Stewart, Steven v. Wall, Edward et al

Filing 225

ORDER that plaintiff is to submit $505 appeal fee or motion to proceed ifp on appeal and Trust Fund Account Statement by 7/29/2016. Signed by Magistrate Judge Peter A. Oppeneer on 7/07/2016. (nln),(ps)

IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF WISCONSIN

STEVEN D. STEWART,

v.

ORDER

Plaintiff,

14-cv-665-jdp
App. No. 16-2824

DR. BURTON COX, JR., et al.,
Defendants.

Plaintiff Steven D. Stewart has filed a notice of appeal from the court’s June 23, 2016
order. To date, however, plaintiff has not paid the appellate docketing fee nor requested
leave to proceed without payment of the appellate filing fee. For this appeal to proceed,
plaintiff must pay the $505 appellate docketing fee or submit a properly supported motion
for leave to proceed without prepayment of the filing fee no later than July 29, 2016.

ORDER
IT IS ORDERED that plaintiff Steven D. Stewart may have until July 29, 2016 to
either (1) pay the $505 appellate docketing fee; or (2) submit a certified trust fund account
statement for the six-month period preceding the filing of the appeal in compliance with 28
U.S.C. § 1915(a)(2). Failure to comply as directed may result in the dismissal of this appeal.
Entered this 7th day of July, 2016.

BY THE COURT:

/s/
PETER OPPENEER
Magistrate Judge

UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF WISCONSIN
STEVEN D. STEWART,
ORDER

Plaintiff,
v.

14-cv-665-jdp
App. No. 16-2824

DR. BURTON COX, JR., et al.,
Defendants.

PRISONER REQUEST TO PROCEED IN DISTRICT COURT
WITHOUT PREPAYING THE FULL FILING FEE
Answer the following questions to the best of your ability.
Note: If you do not tell the truth, the court may dismiss your lawsuit.
I.

Personal Information

1)

Your name: ___________________________________________________________
(a)

State the place of your incarceration and provide your prisoner identification
number:

_______________________________________
(place)

_____________________________
(number)

(b)

Are you employed at the institution?

□Yes

□ No

(c)

Do you receive any payment from the institution?

□Yes

□ No

Attach a printout of your prison trust account statement showing transactions for the sixmonth period immediately preceding the filing of this request and showing the current
balance of your account.
2)

Do you have any dependents that you are responsible for supporting?
□ Yes

□ No

If “yes,” list them below.

Name or initials (for
minor children only)

Relationship to You

Age

Amount of Support
Provided per Month

________________________

_________________

________

$____________

________________________

_________________

________

$____________

________________________

_________________

________

$____________

II.

Property or Assets: - If you are married, your answers must include your spouse's
property.

1)

Do you own a car?
□ Yes

□ No

If “yes,” list the car(s) below:

Make and Model

Year

Approximate Current
Value

_______________________________________________ __________

$________________

_______________________________________________ __________

$________________

2)

Do you own your home(s)?

□ Yes

If “Yes,” state the approximate value(s).

□ No
$ ____________________

What is the amount of equity (assessed value of residence minus outstanding
mortgage balance) in the home(s)? $ ____________________
3)

Do you have any cash or checking, savings, or other similar accounts?
□ Yes
□ No
If “Yes,” state the total of such sums.

4)

$ ____________________

Do you own any other property of value, such as real estate, stocks, bonds, trusts, or
individual retirement accounts (e.g., IRA, 401 k), artwork, or jewelry?
□ Yes

□ No

If “Yes,” describe the property and the approximate value(s).
______________________________________________________________________
______________________________________________________________________

III.

Litigation History

For each federal lawsuit that you recall having filed, list as much of the following
information that you remember about each case: The name of the case (that is, the plaintiffs and
the defendants), the case number or year of filing, and the federal district in which you filed the
case. Use more paper if needed.
Case Name
(Plaintiffs and defendants)

Case number
(or year of filing)

Federal district

________________________

____________________

_______________________

________________________

____________________

_______________________

________________________

____________________

_______________________

________________________

____________________

_______________________

IV.

Other Circumstances - Describe any other financial circumstance(s) that you would
like the court to consider when reviewing this petition.

____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

I, ____________________, declare that I am the plaintiff bringing this complaint. I declare that
I am unable to prepay the full filing fee and that I am entitled to the relief sought in the
complaint.
___________________________
Date

_________________________________________
Signature - Signed Under Penalty of Perjury