Oo3d

mr JR US JBCQUELINE GLOSSQ

QfflE FILED 08/28/2014

IN THE DISTRICT COURT

BEXAR, COUNTY

STATC OF TEXAS'

JAMES W. MYART. JR.

PLAINTIFF,

V.

JACQUELINE GLOSSON AND

EWtN NORMAN GLOSSON, DEFENDANTS

IN THE DISTRICT COURT OF BEXAR, COUNTY STATE OF TEXAS, JAMES W. MYART, JR., Petitioner and

JACQUELINE GLOSSON AND CW1N NORMAN GLOSSON, DEFENDANTS

PAUPER'S AFFIDAVIT IN REQUE5TTHAT FILING AND OTHER FEES BE WAIVED

Personally appeared before the undersigned officer, duly authorized by law to administer oaths in the

State ol TEXAS, JAMES W. MYART, JR., Petitioner in the above styled cose and on oath stales that:

am the Petitioner in the above styled case and that owing to my poverty am unable to pay any costs

the foregoing matter. My monthly income is S741.00 and pay S938.00 per month rent tent and)

iving expensed.

This Affidavit represent myaexpenses«aQgJ5Jncorporated anses^Qgjsj herein as if fully set torch verbatim.-^- ^7

KOfllNAZAHORA

MY COMMISSION EXPIRES

jr.--.-

co ■--r
SOCIAL SECURITY ADMINISTRATION

Date: July 28, 2014

Claim Number: XXX-XX-9315A

XXX-XX-9315DI

JAMES MYART

323 PRESTON AVE

SAN ANTONIO TX 78210-2315

You asked us for information from your record. The information that you

requested is shown below. If you want anyone else to have this information, you

may send them this letter.

Information About Supplemental Security Income Payments

Beginning August 2014, the current

Supplemental Security Income payment is 721.00

This payment amount may change from month to month if income or

living situation changes.

Supplemental Security Income Payments are paid the month they are due. (For

example, Supplemental Security Income Payments for March are paid in March.)

IP YOU HAVE ANY QUESTIONS

We invite you to visit our web site at www.socialsecurity.gov on the Internet

to find general information about Social Security. If you have any specific

questions, you may call us toll-free at 1-800-772-1213, or call your local

office at 866-964-7432. We can answer most questions over the phone. If you are

deaf or hard of hearing, you may call our TTY. number, .1-800-325-0778. You can

also write or visit any Social Security office. The office that serves your

area is located at:

SOCIAL SECURITY

3438 SOUTHCROSS

SAN ANTONIO, TX 78223

DOCUMENT SCANNED AS FILED
If you do call or visit an office, please have this letter with you. It will

helD lis answer your Questions. Also, if you plan to visit an office, you may

call ahead to make an appointment. This will help us serve you more quickly

when you arrive at the office.

OFFICE MANAGER
\'«

Supplemental Security Income

Notice

From: Social Security Administration

Date: JUL2120H

Claim Number: xxx-xx-9315

James Willie Myart Jr.

323 Preston Ave.

San Antonio, TX 78210

You must meet certain medical and nonmedical requirements to be entitled to disability

benefits: ""- •• •• ,..._ ... .. ..

We have found that you meet the medical requirements for disability benefits. An

explanation of our findings follows. Please read it carefully.

We used the following report(s) in deciding your claim:

Shannon Kelly. Consultative Examination, report received, 06/17/2014

The Center for Health Care, reports received, 05/22/2014

Leo K. Edwards Jr., reports received, 05/21/2014

Southeast Baptist Hospital, reports received, 05/13/2014

You said that you became unable to work on August 21, 2010 because of bipolar, high

blood pressure, and diabetes.

While you stopped work because of your condition, the medical evidence did not show

your condition was severe enough to meet our requirements until your hospitalization

on April 16. 2014. Because of the severity of your condition at that time and medical

experience with your type of condition, your impairment(s) met our requirements! as

early as April 16, 2014.

We have not yet made decision about whether you meet the nonmedical

requirements, but we will make that decision soon. Then we will send you second

notice explaining our decision. AFTER YOU RECEIVE THIS SECOND NOTICE, YOU

WILL HAVE 60 DAYS TO APPEAL THE DETERMINATION WE MADE ABOUT YOUR

CLAIM FOR DISABILITY BENEFITS.

IF YOU HAVE ANY QUESTIONS ABOUT YOUR DISABILITY CLAIM OR WISH TO

APPEAL OUR FINDINGS, PLEASE DO NOT GET IN TOUCH WITH THE SOCIAL

SECURITY OFFICE UNTIL YOU HAVE THE SECOND NOTICE. The people atthe

Social Security office will be better able to answer your questions when they have the

DOCUMENT SCANNED AS FILED
.information from both notices. You can look us up online at www.ssa.gov. call our

national 1-800 number at 1-800-772-1213.

If You Want Help With Your Appeal

You can have friend, lawyer, or someone else help you. There are groups that can

find you lawyer or give you free legal services if you qualify. There are also lawyers

who do not charge unless you win your appeal. Your local Social Security office has

list of groups that can help you with your appeal.

If you get someone to help you, you should let us Know. If you hire someone, we must

approve the fee before he or she can collect it. And if you hire lawyer, we will

withhold up to 25 percent of any past due benefits to pay toward the fee.

After you have received your second notice, you can call or write any Social Security

office to appeal our determination or to get answers to your questions. Most questions

can be handled by telephone or mail. If you go to the Social Security office in person,

please take both notices with you.

Social Security Administration

SSA-L1157-SI

DOCUMENT SCANNED AS FILED
Civil Action File No.

ORDER OF THE COURT

JAMES W. MYART, JR.

PLAINTIFF,

V.

JACQUELINE GLOSSON AND

EWIN NORMAN GLOSSON, DEFENDANTS

IN THE DISTRICT COURT

BEXAR, COUNTY

STATE OF TEXAS

This Court, having considered the Petitioner's request to proceed in forma pauperis, hereby grants the

request.

This .day of.

Judge, DISTRICT COURT

BEXAR COUNTY, TEXAS

DOCUMENT SCANNED AS FILED