Gordon, Bernard v. Adams County Sheriff Department et al

Filing 3

ORDER on ifp request: Trust Fund Account Statement due 4/23/2024. Signed by Magistrate Judge Andrew R. Wiseman on 3/26/2024. (jef),(ps)

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IN THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF WISCONSIN BERNARD T. GORDON, Plaintiff, ORDER v. Case No. 24-cv-193-jdp ADAMS COUNTY SHERIFF DEPARTMENT, et al., Defendants. Plaintiff Bernard T. Gordon has filed a proposed civil complaint and has requested leave to proceed without prepaying the filing fee. To evaluate plaintiff’s request to proceed without prepayment, I must review a certified copy of plaintiff’s inmate trust fund account statement (or institutional equivalent) for the six-month period immediately preceding the filing of the complaint. 28 U.S.C. § 1915(a)(2). For this case to proceed, plaintiff must submit a certified trust fund account statement no later than April 23, 2024. If I find that plaintiff is indigent, I will calculate an initial partial payment of the filing fee that plaintiff must pay before the court can screen the complaint on the merits 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 Bernard T. Gordon may have until April 23, 2024 to submit a certified trust fund account statement for the period beginning approximately September 25, 2023 and ending approximately March 25, 2024. If plaintiff fails to respond to this order by April 23, 2024, then I will assume that plaintiff wishes to withdraw this action voluntarily. In that event, the case will be dismissed without prejudice to plaintiff refiling at a later date. Entered this 26th day of March, 2024. BY THE COURT: /s/ ANDREW R. WISEMAN United States Magistrate Judge UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF WISCONSIN BERNARD T. GORDON, Plaintiff, ORDER v. ADAMS COUNTY SHERIFF DEPARTMENT, Case No. 24-cv-193-jdp 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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