Opinion
CIV S-08-2412 LKK KJM PS.
October 22, 2008
ORDER
Plaintiffs have not paid the fee ordinarily required to file an action in this court, and have filed an incomplete application to proceed without prepayment of fees in that the application is not signed by both plaintiffs. See 28 U.S.C. §§ 1914(a), 1915(a). In addition, the application is inconsistent in that sections 3(d) and (e) indicate both "yes" and "no" to the question as to whether plaintiffs have received any money from disability, workers' compensation and gifts or inheritances within the past twelve months. In addition, although the application indicates plaintiff Jose Perez has zero assets and zero income, he indicates four people as dependent on him for support. Plaintiff is reminded that the application must be signed under penalty of perjury and that false statements in the application to proceed in forma pauperis will be sanctioned severely, including possible dismissal of the action or other sanctions as the court deems appropriate.
Plaintiff will be provided the opportunity to submit another affidavit in support of a request to proceed in forma pauperis, signed by both plaintiffs, or the appropriate filing fee.
In accordance with the above, IT IS HEREBY ORDERED that:
1. Plaintiffs shall submit, within twenty days from the date of this order, either a completed application and affidavit in support of the request to proceed in forma pauperis on the form provided by the Clerk of Court, signed by both plaintiffs under penalty of perjury, or the appropriate filing fee; plaintiffs' failure to comply with this order will result in a recommendation that this action be dismissed; and
2. The Clerk of the Court is directed to send plaintiffs a new Application to Proceed In Forma Pauperis used in pro se cases. APPLICATION TO PROCEED IN FORMA PAUPERIS BY A PRISONER CASE NUMBER:
UNITED STATES DISTRICT COURT EASTERN DISTRICT OF CALIFORNIA Petitioner vs. Respondent(s) I, ____________________________________, declare that I am the petitioner in the above-entitled proceeding; that, in support of my request to proceed without prepayment of fees under 28 U.S.C. § 1915, I declare that I am unable to pay the fees for these proceedings or give security therefor and that I am entitled to the relief sought in the petition.In support of this application, I answer the following questions under penalty of perjury: Have the institution fill out the Certificate portion of this application. and
1. Are you currently incarcerated: Yes No (If "No" DO NOT USE THIS FORM) If "Yes" state the place of your incarceration. ____________________________________ 2. Are you currently employed? Yes No a. If the answer is "Yes" state the amount of your pay. 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 twelve months have you received any money from any of the following sources? a. Business, profession or other self-employment Yes No b. Rent payments, interest or dividends Yes No c. Pensions, annuities or life insurance payments Yes No d. Disability or workers compensation payments Yes No e. Gifts or inheritances Yes No f. Any other sources Yes No If the answer to any of the above is "Yes" describe by that item each source of money and state the amount received what you expect you will continue to receive. Please attach an additional sheet if necessary. 4. Do you have cash or checking or savings accounts? Yes No If "Yes" state the total amount: ________________________ 5. Do you own any real estate, stocks, bonds, securities, other financial instruments, automobiles or other valuable property? Yes No If "Yes" describe the property and state its value. ___________________________________________ 6. Do you have any other assets? Yes No If "Yes" list the asset(s) and state the value of each asset listed. 7. 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. I declare under penalty of perjury that the above information is true and correct. ____________________________ __________________________________________________________________ DATE SIGNATURE OF APPLICANT