Free Order (PLRA) Missing Documents - District Court of Delaware - Delaware

V ceee {:0%-ei}-0o7s?-SLR Document 6 Filed 01/os/200s Page 1 er 2
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF DELAWARE
EZEADIGO ODUCHE, )
Plaintiff, g
v. g Civ. No. 07-757-SLR
ANDREW J. VELLA, g
STATE ATTORNEYS OFFICE, )
DOVER POLICE DEPARTMENT OF )
PUBLIC SAFETY and )
EDWARD FISHER, JR., )
Defendants. g
O R D E R
1. The plaintiff Ezeadigo Oduche, SBI #107414, a pg; se lltigant who is
presently incarcerated, has filed this action pursuant to 42 U.S.C. § 1983 and has
requested leave to proceed in forma pauperis pursuant to 28 U.S.C. § 1915.
2. On December 6, 2007, this Court ordered the plaintiff to provide a
request to proceed m fp;n_a pauperis and a certified copy of his prison trust fund
account statement for the six-month period immediately preceding the filing of the
above-referenced complaint. The plaintiff submitted an incomplete request to proceed
m f_o@a_ pauperis on December 28, 2007, and an incomplete, non-certified copy of his
"Account Balance" sheet on January 2, 2008, but has not yet complied with the Court’s
order to provide a complete in forma pauperls application, which must include a
certified prison trust fund account statement which shows all deposits, expenditures

Case 1:07-cv—O0757-SLR Document 6 Filed O1/08/2008 Page 2 of 2
and balances during the six-month period immediately preceding the filing ofthe
complaint.
THEREFORE, IT IS HEREBY ORDERED that within thirty days from the
date ofthis order, plaintiff shall submit a complete in forma pauperis application (which
contains all of the information required on the attached AO Form 240 — Application to
Proceed Without Prepayment of Fees and Affidavit) and a prison trust fund account
statement which includes ledger sheets showing all deposits, expenditures and
balances during the six-month period immediately preceding the filing ofthe complaint.
FAILURE OF THE PLAINTIFF TO RETURN THE REQUESTED
INFORMATION WITHIN 30 DAYS FROM THE DATE OF THIS ORDER SHALL
RESULT IN DISMISSAL OF 'l'HIS ACTION WITHOUT PREJUDICE.
United States%istrict Judge
DATED: ijx/ad
2

Case 1 :07—cv—00757-SLR Document 6-2 Filed 01/08/2008 Page 1 of 2
` AO 240 (Rev. IO/O3)
DELAWARElRev. 4/052
i ` UNITED STATES DISTRICT COURT
I DISTRICT OF DELAWARE
riaimirr APPLICATION TO PROCEED
V. WITHOUT PREPAYMENT OF
. FEES AND AFFIDAVIT
Defendant(s)
` CASE NUMBER:
I, declare that I am the (check appropriate box)
El Petitioner/Plaintiff/Movant El Other
in the above—entitled proceeding; that in support of my request to proceed without prepayment of fees or costs under
28 USC §l9l5, I declare that I am unable to pay the costs of these proceedings and that I am entitled to the relief
sought in the complaint/petition/motion. r
In support of this application, I answer the following questions under penalty of perjury:
l. Are you currently incarcerated? lj Yes El No (If "No" go to Question 2)
If "YES" state the place of your incarceration '
Inmate Identitication Number (Required):
Are you employed at the institution? Do you receive any payment from the institution?
Attach a ledger sheet Qorn the institution of your incarceration showing at least the gas! six rnonths’
Iransactions
2. Are you currently employed? El Yes El No
a. If the answer is "YES" state the amount of your take-home salary or wages and pay period a
and give the name and address of your employer.
b. If the answer is "NO" state the date of your last employment, the amount of your take—home
salary or wages and pay period and the name and address of your last employer.
3. In the past I2 twelve months have you received any money from any ofthe following sources?
a. Business, profession or other self—ernployment I3 Yes El No
b. Rent payments, interest or dividends El Yes El No
c. Pensions, armuities or life insurance payments El Yes U No
d. Disability or workers compensation payments El Yes El No
e. Gifts or inheritances El Yes El No
£ Any other sources El Yes El No
If the answer to any of the above is "YES" describe each source of money and state the amount
received AND what you expect you will continue to receive.

Case 1 :07—cv—00757-SLR Document 6-2 Filed 01/08/2008 Page 2 of 2
AO 240 Reverse (Rev. 10/DJ}
DELA`\VA.R.E Rev, 4/05
4. Do you have any cash or checking or savings accounts? El Yes K1 No
if "Yes" state the total amount S
5. Do you own any real estate, stocks, bonds, securities, other financial instruments, automobiles or other
valuable property?
D Yes Ei No
If "Yes" describe the property and state its value.
6. List the persons who are dependent on you for support, state your relationship to each person and
indicate how much you contribute to their support, OR state NONE if applicable.
I declare under penalty of perjury that the above information is true and correct.
DATE SIGNATURE OF APPLICANT
NOTE TO PRISONER: I A Prisoner seeking to proceed without prepayment of fees shall submit an
affidavit stating all assets. Ineaddition, 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. If you have multiple accounts, perhaps because you have been in multiple
institutions, attach one certified statement of each account.

Case 1:07-cv-00757-SLR

Document 6

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Case 1:07-cv-00757-SLR

Document 6

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Case 1:07-cv-00757-SLR

Document 6-2

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Case 1:07-cv-00757-SLR

Document 6-2

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