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

Case1:07-cv—00429—G|\/IS D0cument5 Filed 07/30/2007 Page10f2
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF DELAWARE
MICHAEL LEAGER, )
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Plaintiff, ) y
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v. ) Civil Action No. 07—429—GMS !
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WARDEN RARHAEL WILLIAMS, ) ‘‘‘‘ " ‘ i‘‘ ‘‘‘i ‘l
DR. KENDALL, AND JIM WELCH, ) Q amaln?;LEi;;mF ii,. {
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Defendants. ) E JULfg@2@Qj E X
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,,_ _DFD??VC“*?$H@¥$A IH; {
AUTHORIZATION LIT" ‘i ‘‘`‘ _
I, Michael Leager, SBI #515275, request and authorize the y i
1
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agency holding me in custody to disburse to the Clerk of the I
Court the initial partial filing fee of $16.63, and the {
subsequent payments pursuant to 28 U.S.C. § l9l5(b) and required `
by the Court’s order dated;%;&!%9: } E , 2007. L
I
This authorization is furnished to the Clerk of Court in i
connection with the filing of a civil action, and I understand E
that the filing fee for the complaint is $350.00. I also E
understand that the entire filing fee may be deducted from my l
i
trust account regardless of the outcome of my civil action. This -
authorization shall apply to any other agency into whose custody i
I may be transferred.
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nate; .\Ui\[ 16, , 2007. I
I ,|V i
[xxi ~ ’¢
Si ature of Plaint I
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Case 1:07-cv-00429—G|\/IS Document 5 Filed 07/30/2007 Page 2 of 2
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