Cross v. City of Hanford District Attorney et al

Filing 3

ORDER GRANTING 2 Motion to Proceed IFP signed by Magistrate Judge Stanley A. Boone on 11/14/2014. (Attachments: # 1 IFP Motion). (Jessen, A)

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Case 1:14-cv-01755---SAB Document 2 Filed 11/10/14 Page 1 of 2 FILED NOV 1.07014 CLERK. U.S. D EASTERN DISTRI ~------~~~~~---UNITED STATES DISTRICT COURT EASTERN DISTRICT OF CALIFORNIA FRESNO DIVISION . I • • 1:1 4 CV ­ 0 1 7 5 5 ­ --~ CASE NUMBER: , . . '. Plaintiff/Petitioner, APPLICATION TO PROCEED IN FORMA PAUPERIS BY A PRISONER vs. Defendants/Respondent. , declare that I am the plaintiff in the above-entitled proceeding; that, in support of my request to proceed without prepayment offees under 28 U.S.c. section 1915, I declare that I am unable to pay the fe~s for these proceedings or give security therefor and that I am entitled to the relief sought in the complaint. In support of this application, I answer the following questions under penalty of perjury: 1. Are you currently incarcerated? State the place of your incarceration. 2. ~ Yes _ No (If "no" DO NOT USE THIS FORM) l6 tJ@US' CoutJ(y Jihl.. Are you currently employed (includes prison employment)? Yes 'j-NO _--.::jG2::=:::.-____ a. b. 3. If the answer is "yes" state the amount of your pay. 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. Have you received any money from the following sources over the last twelve months? a. Business, profession, or other self-employment: b. Rent payments, interest or dividends: -1­ Yes ~No Case 1:14-cv-01755---SAB Document 2 Filed 11/10/14 Page 2 of 2

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