Chavis v. McCulloch et al, No. 9:2020cv00435 - Document 6 (N.D.N.Y 2020)

Court Description: DECISION AND ORDER: ORDERED that 1. Plaintiff must, within thirty (30) days of the filing date of this Decision and Order, either (1) pay the $400.00 filing fee in full, or (2) provide the Clerk with a signed authorization form consenting t o pay the full filing fee in installments as directed herein; 2. In the event Plaintiff fails to timely comply with the filing fee requirements set forth in this Decision and Order, this action will be dismissed without prejudice without further Ord er of this Court; 3. Upon Plaintiff's compliance with this Decision and Order, the file shall be returned to the Court for further review; and 4. The Clerk shall serve a copy of this Decision and Order on Plaintiff together with a blank Inma te Authorization Form. Signed by Judge David N. Hurd on 6/18/2020. (Attachments: # 1 authorization form) ( Notice of Compliance Deadline 7/20/2020, Case Review Deadline 8/18/2020){order and blank authorization form served via regular mail on plaintiff}(nas, )

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Chavis v. McCulloch et al Doc. 6 Att. 1 INMATE AUTHORIZATION I, , authorize the agency holding me in custody to send to the Clerk of the United States District Court for the Northern District of New York ("Clerk"), at his request, certified copies of statements of my trust fund account (or institutional equivalent) at the institution where I am currently incarcerated. If I have not been incarcerated at my current place of confinement for at least six (6) months, I authorize such agency to provide said Clerk, at his request, with copies of such account statements from the institution(s) in which I had previously been incarcerated. I further request and authorize the agency holding me in custody to calculate, encumber and/or disburse funds from my trust fund account (or institutional equivalent) in the amounts specified by 28 U.S.C. § 1915(b). This authorization is furnished in connection with the commencement of the civil action submitted herewith (or noted below), and I understand that the total filing fee which I am obligated to pay is $350.00. I also understand that this fee will be debited from my account regardless of the outcome of my lawsuit. This authorization shall apply to any other agency into whose custody I may be transferred. º Signature: i NOTE: You must sign your name on the above line.i 44444444444444444444444444444444444444444444444444444444444444444444444444 Name and DIN Number: Civil action number: Short name of case: FORM G Dockets.Justia.com

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