Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_16-cv-02790/USCOURTS-caed-2_16-cv-02790-0/pdf.json

Parties Involved:
Alex Leonard Azevedo
Plaintiff
Colusa County Jail
Defendant

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UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

ALEX LEONARD AZEVEDO,

Plaintiff,

v.

COLUSA COUNTY JAIL,

Defendant.

No. 2:16-cv-2790 CKD P

ORDER

Plaintiff, a county inmate proceeding pro se, has filed a civil rights action pursuant to 42 

U.S.C. § 1983 together with a request for leave to proceed in forma pauperis pursuant to 28 

U.S.C. § 1915. However, the second page, with the certificate portion of the request which must 

be completed by plaintiff’s institution of incarceration and plaintiff’s signature, is missing. Also, 

plaintiff has not filed a certified copy of his prison trust account statement for the six month 

period immediately preceding the filing of the complaint. See 28 U.S.C. § 1915(a)(2). Plaintiff 

will be provided the opportunity to submit a completed in forma pauperis application and a 

certified copy in support of his application.

In accordance with the above, IT IS HEREBY ORDERED that:

1. Plaintiff’s request to proceed in forma pauperis (ECF No. 3) is dismissed without 

prejudice;

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Case 2:16-cv-02790-CKD Document 5 Filed 12/08/16 Page 1 of 2
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2. Plaintiff shall submit, within thirty days from the date of this order, a completed 

affidavit in support of his request to proceed in forma pauperis on the form provided by the Clerk 

of Court; 

3. The Clerk of the Court is directed to send plaintiff a new Application to Proceed In 

Forma Pauperis By a Prisoner; and

4. Plaintiff shall submit, within thirty days from the date of this order, a certified copy of 

his prison trust account statement for the six month period immediately preceding the filing of the 

complaint. Plaintiff’s failure to comply with this order will result in a recommendation that this 

action be dismissed without prejudice.

Dated: December 8, 2016

2/kly

azev2790.3c+new

_____________________________________

CAROLYN K. DELANEY

UNITED STATES MAGISTRATE JUDGE

Case 2:16-cv-02790-CKD Document 5 Filed 12/08/16 Page 2 of 2