Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_16-cv-03511/USCOURTS-cand-3_16-cv-03511-0/pdf.json

Nature of Suit Code: 864
Nature of Suit: Social Security - SSID Title XVI
Cause of Action: 42:205 Denial Social Security Benefits

---

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

JESSE ALAN LACKEY, SR.

Plaintiff,

v.

CAROLYN W. COLVIN,

Defendant.

Case No. 16-cv-03511-SI 

ORDER RE APPLICATION TO 

PROCEED IN FORMA PAUPERIS

(x ) IT IS ORDERED that the application to proceed in forma pauperis is GRANTED. 

Issuance of summons and service will be determined separately.

(x ) The complaint having been found to comply with Title 28 USC § 1915, IT IS 

FURTHER ORDERED that the Clerk issue summons, and IT IS FURTHER ORDERED that the 

U.S. Marshal for the Northern District of California serve, without prepayment of fees, a copy of 

the complaint, any amendments, scheduling orders, attachments, plaintiff's affidavit and this order 

upon the defendant.

( ) IT IS ORDERED that the application to proceed in forma pauperis is DENIED, and 

that the filing fee is $400.00 be paid no later than. Failure to pay the filing fee by that date will 

result in dismissal for the above- entitled action without prejudice. The plaintiff is hereby 

apprised of his/her responsibility to serve the complaint and any amendments, scheduling orders, 

attachments, pursuant to Rule 4, Federal Rules of Civil Procedure. Plaintiff has a continuing 

obligation to keep the Court informed of his or her current address. Failure to do so may result in 

dismissal of this action.

( ) IT IS ORDERED that the application to proceed in forma pauperis is DENIED and 

the plaintiff is further ordered that:

Case 3:16-cv-03511-SI Document 6 Filed 06/27/16 Page 1 of 2
2

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

United States District Court

Northern District of California

( ) Filing fee waived in part: partial payment of $ due on, remaining balance to 

be waived.

( ) Partial payment of $ due on, remaining balance due and payable on. 

( ) Partial payment of $ due on, remaining balance due in installments as 

follows. 

Failure to pay this amount will result in dismissal of the above-entitled action without 

prejudice. The plaintiff is hereby apprised of his/her responsibility to serve the complaint and any 

amendments, scheduling orders, attachments, pursuant to Rule 4, Federal Rules of Civil 

Procedure. Plaintiff has a continuing obligation to keep the Court informed of his or her current 

address. Failure to do so may result in dismissal of this action.

Dated:

______________________________________

SUSAN ILLSTON

United States District Judge

(Not to be used in PRISONER OR HABEAS CORPUS CASES) (rev. 4/22/2014)

6/27/16

Case 3:16-cv-03511-SI Document 6 Filed 06/27/16 Page 2 of 2