Veal v. Penzone ( 2022 )

1 WO MDR 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA 8 9 Gene Veal, No. CV 22-00240-PHX-MTL (CDB) 10 Plaintiff, 11 v. ORDER 12 Paul Penzone, et al., 13 Defendants. 14 15 On February 14, 2022, Plaintiff Gene Veal, who is not in custody, filed a pro se civil 16 rights Complaint pursuant to 42 U.S.C. § 1983. Plaintiff did not pay the $350.00 civil 17 action filing fee and $52.00 administrative fee or file an Application to Proceed in District 18 Court Without Prepaying Fees or Costs. The Court will give Plaintiff 30 days to pay the 19 filing and administrative fees or file a complete Application to Proceed. 20 I. Filing Fee or Application to Proceed 21 A party instituting a civil action in district court is required to pay a $350.00 filing 22 fee and a $52.00 administrative fee unless the party is granted leave to proceed in forma 23 pauperis. 28 U.S.C. §§ 1914, 1915. Thus, the Court will give Plaintiff thirty days to either 24 pay the $350.00 filing fee and the $52.00 administrative fee or file an Application to 25 Proceed in District Court Without Prepaying Fees or Costs using the form included with 26 this Order. 27 . . . . 28 . . . . 1| IL Warnings 2 A. Address Changes 3 Plaintiff must file and serve a notice of a change of address in accordance with Rule 83.3(d) of the Local Rules of Civil Procedure. Plaintiff must not include a motion for other 5 | relief with a notice of change of address. Failure to comply may result in dismissal of this 6| action. 7 B. Possible Dismissal 8 If Plaintiff fails to timely comply with every provision of this Order, including these warnings, the Court may dismiss this action without further notice. See Ferdik v. Bonzelet, 963 F.2d 1258, 1260-61 (9th Cir. 1992) (a district court may dismiss an action for failure 11 | to comply with any order of the Court). 12| ITIS ORDERED: 13 (1) Within 30 days of the date this Order is filed, Plaintiff must either pay the $350.00 filing fee and $52.00 administrative fee or file a complete Application to Proceed 15 | in District Court Without Prepaying Fees Or Costs. 16 (2) □ If Plaintiff fails to either pay the $350.00 filing fee and $52.00 administrative 17 | fee or file a complete Application to Proceed in District Court Without Prepaying Fees Or 18 | Costs within 30 days, the Clerk of Court must enter a judgment of dismissal of this action 19 | without prejudice and without further notice to Plaintiff and deny any pending unrelated 20 | motions as moot. 21 (3) The Clerk of Court must mail Plaintiff a court-approved Application to 22 | Proceed in District Court Without Prepaying Fees Or Costs. 23 Dated this 14th day of March, 2022. Micha T. Siburde Michael T. Liburdi 26 United States District Judge 27 28 Page | of 5 AO 239 (Rev. 01/15) Application to Proceed in District Court Without Prepaying Fees or Costs (Long Form) UNITED STATES DISTRICT COURT for the District of ) Plaintiff/Petitioner ) v. ) Civil Action No. ) Defendant/Respondent ) APPLICATION TO PROCEED IN DISTRICT COURT WITHOUT PREPAYING FEES OR COSTS (Long Form) Affidavit in Support of the Application Instructions Iam a plaintiff or petitioner in this case and declare Complete all questions in this application and then sign it. that I am unable to pay the costs of these proceedings Do not leave any blanks: if the answer to a question is “O,” and that I am entitled to the relief requested. declare “none,” or “not applicable (N/A),” write that response. If under penalty of perjury that the information below is you need more space to answer a question or to explain your true and understand that a false statement may result in answer, attach a separate sheet of paper identified with your a dismissal of my claims. name, your case's docket number, and the question number. Signed: Date: 1. For both you and your spouse estimate the average amount of money received from each of the following sources during the past 12 months. Adjust any amount that was received weekly, biweekly, quarterly, semiannually, or annually to show the monthly rate. Use gross amounts, that is, amounts before any deductions for taxes or otherwise. Income source Average monthly income Income amount expected amount during the past 12 next month months Gift Page 2 of 5 AO 239 (Rev. 01/15) Application to Proceed in District Court Without Prepaying Fees or Costs (Long Form) Retirement (such as social security, pensions, annuities, $ $ $ $ insurance) oy “ “enn “nn mae mone Unemployment payments Public-assistance (such as welfare) i S S S Other (specify): S S S 2. List your employment history for the past two years, most recent employer first. (Gross monthly pay is before taxes or other deductions.) Employer Address Dates of employment Gross monthly pay 3. List your spouse's employment history for the past two years, most recent employer first. (Gross monthly pay is before taxes or other deductions.) Employer Address Dates of employment Gross monthly pa 4. How much cash do you and your spouse have? $ Below, state any money you or your spouse have in bank accounts or in any other financial institution. Financial institution Type of account Amount you have Amount your spouse has Pf pf ff If you are a prisoner, you must attach a statement certified by the appropriate institutional officer showing all receipts, expenditures, and balances during the last six months in your institutional accounts. If you have multiple accounts, perhaps because you have been in multiple institutions, attach one certified statement of each account. Page 3 of 5 AO 239 (Rev. 01/15) Application to Proceed in District Court Without Prepaying Fees or Costs (Long Form) 5. List the assets, and their values, which you own or your spouse owns. Do not list clothing and ordinary household furnishings. Assets owned by you or your spouse Make and year: Registration #: Make and year: Registration #: 6. State every person, business, or organization owing you or your spouse money, and the amount owed. Person owing you or your spouse Amount owed to you Amount owed to your spouse money 7. State the persons who rely on you or your spouse for support. Name (or, if under 18, initials only) Relationship Page 4 of 5 AO 239 (Rev. 01/15) Application to Proceed in District Court Without Prepaying Fees or Costs (Long Form) spouse. Adjust any payments that are made weekly, biweekly, quarterly, semiannually, or annually to show the monthly rate. ee “Ease ee fF Are real estate taxes included? Yes No $ $ Is property insurance included? 1 Yes O No Insurance (not deducted from wages or included in mortgage payments) ee Homeowner's or renters: Installment payments ee Credit card (name): Department store (name): Page 5 of 5 AO 239 (Rev. 01/15) Application to Proceed in District Court Without Prepaying Fees or Costs (Long Form) Regular expenses for operation of business, profession, or farm (attach detailed $ $ statement) . Total monthly expenses: 9. Do you expect any major changes to your monthly income or expenses or in your assets or liabilities during the next 12 months? O Yes O No If yes, describe on an attached sheet. 10. Have you spent — or will you be spending — any money for expenses or attorney fees in conjunction with this lawsuit? [ Yes [No If yes, how much? $ 11. Provide any other information that will help explain why you cannot pay the costs of these proceedings. 12. Identify the city and state of your legal residence. Your daytime phone number: Your age: Your years of schooling: