Court Opinion

ID: 4100904
Source: CourtListenerOpinion
Date Created: 2016-11-22 07:13:29.24938+00
Date Added: 2024-06-11T08:45:08.854742
License: Public Domain

November 15, 2016
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                 Do you own cash, or do you have money in a checking or savings account, including any funds
                 in prison accounts?                                          ^
                                                      Yes T |          No •

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

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

                                                  Yes •          No a^
               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).

       Signed this the    0 \>^f               ,20 /U.

                                  KV^k?^ j&^                       i°miros
                                 Signature of Plaintiff                    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 LD3RARY AT YOUR PRISON UNIT.

                                                                                                  •&ATCIFP (REV. 9/02)
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                                                     THIRD COURT OF APPEALS
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