Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_10-cv-00496/USCOURTS-caed-1_10-cv-00496-0/pdf.json

Nature of Suit Code: 550
Nature of Suit: Prisoner - Civil Rights (U.S. defendant)
Cause of Action: 42:1983 Prisoner Civil Rights

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UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF CALIFORNIA

JUNIOR HOLT,

Plaintiff,

vs.

CALIFORNIA DEPARTMENT OF

CORRECTIONS MEDICAL

DEPARTMENT, et al., 

Defendants.

 /

1:10-cv-00496-GSA (PC)

ORDER TO SUBMIT APPLICATION

TO PROCEED IN FORMA PAUPERIS

OR PAY FILING FEE WITHIN 45 DAYS

Plaintiff is a state prisoner proceeding pro se in a civil rights action pursuant to 42 U.S.C. §

1983. Plaintiff has not paid the $350.00 filing fee, or submitted a current application to proceed in

forma pauperis – while Plaintiff did submit a document entitled “Motion and Declaration Under

Penalty of Perjury in Support of Motion to Proceed In Forma Pauperis,” it is neither the current, nor

correct form pursuant to 28 U.S.C. § 1915. 

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Accordingly, IT IS HEREBY ORDERED that:

1. The Clerk of the Court is to serve Plaintiff with a copy of the current prisoner

application to proceed in forma pauperis;

2. Within forty-five (45) days of the date of service of this order, Plaintiff shall submit

the attached application to proceed in forma pauperis, completed and signed, or in the

alternative, pay the $350.00 filing fee for this action; no requests for extension will

At least a portion of the form Plaintiff submitted appears to be a form approved by the Judicial Counsel of

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California for actions brought in state superior court.

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Case 1:10-cv-00496-SKO Document 4 Filed 03/23/10 Page 1 of 2
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be granted without a showing of good cause; 

3. If Plaintiff chooses to submit the attached application to proceed in forma pauperis,

within sixty (60) days of the date of service of this order, Plaintiff shall submit a

certified copy of his/her prison trust statement for the six month period immediately

preceding the filing of the complaint; and

4. Failure to comply with this order will result in dismissal of this action. 

IT IS SO ORDERED. 

Dated: March 22, 2010 /s/ Gary S. Austin 

b742a4 UNITED STATES MAGISTRATE JUDGE

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Case 1:10-cv-00496-SKO Document 4 Filed 03/23/10 Page 2 of 2