CSINIH02/CINIBQi2 TEXAS DEPARTNENT OF CRI~ln!AL JU5TICE 

R147/ALE1031 IN-FORNA-PiU'ERIS DATA 

TDCJfi: 0173731!11 SiiRI: 03213784 LOCATION: RANSEY 

06/02/15 

10:24:02 

I;~DIG8;T DTE: ~1/21/14 

:-:Ai~E: OIAZ, JIMMY BEGINi'~ING PERIOD: 12/01/14 

PREVIOUS TDCJ NUMBERS: 00475593 00721195 01201534 

~RRENT BAL: 0. 00 TOT HOLD ANT: 0. e-0 ~i'1TH TOT DEP: 0. 00 

6MTH DEP: 0.0ll f.[i!TH AVG BrtL: 0.00 f:lilTH AVG DEP: G.00 

MONTH HIGF.EST BALAJ\'CE TOTAL DEP03ITS XONTH HIGHEST BALANCE TOTAL DEPOSITS 

~~5/15 0.00 0.00 02/:5 0.00 0.Q:O 

04/15 0.0~ 0.021 01/15 0.00 0.00 

~3/15 0.00 0.~ 12/14 0.~0 0.00 

PROCESS DATE HOLD Ai't.OU:-JT HDLD DES'CR~~TIGJ 

STATE OF TEXAS COUNTY CF 8 RA L6 RJ A 

Otl THIS THE~'AY OFV\4~~ ~()if I CERTIFY THAT THIS DOCUMENT IS A TRUE 

COtf.PLET£1 Ai~D UNALTERED COPY !r~DE BY ME CF n;roRt~ATIGtl CONTAWEO IN -:-;;t:: .. (2~ 

COt~PUTER DATABASE REGARDit\6 THE OFFENDER'S ACCOL!!H. NP SIG: ,...ec.....~ 

PFl-HELP PF3-END ENTER NEXT TDCJ NUMBER: OR SID i,ul•IBER: __ _ 
CSINIBQJ2/CINIB~i2 TEXAS DEPhRnlHH OF CRIP1!1'\AL JU3TICE 

R147/ALE1031 IN-FOffi~A-PAUPERIB DATA 

06/~2/15 

10:24:02 

TDCJfl: 017373~1 SIDfl: \B213784 LOCATION: RAi4SEY MDIGEm DTE: llll/21114 

~Ai4E: OIAZ1 JifliJilY BEGIN;>JING PERIOD: 12/01/14 

PREVI~JS TDCJ ~UMBERS: 00475593 0~72119~ 01201534 

CURRENT BAL: 0. 00 TOT HOLD ANT: 0. 00 3i1TH TOT DEP: 0. 00 

f.MTH DEP: 0. 0~1 £tolTH AVG BF1L: 0. 00 f.NTH AV6 DEP: G. 00 

WJNTH HIGHEST BALA~CE TOTAL DEP03ITS :rlOifiH HIGHEST BALANCE TOTAL DEPOSITS 

iG/15 0. 00 0. 00 02/~5 0. 00 0. fl:0 

04/15 0. 0~ 0. 021 0111s e. oo 0. 00 

03/15 0.00 0.00 12/14 0.00 0.00 

PROCESS DATE HOLD AXOUNT HULD DESCR:~·TICJ 

STATE OF TEXAS COUNTY OF 8 RA 'Z6 FJ A 

ON THIS THE~~AY OFJUK.~.&()ifi CERTIFY THAT THIS DOCUI4ENT !S A TRUE 

COMPLETE, AND UNALTERED COPY fr~DE BY t4E CF Ir:FORMATIGt4 CONTAit~ED IN -:-i;t .. £2~ 

COI4PUTER DATABASE REGARDING THE OFFENDER'S ALXOUNT. NP SIG: ...ec,....~ 

PFl-HELP PF3-END ENTER NEXT TDCJ NUMBER: OR SID ,,Ulq!lER: __ _ 

: • • • • • • o I o o o o o • I • I o o o o o a • 
. J. lbm1 bHrtz J:f r?lf ~ .. )/ 

Plaintiff's name and II} Number 

I.Anl~l'Jlllnn l1o0 nfll1 ttl .. Place of Confinemeni&shnr.:111. f:f 195~3 

·.-.•. ,. 

·-. ·- CASE NO. _________ _ ....... _ ... 

(Clerk will assign the number) 

... 

APPLICATION TO PROCEED 

IN FORMA PAUPERIS 

·,, ... 

f.' 

l IIi: 

~ { 

I; , declare, depose, and say I am the Plaintiff in the above entitled case. In support 

of my motwn o pro eed williout being required to prepay fees, costs, or give security therefor, I state because of my 

poverty, I am unable to pay in advance the filing fee for said proceedings or to give security for the filing fee. !believe I 

am entitled to relief. · · · 

I, further declare the responses which! have made .to the questions.and instructions below are true. 

L Have you received, within the last 12 months, any money from any of the following sources? 

a. Business, profession or from self-employment? 

b. Rent payments, interest or dividends? 

c. Pensions, annuities or life insurance payments? 

d. Gifts or inheritances? 

e. Family or friends? 

f. Any other sources? 

YesO 

Yes 0 

Yes 0 

Yes 0 

Yes o· 

Yes 0 

No 0 

No 0 

No 0 

No 0 

No 0 

No 0 

If you answered YES to any of the questions above, describe each source of money and state 

the amount received from each during the past 12 months. 

2. Do you own cash, or do you have money in a checking or savings account, including any funds 

in prison accounts? · '""'"'"' · 

Yes 0 No 0 

/ 

If you answered YES to any of the questions above, stat~ total value of the items .owned. 

~-... 

! ~ATCIFP (REV. 9/02) 

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., 

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3. Do you own real estate.'stocks~··ho~ds: note, automobil;ls, . other valuable property, excluding 

ordinary household furnishings a~d clothing? . · . . · . . 

·, . . Ye~ D No [j 

. If you answered YES, descri~I'Jtperty and state its approximate value. 

I unders'tand a false statement in .answer to any question in this affidavit will subject me to penalties for 

perjury. I declare (cettify,}'erify, or state) under .. penalty of perjury that the foregoing is true and correct 

(28 u.s.c. §1746).. . . . . 

.,. .. 

~ udNt day of · 15 ,20_._.· 

ID Number 

YOU MUST ATTACH A CURRENT SIX (6) MONTH HISTORY OF 

YOUR INMATE TRUST ACCOUNT. · YOU CAN ACQUIRE THE 

APPROPRIATE INMATE ACCOUNT CERTIFICATE FROM THE 

LAW LIBRARY AT YOUR PRISON UNIT. 

_.., 

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. , STATE COUNSEL.FOR OFFENDERS 

A DIVISION OF TEXAS DEPARTMENT OF CRIMINAL JUSTICE ~ 

January 13, 2012 

Jimmy D:laz . TDCJ #1737301 

Ramsey 1 Unit 

1100 FM 655 

Rosharon, Texas 77583 

Dear Mr. Diaz : 

P.O. Box 4005 

Huntsville, Texas 77342-4005 

(936) 437-52003 

The ·TDCJ com~uter indicates you are presently serving the following offenses: 

Cause No. Offense Sentence Begin Date Jail Time Credit 

L •'•65575 Haeeassment PS 07-16-11 37 

State ID No.: TX TX03213784 

2. -!;65576 Tamper Phys Evid 07-16-11 37 

State ID No.: TX TX03213784 

3. 63746 Burg of Habit 06-28-11 37 

State ID No. : TX TX03213784 

-!~ese are considered your holding cases because it will keep you in TDCJ the longest. 

Sincerely, 

T.K.Partin 

Legal Assistant-Appellate Services 

cc: File 

.. , .. ' 

ATTAlh £thihd:-D. 

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