Court Opinion

ID: 4042071
Source: CourtListenerOpinion
Date Created: 2016-09-28 22:59:26.313611+00
Date Added: 2024-06-11T14:28:36.481455
License: Public Domain

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                                                                                                         · RECEIVED IN
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                            ·fL,e sfJ e ~ Dt i-.\ r.                                                         MAR 16 2015
                                  ,                    I

                                             ..
                                                                                                          Ab8f Acosta, Clerk
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                                                                                         ..
                                  IN THE UNITED STATES DISTRICT COURT
                                          1
                                 FOR mE '. • .       DISTRICT OF TEXAS
                                                      DIVISION

Plaintiff's name and ID Number

Place of Confmement

                                                                                          O.,i) 'E,U
                                                                               CASE NO._..,--__              /-'1 :'\-
                                                                                                   -r_c..J'r __   - __ D __
                                                                                        (Clerk will assign the number)
v.
·D ~s r-~~ 1sc.:r c·l-e~-kp Tit'~!A·-1 ~ s- Ccu..~\1"'[                        APPLICATION TO PROCEED
 P, ~- .l3o~ \-q., 3 b % G-r, q <.:J ~W '3                                        IN FORMA PAUPERIS
  A--t-4. ~ If1.: liJ "1'-t::-AA-~ "1 &1 {.17 "1
Defendant's name and address

                   : ''. t , -~-· . .1. l'' " V• c
         I, Q_ II
               l<.ttt-1""' VL       tot- u-d"" u                                        .
                                                   deClare, depose, and say I am the Plaintiff in the above entitled case. In support
of iny motion to proceed without 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. I believe I
am entitled to relief.

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

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

                  a. Business, profession or from self-employment?                                Yes   0      NoW
                  b. Rent payments, interest or dividends?                                        Yes   0      No r.a--'
                  c. . Pensions, annuities or life insurance payments?                            Yes   0      No   c::r-
                  d. Gifts or inheritances?                                                       Yes   0      No 8"'
                  e. Family or friends? .                                                         Yes   0      No 0
                  f. Any other sources?                                                           Yes   0      No [3/.

                  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 checldJlg or savings account, including any funds·
                 ·in prison accounts?
                                                Yes 0           No E'r

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

                                                                  1
                                                                                                               -t.ATCIFP (REV. 9/02)
       3.     Do you own real estate, stocks, bonds, note, automobiles, or other valuable property, excluding
              ordinary household furnishings and clothing?

                                                Yes 0

              If you answered YES, describe the property and state its approximate value.

I understand a false statement in answer to any question in this affidavit will subject me to penalties for
perjury. I declare (certify, verify, or state) under penalty of perjury that the foregoing is true and correct
(28 u.s.c. §1746).

                          0
       Signed this the _ __r   _n_~_:f__day of--~--         _·u:._Vf_;,'_ _ __, 20
                                                         A:f_.                       1:3"".

                               ~~??~..:;iT                              :#/21/?f/ f/
                               -Signature of Plaintiff                      ID Number

       YOU MUST ATTACH A CURRENTSIX (6) MONTH HISTORY OF
       YOUR INMATE TRUST ACCOUNT. YOU CAN ACQUIRE THE
       APPROPRIATE INMATE ACCOUNT CERTIFICATE FROM THE
       LAW LIBRARY AT YOUR PRISON UNIT•.

                                                                 2                                 uATCIFP (REV 9/02)
C~INIB0~/CINIB02     TEXAS DEPARTMENT OF CRIMINAL JUSTICE             03/10/15
DH31/SR00118                IN-FORMA-PAUPERIS DATA                    09:02:50
TDCJ#: 01247914 SID#: 04344114 LOCATION: DALHART            INDIGENT DTE: 02/23/15
NAME: ADRMS,CHARLES                       BEGINNING PERIOD: 08/01/14
PREVIOUS TDCJ NUMBERS: 01012355
CURRENT BAL:          0.35 TOT HOLD RMT:           0.00 3MTH TOT DEP:           0.00
6MTH DEP:           100.00 6MTH RUG BRL:           6.60 6MTH RUG DEP:          16.67
MONTH HIGHEST BALANCE TOTAL DEPOSITS       MONTH HIGHEST BALANCE TOTAL DEPOSITS
01/15        1.70             0.00         10/14     102.24           100.00
12/14        1.70             0.00         09/14       2.24             0.00
11/14        1.99             0.00         08/14       2.24             0.00
PROCESS DATE    HOLD AMOUNT      HOLD DESCRIPTION

STATE OF TEXAS COUNTY OF HARTLEY_
ON THIS THE I 0 DAY OF MAQ C:. H , T;, I CERTIFY THAT THIS DOCUMENT IS A TRUE,
COMPLETE,RND UNALTERED COPY MADE BY ME OF INFORMATION CONTAINED IN THE
COMPUTER DATABASE REGARDING THE OFFENDER'S ACCOUNT. NP SIG:
PFl-HELP PF3-END ENTER NEXT TDCJ NUMBER:            OR SID NUMBER:

      /if:~·~·~\    ROBERT E. STOUT
      ~\          }*! MY COMMISSION EXPIRES
          ..
      "~
                          TEXAS DEPARTMENT OF CRIMINAL JUSTICE
                                     RECORDS RELEASE
                                      AUTHORIZATION

I, the below named and numbered offender, hereby authorize the Texas Department of Criminal
~          to    release records pertaining to                 my trust . fund          account,       as     request~d    by
IIJfllfl!.. dC0$7?l C'k&t. Ccx.;~z C/4'cv/tll91                       (Identify Court, Attorney, or entity as
                                                       4'a 8o...V /2 .Jo8 c...;.L"J//ZJC.
defined in Rule 3 9 2 !-Special Correspondence Rules) r&:•                    ,-          S/#~.AJ
                                                                         /tw.s 7//v      0 ' 7!3 7//

I, offender      ~~ ~                                                     ' - TDCJ#       _/Z._L_V_7___:.9_'/_._Y_ _
being presently incarcerated at the _ _,().c:.._W.:...:'L.=:!:h'-"~!..!.!...V<...:::.T.___ _ _ _ _ _ _ _ _ Unit/Facility of the
Texas Department of Criminal Justice, in                     ;/;l12. 72)1                                     County, Texas
declare under penalty of peJ.jury that the foregoing is true and correct

Executed on this the ----=-/,-"''t)"--'--'llt-L--___ day of           12711/Zc/1                         20    ;s-
By..   Cb.zab            _?~
                       (Offender Signature)
                                                          Witness
                                                                          (Approved-Witnessing Authority Signature)

INSTRUCI'IONS:
1   The offe:nder completes above information, signs and dates the
    Records Release Authorization in the presence of the approved
    witnessing authority (Access to Courts Representative)
2   The witnessing authority identifies the offender by ID card or
    records ;md, upon verification, witnesses the offender's signature
    by signing the Records Release Authorization, which the
    witnessing authority will maintain
3   The witnessing authority prints out a copy of the offender's
    "TFBA" computer screen, certifies it, and retains a duplicate copy
    for their records
4   The offender is required to have an addressed, stamped envelope
    prepared for mailing The witnessing authority then places a copy
    of the c•::rtified "TFBA" printout in the addressed and stamped
    envelope and the envelope is sealed and placed in the outgoing
    mail

ATC01- Authorization No. 1 (10/01)