Opinion
No. 2:15-CV-0041-NAB
06-12-2015
MICHAEL A. TAYLOR, Plaintiff, v. PIKE COUNTY JAIL, Defendant.
MEMORANDUM AND ORDER
This matter is before the Court on plaintiff's pro se complaint. The complaint is defective because it has not been drafted on a Court-provided form, see Local Rule 2.06(A), and because plaintiff has neither paid the filing fee nor submitted a motion to proceed in forma pauperis along with a prison account statement, see 28 U.S.C. § 1915(a). Accordingly,
IT IS HEREBY ORDERED that the Clerk shall mail to plaintiff a copy of the Court's form Prisoner Civil Rights Complaint.
IT IS FURTHER ORDERED that the Clerk shall mail to plaintiff a copy of the Court's Motion to Proceed in Forma Pauperis - Prisoner Cases.
IT IS FURTHER ORDERED that plaintiff shall file an amended complaint on the Court-provided form within (30) days of the date of this Order.
IT IS FURTHER ORDERED that plaintiff shall either pay the $400 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 complaint.
IT IS FURTHER ORDERED that if plaintiff fails to comply with this Order, the court will dismiss this action without prejudice. If the case is dismissed, the dismissal will not constitute a "strike" under 28 U.S.C. § 1915(g).
Dated this 12th day of June, 2015.
/s/ Nannette A. Baker
NANNETTE A. BAKER
UNITED STATES MAGISTRATE JUDGE
__________ (Enter above the full name of the Plaintiff[s] in this action.)
- vs -
__________ (Enter above the full name of ALL Defendant[s] in this action. Fed. R. Civ. P. 10(a) requires that the caption of the complaint include the names of all the parties. Merely listing one party and "et al." is insufficient. Please attach additional sheets if necessary.
Case No. __________
(To be assigned by Clerk of District Court)
COMPLAINT I. State the grounds for filing this case is Federal Court (include federal statutes and/or U.S. Constitutional provisions, if you know them): II. Plaintiff, ___ resides at ___ street address, ___ city, ___ county, ___ state, ___ zip code, ___ telephone number.
(if more than one plaintiff, provide the same information for each plaintiff below) III. Defendant, ___ lives at, or its business is located at ___ street address, ___ city, ___ county, ___ state, ___ zip code.
(if more than one defendant, provide the same information for each defendant below) IV. Statement of claim (State as briefly as possible the facts of your case. Describe how each defendant is involved. You must state exactly what each defendant personally did, or failed to do, which resulted in harm to you. Include also the names of other persons involved, dates, and places. Be as specific as possible. You may use additional paper if necessary): V. Relief: State briefly and exactly what you want the Court to do for you. VI. MONEY DAMAGES:
A) Do you claim either actual or punitive monetary damages for the acts alleged in this complaint?VII. Do you maintain that the wrongs alleged in the complaint are continuing to occur at the present time?
YES [ ] NO [ ]
B) If your answer to "A" is YES, state below the amount claimed and the reason or reasons you believe you are entitled to recover such money damages:
I declare under penalty of perjury that the foregoing is true and correct. Signed this ___ day of ___, 20___YES [ ] NO [ ]
/s/_________
/s/_________
Signature of Plaintiff(s)
__________, Plaintiff(s),
v.
__________, Defendant(s).
No. __________ MOTION TO PROCEED IN FORMA PAUPERIS AND FINANCIAL AFFIDAVIT
I, ___, hereby apply for leave to proceed in this action without prepayment of fees or costs and without giving security therefor. In support of this application, I declare that the following facts are true:
(1) I am the plaintiff in this case and I believe I am entitled to relief.
(2) Because of my poverty I am unable to prepay the costs of this proceeding or to give security therefor.
(3) The nature of my action, defense, or appeal is briefly stated as follows:
I declare under penalty of perjury that the foregoing is true and correct. Executed on ___, 20___.
/s/_________
Signature of plaintiff