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

Case 1:07-cv-00656-JJF Document 5 Filed 11/16/2007 Page1 of 2
' Case 1:07-cv—00656-JJF Doonrnenvl Filed 11/02/2007 Page 4 of4
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF DELAWARE
AUGUSTUS H. EVANS, JR., )
)
Plaintiff, )
l
v. ) Civil Action No. 07-656-JJF
l
CINDY WRIGHT, )
DCC RECORDS REBECCA MCBRIDE, )
THOMAS ZANDA, > T`·r_" *7*-
EVELYN STEVENSON, l _
LT. MICHAEL CASTELLO, l Eq: Q - l I
MIKE REcoRns, > _ 1 F __ __ I
soMyA LEWIS, > _ ;’: #- I .;-131 ·_
l E §
Defendants. l U_g,¤·¤n:l{sT?gr3L;gT ·‘
DlSTf·at4-.; -,·- __._.,-EJAHE _ J
AUTHORIZATION ` " '"'
Hip ;,r J { l *~ I l,.-
I, Augustus H. Evans, Jr., SBI #l9l247 request and authorize
the agency holding me in custody to disburse to the Clerk of the
Court all payments pursuant to 28 U.S.C. § l9l5(b) and required
r -;g
by the Court’s order dated /77 /276 ’ , 2007.
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 $350.00. I also
understand that the entire filing fee may be deducted from my
trust account regardless of the outcome of my civil action. This
authorization shall apply to any other agency into whose custody
I may be transferred.
» -' ;'$' .):-37
Date: /7/ g° 67 ’ , 2007.
/
gnature of Plaintiff


Case 1:07-cv-00656-JJF Document 5 Filed 11/16/2007 Page 2 of 2
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Case 1:07-cv-00656-JJF

Document 5

Filed 11/16/2007

Page 1 of 2

Case 1:07-cv-00656-JJF

Document 5

Filed 11/16/2007

Page 2 of 2