate Judge
UNITED STATES DISTRICT COURT
District of
NOTICE, CONSENT, AND ORDER OF REFERENCE —
EXERCISE OF JURISDICTION BY A UNITED STATES
Plaintiff MAGISTRATE JUDGE
V.
Case Number:
Defendant
NOTICE OF AVAILABILITY OF A UNITED STATES MAGISTRATE JUDGE
TO EXERCISE JURISDICTION
In accordance with the provisions of 28 U.S.C. §636(c), and Fed.R.Civ.P. 73, you are notified that a United States
magistrate judge of this district court is available to conduct any or all proceedings in this case including ajury or nonjury trial,
and to order the entry of a final judgment. Exercise of this jurisdiction by a magistrate judge is, however, permitted only if all
parties voluntarily consent.
You may, without adverse substantive consequences, withhold your consent, but this will prevent the court’sjurisdiction
from being exercised by a magistrate judge. If any party withholds consent, the identity ofthe parties consenting or withholding
consent will not be communicated to any magistratejudge or to the districtjudge to whom the case has been assigned.
An appeal from ajudgment entered by a magistrate judge shall be taken directly to the United States court of appeals for
this judicial circuit in the same manner as an appeal from any other judgment of this district court.
CONSENT TO THE EXERCISE OF JURISDICTION BY A UNITED STATES MAGISTRATE JUDGE
In accordance with provisions of 28 U.S.C. §636(c) and Fed.R.Civ.P. 73, the parties in this case consent to have aUnited
States magistrate judge conduct any and all proceedings in this case, including the trial, order the entry of a final judgment, and
conduct all post-judgment proceedings.
Party Represented Signatures Date i
ORDER OF REFERENCE
IT IS ORDERED that this case be referred to
United States Magistrate Judge, to conduct all proceedings and order the entry of judgment in accordance with 28 U.S.C.
§636(c) and Fed.R.Civ.P. 73.
Date United States District Judge
NOTE: RETURN THIS FORM TO THE CLERK OF THE COURT ONLY IF ALL PARTIES HAVE CONSENTED
ON THIS FORM TO THE EXERCISE OF JURISDICTION BY A UNITED STATES MAGISTRATE JUDGE.

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