Mason v. Hyatte et al, No. 3:2021cv00834 - Document 17 (N.D. Ind. 2022)
Court Description: OPINION AND ORDER: The court DIRECTS the clerk to put this case number on a blank Prisoner Complaint Pro Se 14 (INND Rev. 2/20) form and send it to French Mason along with three blank Prisoner Complaint Pro Se 14 (INND Rev. 2/20) forms and three b lank AO 240 (Rev. 7/10) (INND Rev. 8/16) Prisoner Motion to Proceed In Forma Pauperis forms; GRANTS French Mason until 05/06/2022 to file an amended complaint containing only related claims on the form with this case number sent to him by the clerk ; and CAUTIONS French Mason that, if he fails to respond by the deadline or files an amended complaint with unrelated claims, the court will select one group of related claims and dismiss the others without prejudice. Signed by Judge Damon R Leichty on 04/04/2022. (Attachments: # 1 Prisoner Complaint Pro Se 14 (INND Rev.2/20) and (Rev.7/10)(INND Rev.8/16))(jdb)
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Mason v. Hyatte et al Doc. 17 Att. 1 3:21-cv-834 Dockets.Justia.com AO 240 (Rev. 7/10) (INND Rev. 8/16) UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF INDIANA [This form is for prisoners who do not pay the filing fee when they file a new case OR a notice of appeal.] [Put your full name on this line.] , v. Case Number , [For a new case in this court, leave blank. The court will assign a case number.] [Put the name of the first person you are suing on this line.] [The top of this page is the caption. Everything you file in this case must have the same caption. Once you know your case number, it is VERY IMPORTANT that you include it on everything you send to the court for this case. DO NOT send more than one copy of anything to the court.] PRISONER MOTION TO PROCEED IN FORMA PAUPERIS I am a prisoner. I am unable to pre-pay the costs of this case or appeal. I have attached an official copy of my prisoner trust fund account statement showing every transaction for the last six months. I declare under penalty of perjury that these statements are true. Signature Prisoner Number Date OFFICIAL CERTIFICATE OF PRISONER ACCOUNT I certify that every transaction for the last six months (or ______ months if the prisoner has been here less than six months) is listed on the attached prisoner trust account statement. Signature of Authorized Officer Date Printed Name and Job Title Name of Facility [DO NOT write in the margins or on the back of any pages. Attach additional pages if necessary.] AO 240 (Rev. 7/10) (INND Rev. 8/16) UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF INDIANA [This form is for prisoners who do not pay the filing fee when they file a new case OR a notice of appeal.] [Put your full name on this line.] , v. Case Number , [For a new case in this court, leave blank. The court will assign a case number.] [Put the name of the first person you are suing on this line.] [The top of this page is the caption. Everything you file in this case must have the same caption. Once you know your case number, it is VERY IMPORTANT that you include it on everything you send to the court for this case. DO NOT send more than one copy of anything to the court.] PRISONER MOTION TO PROCEED IN FORMA PAUPERIS I am a prisoner. I am unable to pre-pay the costs of this case or appeal. I have attached an official copy of my prisoner trust fund account statement showing every transaction for the last six months. I declare under penalty of perjury that these statements are true. Signature Prisoner Number Date OFFICIAL CERTIFICATE OF PRISONER ACCOUNT I certify that every transaction for the last six months (or ______ months if the prisoner has been here less than six months) is listed on the attached prisoner trust account statement. Signature of Authorized Officer Date Printed Name and Job Title Name of Facility [DO NOT write in the margins or on the back of any pages. Attach additional pages if necessary.] AO 240 (Rev. 7/10) (INND Rev. 8/16) UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF INDIANA [This form is for prisoners who do not pay the filing fee when they file a new case OR a notice of appeal.] [Put your full name on this line.] , v. Case Number , [For a new case in this court, leave blank. The court will assign a case number.] [Put the name of the first person you are suing on this line.] [The top of this page is the caption. Everything you file in this case must have the same caption. Once you know your case number, it is VERY IMPORTANT that you include it on everything you send to the court for this case. DO NOT send more than one copy of anything to the court.] PRISONER MOTION TO PROCEED IN FORMA PAUPERIS I am a prisoner. I am unable to pre-pay the costs of this case or appeal. I have attached an official copy of my prisoner trust fund account statement showing every transaction for the last six months. I declare under penalty of perjury that these statements are true. Signature Prisoner Number Date OFFICIAL CERTIFICATE OF PRISONER ACCOUNT I certify that every transaction for the last six months (or ______ months if the prisoner has been here less than six months) is listed on the attached prisoner trust account statement. Signature of Authorized Officer Date Printed Name and Job Title Name of Facility [DO NOT write in the margins or on the back of any pages. Attach additional pages if necessary.]
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