Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_15-cv-01298/USCOURTS-caed-1_15-cv-01298-0/pdf.json

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

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UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF CALIFORNIA

MIKE ROCHA,

Plaintiff,

v.

COMMISSIONER OF SOCIAL SECURITY,

Defendant.

Case No. 1:15-cv-01298-SAB

ORDER DENYING APPLICATION TO 

PROCEED IN FORMA PAUPERIS AND 

REQUIRING PLAINTIFF TO FILE LONG 

FORM APPLICATION

(ECF No. 2)

TWENTY DAY DEADLINE

Plaintiff Mike Rocha filed a complaint challenging the Commissioner’s final decision 

denying his application for Social Security benefits. (ECF No. 1.) Plaintiff did not pay the filing 

fee in this action and instead filed an application to proceed in forma pauperis pursuant to 28 

U.S.C. § 1915. However, Plaintiff’s application was not adequately completed. Plaintiff 

indicated that he receives “Disability or workers compensation payments,” but did not indicate 

the amount of such benefits that he receives. 

Accordingly, the Court will order Plaintiff to complete and file an Application to Proceed 

in District Court Without Prepaying Fees or Costs (Long Form) – AO 239. If Plaintiff is 

unwilling to complete and submit the long form application, Plaintiff must pay the filing fee in 

full.

Based upon the foregoing, it is HEREBY ORDERED that:

1. Plaintiff’s application to proceed in forma pauperis is DENIED without prejudice;

Case 1:15-cv-01298-SAB Document 3 Filed 08/25/15 Page 1 of 2
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2. The Clerk of the Court is directed to forward an Application to Proceed in District 

Court Without Prepaying Fees or Costs (Long Form) – AO 239 to Plaintiff;

3. Within twenty (20) days of the date of this order, Plaintiff shall either (1) pay the 

$400.00 filing fee for this action, or (2) complete and file the enclosed 

Application to Proceed in District Court Without Prepaying Fees or Costs (Long 

Form) – AO 239; and

4. If Plaintiff fails to comply with this order, this action shall be dismissed.

IT IS SO ORDERED.

Dated: August 25, 2015 

UNITED STATES MAGISTRATE JUDGE

Case 1:15-cv-01298-SAB Document 3 Filed 08/25/15 Page 2 of 2