Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_13-cv-02616/USCOURTS-azd-2_13-cv-02616-1/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:405 Review of HHS Decision (SSID)

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WO 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Armentha Hooker, 

Plaintiff, 

v. 

Carolyn W. Colvin, 

Defendant.

No. CV-13-02616-PHX-JAT

ORDER 

 Before the Court is Plaintiff’s Motion for Leave to Proceed In Forma Pauperis 

(Doc. 23). The Court now rules on the motion. 

 Plaintiff’s motion requests leave to appeal, in forma pauperis, this Court’s 

February 3, 2015 order affirming the decision of the Social Security Administrative Law 

Judge (“ALJ”). (Doc. 19). Plaintiff attached to the motion her affidavit showing why she 

is unable to pay or give security for fees and costs and stating her grounds on appeal. 

(Doc. 23-1). 

 Federal Rule of Appellate Procedure 24(a)(1) provides that a party’s motion to 

appeal in forma pauperis is filed with the district court and must be accompanied by an 

affidavit that: “(A) shows in the detail prescribed by Form 4 of the Appendix of Forms 

the party’s inability to pay or to give security for fees and costs; (B) claims an entitlement 

to redress; and (C) states the issues that the party intends to present on appeal.” 

Case 2:13-cv-02616-JAT Document 26 Filed 05/20/15 Page 1 of 2
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 In her affidavit, Plaintiff declares that she averages approximately $912 in 

monthly expenses and that her income is approximately $953 per month. (Doc. 23-1). 

She also declares that she is unemployed, has only $3 in a single checking account, does 

not own a home, owns a 2007 Chevy Equinox, and has a twelve year old daughter and 

fifteen year-old son who rely on Plaintiff for support. The Court finds that these 

circumstances demonstrate Plaintiff’s inability to pay or give security for the fees and 

costs associated with her appeal. 

 Plaintiff’s affidavit also describes her issues on appeal: whether the ALJ erred in 

determining Plaintiff’s residual functional capacity and in weighing the medical source 

opinion. (Doc. 23-1). The affidavit also states that Plaintiff “believes [she] is entitled to 

redress.” (Id.). Thus, the Court finds that Plaintiff has stated the issues that she intends to 

present on appeal and that she is entitled to redress. 

 Accordingly, 

IT IS ORDERED that Plaintiff’s Motion for Leave to Proceed In Forma Pauperis 

(Doc. 23) in GRANTED. 

 Dated this 19th day of May, 2015. 

Case 2:13-cv-02616-JAT Document 26 Filed 05/20/15 Page 2 of 2