TRUMP v. PLAYBOY ENTERPRISES, INC. et al

Filing 1

Complaint Received. (Attachments: # 1 Application IFP, # 2 Text of Proposed Order, # 3 Notice of Motion, # 4 Certificate of Service, # 5 Civil Cover Sheet, # 6 Envelope)(gl)

Download PDF
Page I ol’ 5 AO 239 (Rev. 01/15) Application to Proceed in District Court Without Prepaying Fees or Costs (Long Form) UNITED STATES DISTRICT COURT for the /€L/rui ) ) Plaintfi7Petitioner v. — /Aq Defendant/Resp&tdent J } Civil Action No. ) APPLICATION TO PROCEED IN DISTRICT COURT WITHOUT PREPAYING FEES OR COSTS (Long Form) Affidavit in Support of the Application Instructions I am a plaintiff or petitioner in this case and declare that I am unable to pay the costs of these proceedings and that I am entitled to the relief requested. I declare under penalty of perjury that the information belotv is true and understand that a false statement may result in a dismissal of my claims, Complete all questions in this application and then sign it. Do not leave any blanks: if the answer to a question is “0,” “none,” or “not applicable (N/A),” write that response. If you need more space to answer a question or to explain your answer, attach a separate sheet of paper identified with your name, your case’s docket number, and the question number. (2 Date: Signe 7/rL — / - /7 . ] 1. / LI F or both you and your spouse estimate the average amount of money received from each of the following sources during the past 12 months. Adjust any amount that was received weekly, biweekly, quarterly, semiannually, or annually to show the monthly rate. Use gross amounts, that is, amounts before any deductions for taxes or otherwise. Income amount expected next month Average monthly income amount during the past 12 months Spouse You Income source Employment Self-employment Income from real property (st,clt as ,‘ental income,,) Interest and dividends $ $ $ $ $ $ $ $ $ $ $ $ s $ $ $ $ $ $ $ $ $ $ Gifts Alimony Child support Spouse You Page 2 ol 5 AO 239 (Rev. 0Cl5) Application to Proceed in District Court Without Prepaving Fees or Costs (Long Form) Retirement (sticli as social securitt, pensions, annuities, s s $ $ $ $ $ $ $ $ $ $ S S $ S-7i0zO S 0.oo $ 0.00 S instuance, Disability (such as social security, insurance payments) Unemployment payments Public-assistance Other (spec,ji’): / . $ (such as ttelfare) -T /JH’_F- 1- .3 7. . . fotal monthly income: List your employment history for the past two years, most recent employer first. 2. 0.00 (Gross monthly pay is before tcLves or other deductions.) Gross monthly pay Dates of employment Address Employer S S List 3. your spouse’s employment history for the past two years, most recent employer first. (Gross monthly pay is before taxes or other deductions.) /Vi9 Address Employer Gross monthly pay Dates of employment S S S How much cash 4. do you and your spouse have? $ Below, state any money you or your spouse have in Financial institution 7 1/ bank accounts or in any other financial institution. C’ At. Ic i. . 2 Amount your spouse_has Amount you have Type of account . c3jf/.’ 7. 0/ S S must attach a statement certified by the appropriate institutional officer showing all receipts, expenditures, and balances during the last six months in your institutional accounts. If you have multiple accounts, perhaps because you have been in multiple institutions, attach one certified statement of each account. If you are a prisoner, you Page 3 of 5 AO 239 (Rev. 01/15) Application to Proceed in District Court Without Prepaying Fees or Costs (Long Forni) 5. List the assets, and their values, which you own or your spouse owns. Do not list clothing and ordinary household furnishings. Assets owned by you or your spouse Home ( (Va/tie) Other real estate A/tv) $ (Va/tie) $ Motor vehicle #1 (Va/tie) $ Make and year: Model: Registration #: Motor vehicle #2 (Va/tie,) $ Make and year: Model: Registration #: Other assets (Va/tied $ Other assets (Va/tie) $ 6. State every person, business, or organization owing you or your spouse money, and the amount owed. Person owing you or your spouse money Amount owed to you Amount owed to your spouse $ $ State the $ persons who rely on you or your spouse for support. Name (or, if under 1$, 1_ndt $ $ 7. $ (? initials onl ) Relationshi Age Page 4 of 5 A0 239 (Rev. 01/15) Application to Proceed in District Court Without Prepaying Fees or Costs (Long Forn) 8. Estimate the average monthly expenses of you and your family. Show separately the amounts paid by your spouse. Adjust any payments that are made weekly, biweekly, quarterly, semiannually, or annually to show the monthly rate. Your spouse You Rent or home-mortgage payment (inchiding lot rented for mobile home,) Are real estate taxes included? Yes No Is property insurance included? Yes No /V Utilities electricitv, heatingfuel, water, sewer, and telepltone Home maintenance (repairs and upkeep) krs 4/4 $ i / it 7%_ 7 o O $ $ $ $ $ food $ ,?COOOf $ Clothing $ Laundry and dry-cleaning S / Medical and dental expenses $ /)t. Transportation not including motor vehicle payments,) $ Recreation, entertainment, newspapers, magazines, etc. $ $ ô ‘ c £ t.tz $ Y $ t’ O) $ d. /O $ Insurance (‘not deductedfrom wages or included in mortgage payments) Homeowner’s or renter’s: $ $ Life: $ $ $ $ Motor vehicle: $ $ Other: $ $ $ $ Motor vehicle: $ $ Credit card (name,): $ $ Department store (name,): $ $ Other: $ $ $ $ Health: tJ Taxes (not deductedfront wages or included in nuortgage payments) ‘spec(fu): Installment payments Alimony, maintenance, and support paid to others Page 5 of 5 AO 239 (Rev. 01/15) Application to Proceed in District Court Without Prepaying Fees or Costs (Long Forni) Regular expenses for operation of business, profession, or farm (attach detailed statement) Other (spec(/’): $ $ $ 0.00 $ 0.00 Do you expect any major changes to your monthly income or expenses or in your assets or liabilities during the next 12 months’? Yes 10. 4/4 $ Total monthly expenses: 9. $ If yes, describe on an attached sheet. or will you be spending—any money for expenses or attorney fees in conjunction with this Have you spent lawsuit? Yes J-No If yes, how much? $ 11. Provide any other information that will help explain why you cannot pay the costs of these proceedings. 12. Identify the city and state of your legal residence. / ?i %/. .rf/,5 Your daytime phone number: Your age: /v% - Your years of schooling: - /hajis 4.

Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.


Why Is My Information Online?