Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_12-cv-01665/USCOURTS-azd-2_12-cv-01665-1/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
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 

Gina L. Samuels, 

Plaintiff, 

v. 

Michael J. Astrue, et al., 

Defendants.

No. CV-12-01665-PHX-JAT

ORDER 

 Pending before the Court is Plaintiff’s Motion for Leave to Proceed in Forma 

Pauperis (Doc. 29). The Court now rules on the motion. 

I. Background

 Plaintiff brought this action seeking review of an Administrative Law Judge 

(“ALJ”)’s decision denying her Social Security benefits. (Doc. 1). Plaintiff paid the filing 

fee for her complaint. (Id.) The Court affirmed the ALJ’s decision, (Doc. 24), and 

Plaintiff filed a notice of appeal to the Ninth Circuit Court of Appeals, (Doc. 26). Plaintiff 

now seeks to proceed in forma pauperis for her appeal. (Doc. 29). 

II. Legal Standard

 Federal Rule of Appellate Procedure (“FRAP”) 24(a)(1) provides that generally “a 

party to a district-court action who desires to appeal in forma pauperis must file a motion 

in the district court.” The movant must attach an affidavit that “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; . . . claims an entitlement to redress; and states the issues that 

the party intends to present on appeal.” Fed. R. App. P. 24(a)(1)(A)-(C).

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III. Analysis 

 Plaintiff has submitted an affidavit showing her indigence in the detail prescribed 

by FRAP Form 4, (Doc. 29-1), and according to this affidavit, Plaintiff is unable to pay 

the costs of her appeal. Plaintiff’s affidavit adequately states her issues on appeal and 

claims her entitlement to redress. 

IV. Conclusion

 For the foregoing reasons, 

IT IS ORDERED granting Plaintiff’s Motion for Leave to Proceed in Forma 

Pauperis (Doc. 29). 

IT IS FURTHER ORDERED that the Clerk of the Court shall forward a copy of 

this Order to the Ninth Circuit Court of Appeals. 

 Dated this 10th day of September, 2014. 

Case 2:12-cv-01665-JAT Document 31 Filed 09/10/14 Page 2 of 2