Davis-Rascoe v. Commissioner of Social Security Administration

Filing 7

ORDER re 3 MOTION for Leave to Proceed in forma pauperis (Restricted Access) filed by Makesha Davis-Rascoe. Case to be brought into proper form by 1/25/2017. (Add an additional 3 days only if served by mail or otherwise allowed under Fed. R. Civ. P. 6.) Signed by Magistrate Judge Jacquelyn D Austin on 1/4/2017. (Attachments: # 1 Plaintiff's Answers to Court's Special Interrogatories)(abuc)

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF SOUTH CAROLINA
MAKESHA DAVIS-RASCOE,

)
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PLAINTIFF,
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vs.
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COMMISSIONER OF SOCIAL SECURITY
)
ADMINISTRATION,
)
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DEFENDANT.
)
______________________________________ )

C/A No. 8:17-3-RBH-JDA

PLAINTIFF’S ANSWERS TO COURT’S
SPECIAL INTERROGATORIES

Plaintiff is directed to answer the following questions as completely as possible in
the space provided. If you need additional space, attach a separate sheet of paper and
indicate which answer(s) are continued on the separate sheet. BE AWARE THAT YOUR
ANSWERS MUST BE COMPLETELY TRUTHFUL AND ARE GIVEN UNDER PENALTY
OF PERJURY.
1. In your motion for leave to proceed in forma pauperis, you appear to
indicate that you receive disability and medical retirement benefits of
approximately $4253.00 each month. And, you state that you have
approximately $2794.00 in expenses each month. Please explain below
more details about why you cannot pay the $400 filing fee.
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2. Provide a list of your regular monthly income.
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3. List below any debts or financial obligations you have and describe the
amounts owed (both the total outstanding balance and the required monthly
payments) and to whom they are payable.
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I declare under penalty of perjury that the foregoing is true and correct.

Signed this ______ day of___________________, 2017

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Signature of Plaintiff

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