Holmes v. Apple Inc. et al

Filing 165

ORDER: On July 26, 2022, pro se Plaintiff Tyrone Holmes filed a document that was coded on ECF as a motion for leave to appeal in forma pauperis and a "notice of appeal." The document itself, however, is titled only "notice of appeal" and does not mention an intent to seek in forma pauperis status. The Court construes this filing as a notice of appeal. If Plaintiff wishes to proceed in forma pauperis on appeal, he must complete and file the attached application with this Court. The Clerk of Court is respectfully directed to mail a copy of this Order to Plaintiff. (Signed by Judge Ronnie Abrams on 7/29/2022) (ate)

USDC-SDNY
DOCUMENT
ELECTRONICALLY FILED
DOC#:
DATE FILED: 07/29/2022

UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF NEW YORK
TYRONE HOLMES,
Plaintiff,

17-CV-4557 (RA)

v.

ORDER

APPLE INC., AMAZON.COM, LLC, and
CHECKPOINT FLUIDIC SYSTEMS
INTERNATIONAL, LTD.,
Defendants.
RONNIE ABRAMS, United States District Judge:

On July 26, 2022, pro se Plaintiff Tyrone Holmes filed a document that was coded on
ECF as a “motion for leave to appeal in forma pauperis” and a “notice of appeal.” The document
itself, however, is titled only “notice of appeal” and does not mention an intent to seek in forma
pauperis status. The Court construes this filing as a notice of appeal. If Plaintiff wishes to
proceed in forma pauperis on appeal, he must complete and file the attached application with this
Court. The Clerk of Court is respectfully directed to mail a copy of this Order to Plaintiff.
SO ORDERED.
Dated:

July 29, 2022
New York, New York
Hon. Ronnie Abrams
United States District Judge

U NITED S TATES D ISTRICT C OURT
S OUTHERN D ISTRICT OF N EW Y ORK

_____CV_________ (

)(

(List the full name(s) of the plaintiff(s)/petitioner(s).)

MOTION FOR LEAVE TO
PROCEED IN FORMA
PAUPERIS ON APPEAL

-against-

(List the full name(s) of the defendant(s)/respondent(s).)

I move under Federal Rule of Appellate Procedure 24(a)(1) for leave to proceed in forma
pauperis on appeal. This motion is supported by the attached affidavit.

Dated

Signature

Name (Last, First, MI)

Address

Telephone Number

Rev. 12/23/13

City

State

E-mail Address (if available)

Zip Code

)

Application to Appeal In Forma Pauperis

______________________v. ______________________

Appeal No. __________________
District Court or Agency No. _________________

Affidavit in Support of Motion

Instructions

I swear or affirm under penalty of perjury that,
because of my poverty, I cannot prepay the docket
fees of my appeal or post a bond for them. I believe
I am entitled to redress. I swear or affirm under
penalty of perjury under United States laws that my
answers on this form are true and correct. (28
U.S.C. § 1746; 18 U.S.C. § 1621.)

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.

Signed: _____________________________

Date: _____________________________

My issues on appeal are: (required):

1.

For 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 source

Average monthly
amount during the past
12 months

Amount expected next
month

You

Spouse

You

Spouse

Employment

$

$

$

$

Self-employment

$

$

$

$

Income from real property (such as
rental income)

$

$

$

$

-112/01/2013 SCC

Interest and dividends

$

$

$

$

Gifts

$

$

$

$

Alimony

$

$

$

$

Child support

$

$

$

$

Retirement (such as social security,
pensions, annuities, insurance)

$

$

$

$

Disability (such as social security,
insurance payments)

$

$

$

$

Unemployment payments

$

$

$

$

Public-assistance (such as welfare)

$

$

$

$

Other (specify):

$

$

$

$

$0

$0

$0

$0

Total monthly income:

2.

List your employment history for the past two years, most recent employer first. (Gross
monthly pay is before taxes or other deductions.)

Employer

Address

Dates of
employment

Gross
monthly pay
$
$
$

3.

List your spouse's employment history for the past two years, most recent employer first.
(Gross monthly pay is before taxes or other deductions.)

Employer

Address

Dates of
employment

Gross
monthly pay
$
$
$

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4.

How much cash do you and your spouse have? $________
Below, state any money you or your spouse have in bank accounts or in any other
financial institution.

Financial Institution

Type of Account

Amount you have

Amount your
spouse has

$

$

$

$

$

$

If you are a prisoner seeking to appeal a judgment in a civil action or proceeding, you 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.

5.

List the assets, and their values, which you own or your spouse owns. Do not list clothing
and ordinary household furnishings.

Home

Other real estate

Motor vehicle #1

(Value) $

(Value) $

(Value) $
Make and year:
Model:
Registration #:

Motor vehicle #2

Other assets

Other assets

(Value) $

(Value) $

(Value) $

Make and year:
Model:
Registration #:

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6.

State every person, business, or organization owing you or your spouse money, and the
amount owed.

Person owing you or your spouse
money

7.

Amount owed to you

Amount owed to your
spouse

$

$

$

$

$

$

$

$

State the persons who rely on you or your spouse for support.

Name [or, if a minor (i.e., underage), initials only]

8.

Relationship

Age

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.
You

Your Spouse

Rent or home-mortgage payment (including lot rented for
mobile home)
Are real estate taxes included?
[ ] Yes [ ] No
Is property insurance included?
[ ] Yes [ ] No

$

$

Utilities (electricity, heating fuel, water, sewer, and telephone)

$

$

Home maintenance (repairs and upkeep)

$

$

Food

$

$

Clothing

$

$

Laundry and dry-cleaning

$

$

Medical and dental expenses

$

$

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Transportation (not including motor vehicle payments)

$

$

Recreation, entertainment, newspapers, magazines, etc.

$

$

Insurance (not deducted from wages or included in mortgage payments)
Homeowner's or renter's:

$

$

Life:

$

$

Health:

$

$

Motor vehicle:

$

$

Other:

$

$

$

$

Motor Vehicle:

$

$

Credit card (name):

$

$

Department store (name):

$

$

Other:

$

$

Alimony, maintenance, and support paid to others

$

$

Regular expenses for operation of business, profession, or
farm (attach detailed statement)

$

$

Other (specify):

$

$

$0

$0

Taxes (not deducted from wages or included in mortgage
payments) (specify):
Installment payments

Total monthly expenses:

9.

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.

[ ] No

If yes, describe on an attached sheet.

Have you spent — or will you be spending —any money for expenses or attorney fees in
connection with this lawsuit? [ ] Yes [ ] No
If yes, how much? $ ____________

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11.

Provide any other information that will help explain why you cannot pay the docket fees
for your appeal.

12.

Identify the city and state of your legal residence.
City __________________________

State ______________

Your daytime phone number: ___________________
Your age: ________ Your years of schooling: ________
Last four digits of your social-security number: _______

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