Filed: Feb. 06, 2017
Latest Update: Feb. 06, 2017
Summary: MEMORANDUM AND ORDER NOELLE C. COLLINS , Magistrate Judge . Plaintiff submitted a notice of appeal without either paying the filing fee or submitting a motion to proceed in forma pauperis. The United States Court of Appeals for the Eighth Circuit has remanded the case for a determination of plaintiff's in forma pauperis status. Accordingly, IT IS HEREBY ORDERED that plaintiff shall either pay the $505 appellate filing fee or submit a motion to proceed in forma pauperis within thirty (30
Summary: MEMORANDUM AND ORDER NOELLE C. COLLINS , Magistrate Judge . Plaintiff submitted a notice of appeal without either paying the filing fee or submitting a motion to proceed in forma pauperis. The United States Court of Appeals for the Eighth Circuit has remanded the case for a determination of plaintiff's in forma pauperis status. Accordingly, IT IS HEREBY ORDERED that plaintiff shall either pay the $505 appellate filing fee or submit a motion to proceed in forma pauperis within thirty (30)..
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MEMORANDUM AND ORDER
NOELLE C. COLLINS, Magistrate Judge.
Plaintiff submitted a notice of appeal without either paying the filing fee or submitting a motion to proceed in forma pauperis. The United States Court of Appeals for the Eighth Circuit has remanded the case for a determination of plaintiff's in forma pauperis status.
Accordingly,
IT IS HEREBY ORDERED that plaintiff shall either pay the $505 appellate filing fee or submit a motion to proceed in forma pauperis within thirty (30) days of the date of this Order.
IT IS FURTHER ORDERED that if plaintiff submits a motion to proceed in forma pauperis, he must also submit a certified copy of his prison account statement for the six-month period immediately preceding the filing of his notice of appeal.
IT IS FURTHER ORDERED that the Clerk shall mail plaintiff a copy of the Court's form "Motion to Proceed in Forma Pauperis — Prisoner Cases."
IT IS FURTHER ORDERED that if plaintiff fails to comply with this Order, the Court will deny in forma pauperis status.
MOTION TO PROCEED IN FORMA PAUPERIS AND AFFIDAVIT IN SUPPORT — PRISONER CASES
I, _____________________________________________ declare (1) that I am the ______ in this case; (2) that because of my poverty, I am unable to pay the $350.00 filing fee; and (3) that I believe I am entitled to relief. The nature of my action and the issues are briefly stated as follows:
In further support of this application, I answer the following questions:
1. Have you ever before brought an action or appeal in a federal court while you were incarcerated or detained?
Yes ___ No ___
If so, how many times?
Were any of the actions or appeals dismissed because they were frivolous, malicious, or failed to state a claim upon which relief may be granted?
Yes ___ No ___
If so, how many of them?
2. Place of confinement of plaintiff or petitioner: ________ _________________________________________________________________
3. Crime(s) for which you have been convicted, date and sentence on each: ________________________________________________________________________
4. Are your presently employed? Yes ___ No ___
a. If the answer is "yes," state the amount of your salary or wages per month, and give the name and address of your employer. _______________________________________________________________________
b. If the answer is "no," state the date of last employment and the amount of the salary and wages per month which you received. _____________________________________________________________________
5. Have you received, within the past twelve (12) months, money from any of the following sources?
Yes No
Business, profession or form of self-employment? ___ ___
Rent payments, interest or dividends? ___ ___
Pensions, annuities or life insurance payments? ___ ___
Gifts or inheritances? ___ ___
Any other sources? ___ ___
If the answer to any of the above is "yes," describe the source and amount of money received from each during the past twelve (12) months. ______________________________________________________________________
6. Do you own any cash, or do you have money in a checking or savings account? Include any funds in prison accounts during the last six (6) months. Yes ___ No ___
If the answer is "yes," state the total amount of cash owned, and the average monthly balance in all checking, savings or prison account during the last six (6) months. ___________________________________________________________________
7. Do you own real estate, stocks, bonds, notes, automobiles, or other valuable property (excluding ordinary household furnishings and clothing)? Yes ___ No ___
If the answer is "yes," describe the property and state its approximate value. _____________________________________________________________________
8. List the persons who are dependent upon you for support, state your relationship to those persons, and indicate how much you contribute toward their support. _______________________________________________________________________
I DECLARE UNDER PENALTY OF PERJURY THAT THE ABOVE INFORMATION IS
TRUE AND CORRECT. I UNDERSTAND THAT PROVIDING FALSE INFORMATION MAY SUBJECT ME TO CRIMINAL PROSECUTION, IMPOSITION OF A FINE, OR OTHER SANCTION THAT MAY ADVERSELY AFFECT MY ABILITY TO PURSUE THIS CASE OR OTHER CASES. I HAVE REVIEWED MY ANSWERS TO INSURE THEIR ACCURACY.
Executed (signed) this ____ day of _______, 20 __.
________________________________
(Signature of plaintiff)
NOTE: THIS AFFIDAVIT MUST BE ACCOMPANIED BY A CERTIFIED COPY OF YOUR PRISON ACCOUNT STATEMENT SHOWING THE AMOUNT OF MONEY ON DEPOSIT DURING THE LAST SIX (6) MONTHS. A "CERTIFIED COPY" OF YOUR ACCOUNT STATEMENT IS ONE THAT HAS BEEN CERTIFIED BY AN AUTHORIZED PRISON OFFICER THAT IT IS A TRUE AND CORRECT COPY. FAILURE TO SUBMIT A CERTIFIED ACCOUNT STATEMENT WILL RESULT IN THE RETURN OF YOUR COMPLAINT OR PETITION.
