Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_16-cv-01442/USCOURTS-caed-1_16-cv-01442-0/pdf.json

Parties Involved:
Commissioner of Social Security
Defendant
Michael Thomas Nommensen
Plaintiff

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UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF CALIFORNIA

MICHAEL THOMAS NOMMENSEN,

Plaintiff,

v.

COMMISSIONER OF SOCIAL 

SECURITY, 

Defendant.

No. 1:16-cv-1442--BAM

REQUIRING PLAINTIFF TO FILE LONG 

FORM APPLICATION TO PROCEED IN 

FORMA PAUPERIS 

TWENTY DAY DEADLINE

Plaintiff Michael Nommensen, appearing pro se in this action for review of denial of 

Social Security benefits, filed a complaint on September 28, 2016. 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’s 

application does not reflect all the income which is being received by the household. For that 

reason, the Court is unable to determine if he is able to proceed in this action without prepayment 

of fees.

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.

Accordingly, IT IS HEREBY ORDERED THAT: 

1. The Clerk of the Court is directed to forward an in forma pauperis application 

(Long Form) to Plaintiff; 

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

Case 1:16-cv-01442-BAM Document 3 Filed 10/04/16 Page 1 of 2
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$400.00 filing fee for this action, or (2) file an application to proceed in forma 

pauperis without prepayment of the fee; and

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

IT IS SO ORDERED.

Dated: October 3, 2016 /s/ Barbara A. McAuliffe _

UNITED STATES MAGISTRATE JUDGE

Case 1:16-cv-01442-BAM Document 3 Filed 10/04/16 Page 2 of 2