Jason Allan Singer v. Matthew Braman et al

Filing 10

ORDER GRANTING In Forma Pauperis Application; ORDER DIRECTING Payment of Inmate Filing Fee by the California Department of Corrections 2 , signed by Magistrate Judge Erica P. Grosjean on 5/31/17. (Attachments: # 1 IFP Application, # 2 Trust Account Statement)(Hellings, J)

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—p "-FILE 6~.&h!( U.S (M~T~iICT COUh1' Case 1:17-cv-00725-EPG Document 2 Filed 05/18/17 Page 1 of 3 ~IA'Y I -8 2017 ~M1i D18TRICT Of C V1~ _ ~3~ 6~.~~CSG~ 5,~~~ Petitioner Respondent(sJ I, ~q~,_i C+1LltC1flN1A DEPIJTy DECLARATION IN SUPPORT OF REQUEST TO PROCEED IN FORMA PAUPERIS ~ t. ~i L . ,declare that I am the petitioner in the above entitled case; ~ ~ ~~--~~~~ i< that in support of my motion to proceed without being required to prepay tees, costs or gi~~e security therefor, I state that because of my' poverty I am unable to pay the costs of said proceeding or to give security therefor; that I believe I am entitled to relief. 1. Are you presently employed? ^1"es `~ No a. If the ans~ti~er is ~•es, state the amount oY ~~our salary or ~~ages per month, and gi~~e the flame anti address of your en~plo~~er. b. If the answer is no, state the date of last employment and the amount of the salar~~ and wages per month which you received. 2. Have you received, within the past twelve months, an}~ money from any of the following sources? ❑Yes ~No b. Rent payments, interest or di~~idends% ❑Yes ~.I~'o c. Pensions, annuities or life insurance pa~~ments? ❑Yes ~,1 No Yes u No ❑Yes '~ No a. Business, profession or forn~ of self-employment? d. Gifts or inheritances? e. Any other sources? if the answer to any of the above is ~-es, describe each source of money and state the an~ount received from each during the past t~vel~~e months: ~ia ~} Cat" I Il-I'S / (~` ~" E Y1 ~ f(7~r• ;,il:"Y's ~~ ;~V~ } ~~ ,~ -~ r ~- ~~{~{~f ~ L S (~~? L~ C ~ j 3. Do you own any cash, or do you ha~~e mone}' in a checking or sa~-ings account? (Include ~~~~i~ttin~ds rn prison nccounts) u Yes (0,%L ~1 ~o PE'I~ITI01 f'OR WRIT OF HABEAS CORPUS BY A PERSON I'~' STATE CUSTODY (28 C.S.0 § 21;-1) Page Case 1:17-cv-00725-EPG Document 2 Filed 05/18/17 Page 2 of 3 If the ans~ti~er is ~-es, state the total ~~alue of the items o~ti~ned: 4. Do you o~+'n any real estate, stocks, bonds, noCes, automobiles, or other valuable propert}'? ('Excluding ordinary householdfisrnishrr~gs nr~d clothing) ❑Yes `~io If the answer is yes, describe the propert}' and state its approximate ealue: 5. List the persons who are dependent upon you for support, state your relationship to those persons, and indicate how m uch you contribute toward their support: ~ ~, I, declare (or certifi~, verity- or state) under penalty of e ; y that the forea ~ Executed on ` J is true and correct. ~' ~ Signature of Petitioner Z. to CERTIFICATE I hereby certify that the Petitioner herein has the sum of $ on account to his credit at the institution where he is confined. I further certif~~ that Petitioner like~~-ise has the follo~+~ing securities to his credit according to the records of said institution: Date CV-69 (OS/l2) Authori<ed Orficer ofIr~stitutiort/Title of O~{icer - PETITION FOR WRIT OF H,~BEAS CORPUS BY A PERSON IN STATE CliSTODl'(28 ti.S.0 4 2254) Page I1 of 11 Verified: CDCR Case 1:17-cv-00725-EPG Document 2 Filed 05/18/17 Page 3 of 3 Inmate Statement Report Date\Time: 4/10/201710:45:41 AM Institution: SATE CDCR# Inmate/Group Name Institution Unit Cell/Bed V85028 SINGER, JASON SATF E 001 1 119001 $0.01 Current Available Balance: Transaction List Transaction Institution Date Source Doc# Transaction Type 01/01/2017 SATF SATF TRACS TRANSFER IN TX02232017 03/20/2017 SATF SALES 04/06/2017 SATF SALES Amount BEGINNING BALANCE 02/23/2017 Receipt#/Check# Account Balance $0.00 $12.16 $12.16 6 ($11.80) $0.36 21 ($0.35) $0.01 Encumbrance List Transaction Date Encumbrance Type Amount * "No information was found for the given criteria.''* Obligation List Court Case# Obligation Type Sum of Tx for Date Range for Oblg Original Owed Balance Current Balance * 'No information was found for the given criteria.** Restitution List Sum of Tx for Date Range for Oblg Current Balance $0.00 $0.00 $0.00 $200.00 $0.00 $0.00 $200.00 Active $200.00 $0.00 $0.00 $200.00 PA046931 Fulfilled $250.00 $0.00 $0.00 $0.00 DIRECT ORDER 62140281 Active $1,657.81 $0.00 $0.00 $1,657.81 RESTITUTION FINE 62140281 Active $6,000.00 $0.00 $0.00 $6,000.00 Original Owed Balance Interest Accrued Restitution Court Case# Status RESTITUTION FINE PA046542 Fulfilled $200.00 FINE PC 1202.45 PA046542 Active FINE PC 1202.45 PA046931 RESTITUTION FINE 30

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