Leiser, Jeffrey v. Richardson, Reed et al

Filing 2

ORDER that plaintiff Jeffrey D. Leiser to submit $400 filing fee or Trust Fund Account Statement by 1/25/2017. Signed by Magistrate Judge Peter A. Oppeneer on 1/03/2017. (nln),(ps)

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IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF WISCONSIN JEFFREY D. LEISER, Plaintiff, ORDER v. Case No. 16-cv-860-wmc REED RICHARDSON, et al., Defendants. Plaintiff Jeffrey D. Leiser has filed a proposed civil complaint, but has neither paid the filing fee nor requested leave to proceed without prepayment. For this case to proceed, plaintiff must pay the $400 filing fee or submit a properly supported motion for leave to proceed without prepayment of the filing fee no later than January 25, 2017. A motion for leave to proceed without prepayment of the filing fee must be accompanied by a certified copy of plaintiff’s inmate trust fund account statement (or institutional equivalent) for the six-month period immediately preceding the date of the complaint. 28 U.S.C. § 1915(a)(2). If I find that plaintiff is indigent, I will calculate an initial partial payment amount that must be paid before the court can screen the merits of the complaint under 28 U.S.C. § 1915(e)(2). Thereafter, plaintiff will be required to pay the balance of the filing fee in installments. ORDER IT IS ORDERED that plaintiff Jeffrey D. Leiser may have until January 25, 2017 to submit the $400 filing fee or a motion for leave to proceed without prepayment and a trust fund account statement for the period beginning approximately June 21, 2016 and ending approximately December 21, 2016. If, by January 25, 2017, plaintiff fails to respond to this order, I will assume that plaintiff wishes to withdraw this action voluntarily. In that event, the case will be closed without prejudice to plaintiff filing the case at a later date. Entered this 3rd day of January, 2017. BY THE COURT: /s/ PETER OPPENEER Magistrate Judge UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF WISCONSIN JEFFREY D. LEISER, ORDER Plaintiff, v. Case No. 16-cv-860-wmc REED RICHARDSON, 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

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