AO240(Reit.07/10)ApplicationtoProceedinDistzictCourtWithoutPrepayingFeesorCostslshortForml

U NITED STATESD ISTRICT C OURT

forthe

Southern DistrictofFlorida Q

DonaldJ.Trump

Plainttfmetitioner

V.

USA

De#ndantmespondent

CivilActionNo.9:22-cv-81294-AMC

APPLICATION TO PROCEED IN DISTRICT COURT W ITHOUT PREPAYING FEESOR COSTS

(ShortForm)

Imnaplaintifforpetitionerillthiscaseanddeclarethat1am unabletopaythecostsoftheseproceedingsand

thatlam entitledtothereliefrequested.

Insupportofthisapplication,Ianswerthefollowlgquestionstmderpenaltyofperjury:

1.Ifincarcerated.lam beingheldat: .

Ifemployedthere,orhaveanaccountintheinstitution,Ihaveattachedtothisdocumentastatementcertifedbythe

appropriateinstitutionalom cershowingallreceipts,exw nditures,andbalancesduringthelastsixmonthsforany

institutionalaccolmtinmyname.lam alsosubmittingasimilarstatementfrom anyotherinstitutionwherelwas

incarcemtedduringthelastsixmonths.

2.Ifnotincarceratei 1flam employed,myemployer'snameandaddressare:

N/A

M ygrosspayorwagesare: $ ,andmytnke-homepayorwagesare: $ per

(spec* paypen'odl .

3.OtherIncome.Inthepast12months,lhavereceivedincomefrom thefollowingsources(checkaIl#ltzfapplylk

(a)Business,profession,orotherself-employment

(b)Rentpayments,interest,ordividends

(c)Pension,annuity,orlifeinsumncepayments

(d)Disability,orworker'scompensationpayments

(e)GiAs,orinheritances

(9 Anyothersources

lfyouansweredc'Yes''toanyquestionabove,describebelow oronseparatepageseachsourceofmoneyand

statetheamountthatyoureceivedandwhatyouexpecttoreceiveinfàe/f/l/re.

$19,000incheck;thiswastopayoffcreditcarddebttoatlendfamilyevent;$11,000+indebtstil;donotexpect

anything.

D Yes

D Yes

O Yes

O Yes

W Yes

O Yes

# No

# No

@ No

# No

O No

# No

FILED BY D.C.

AtJ6 26 2822

ANGELAE.NOSLE

CLERK US DIS'ECX

s.D.oFglA.-w.RB.

Case 9:22-cv-81294-AMC Document 22 Entered on FLSD Docket 08/26/2022 Page 1 of 3
AOz7.40(Re%.07/10)ApplicationtoProceedinDistrictCoudWitlzoutPrepayingFeesorCosts(ShortForml

4.Amotmtofmoneyth1 lhaveincashorinacheckingorsavingsaccount: $ 4,000.00 .

5.Anyautomobile,realestate,stock,bond,sccurity,t111s-t,jewelry,artwork,orotherfmancialinstrnmentor

thingofvaluethatlown,hcludinganyitem ofvalueheldinsomeoneelse'sname(describefàepmperl.panditsapproximate

value):

N/A

6.Anyhousing,transportation,utilities,orloanpayments,orotherregularmonthlyexpenses(describeandprovide

theamountofthemonthlyexpensell

$80celphonebill;$1,500minimunpayment;$1,500foodexpenses;clothsexpenses.

7.Nmnes(or,iftmder18,initialsonly)ofa11personswhoaredependentonmeforsupport,myrelationship

witheachperson,andhow muchIcontributetotheirsupport:

N/A

8.Anydebtsorfnancialobligations(describetheamountsowe#tzrlétowào?sfàe.parepayablel:

Iam takingIoansandcashadvances.

$0.But,Ihaveabout$4,500incashadvanceWhichisapartOfmydebt.

IFPwasrecentlygrantedinPatelv.US,No.1:22-cv-734-LAS(C.F.C.202-)

Declaration:ldeclaretmderpenaltyofperjurythattheaboveinformationistmeandtmderstandthatafalse

statementmayresultinadismissalofmyclaims.

Date: 8/25/2022 /s/RajK.Patel

Applicant'sa'fgpafxrc

RajK.Patel

Printedname

* z. z z . @ à '-

Case 9:22-cv-81294-AMC Document 22 Entered on FLSD Docket 08/26/2022 Page 2 of 3
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Case 9:22-cv-81294-AMC Document 22 Entered on FLSD Docket 08/26/2022 Page 3 of 3