Wrhel, Eric v. United States Department of Justice

Filing 3

ORDER on ifp request: Amended Financial Affidavit due 4/4/2018. Signed by Magistrate Judge Peter A. Oppeneer on 3/13/2018. (jef),(ps)

IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF WISCONSIN
ERIC THOMAS WRHEL ,
Plaintiff,

ORDER

v.
Case No. 18-cv-180-jdp
UNITED STATES DEPARTMENT OF JUSTICE,
Defendant.

Plaintiff Eric Thomas Wrhel has filed a proposed complaint.

Plaintiff seeks to

commence this lawsuit without prepayment of the filing fee pursuant to 28 U.S.C. § 1915.
From plaintiff’s affidavit of indigency, I cannot determine whether plaintiff qualifies
for indigent status. The affidavit indicates that plaintiff is unemployed, has no income and is
not married, however, plaintiff does not include information regarding paying for basic living
expenses, such as food, clothing and shelter.

Without this information, I am unable to

determine whether plaintiff qualifies for indigent status. Therefore, I will provide plaintiff
with the opportunity to supplement the request for leave to proceed without paying the filing
fee by completing the enclosed affidavit of indigency.

When completing the affidavit,

plaintiff should take care to show how basic necessities are paid, and include plaintiff’s actual
gross monthly income from all sources for the last 12 months.

ORDER
IT IS ORDERED that plaintiff Eric Thomas Wrhel, may have until April 4, 2018, to
amend and return the affidavit of indigency, taking particular care to show how basic
necessities are paid, and include actual gross monthly income from all sources for the last 12
months. If plaintiff fails to provide this requested financial information, then the court will

deny the request for leave to proceed without prepayment of the filing fee for failure to show
indigency.

Entered this 13th day of March, 2018.
BY THE COURT:
/s/
PETER OPPENEER
Magistrate Judge

UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF WISCONSIN
ERIC THOMAS WRHEL ,
Plaintiff,

ORDER

v.
Case No. 18-cv-180-jdp
UNITED STATES DEPARTMENT OF
JUSTICE,
Defendant.

NON-PRISONER REQUEST TO PROCEED IN DISTRICT COURT
WITHOUT PREPAYING THE 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)

Are you employed?

□Yes

□ No

2)

Are you married?
If “Yes,” is your spouse employed?

□ Yes
□ Yes

□ No
□ No

3)

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.

Income - If you are married, your answers must include your spouse's income.
(When calculating income, include any wages, salary, rent, child support, public
assistance, unemployment compensation, disability payments, life insurance payments,
pensions, annuities, workers' compensation, stock dividends and interest, gifts and
inheritance, or other money you receive from any source.)

1)

State your total monthly wages or salary?

2)

Provide the name and address of your employer(s):

$ ______________

______________________________________________________________
3)

State your spouse's total monthly wages or salary? $ ______________

State the amount of money you have received from any other source in the last twelve months,
such as the sources listed above. Please attach an additional sheet if necessary.
Source of income

Amount

______________________________________________

$ ______________________

______________________________________________

$ ______________________

III.

Expenses - If you are married or have dependents, your expenses should also include
your household's expenses.
(When calculating household expenses, you may include groceries, clothing, medical
costs, utilities that are not included in your rental payments, transportation, and
insurance.)

1)

Identify the following amounts that you pay per month:
□ Rent or

□ Mortgage

$ __________________________________

Car payment(s)

$ __________________________________

Alimony or court-ordered child support

$ __________________________________

Credit card payment(s)

$ __________________________________

2)

Do you have any other monthly expenses that you have not already listed?
□ Yes
□ No
If “Yes,” list them below:
Expense

Amount

____________________________

$ __________________________________

____________________________

$ __________________________________

____________________________

$ __________________________________

3)

What are your total monthly expenses?

$___________________________________

IV.

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

1)

Do you own a car?

□ Yes

□ No

If “Yes,” list 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).
________________________________________________________________

V.

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 fee and that I am entitled to the relief sought in the
complaint.
___________________________
Date

_________________________________________
Signature - Signed Under Penalty of Perjury