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Affidavit To Proceed In Forma Pauperis (Prisoner) - Louisiana
| Affidavit To Proceed In Forma Pauperis (Prisoner) Form. This is a Louisiana form and can be used in Western District District Court Federal . |
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SECTION P Civil Action No.__________________ INSTRUCTIONS FOR FILING AN APPLICATION TO PROCEED IN FORMA PAUPERIS PURSUANT TO 28 U.S.C. § 1915 (FOR BOTH PRISONERS AND INS DETAINEES) Last Updated: January 2012 1.WHO SHOULD USE THIS FORM. Prisoners and INS detainees who are unable to pay the filing fee and service costs to file a suit with this court should use this in forma pauperis ("IFP") application. Please note that prisoners and INS detainees follow different rules when an IFP application is granted and the following requirements should be followed: A. For Prisoners (Not INS Detainees): In the past, some prisoners granted IFP status were ordered to pay only part of the $350.00 filing fee and were never obligated to pay any more. However, the Prison Litigation Reform Act ("PLRA") has now changed this. The PLRA amended 28 U.S.C. §1915 to obligate a prisoner granted IFP status to pay the entire filing fee of $350.00 in a civil action and $5.00 in a habeas corpus petition. The granting of in forma pauperis status allows a prisoner to proceed in a civil case without having to prepay the entire filing fee. A prisoner granted IFP status is able to pay the filing fee of $350.00 in small increments over time and is obligated to pay the full amount no matter how long it takes and regardless of whether the action is dismissed or if the prisoner is released from confinement. B. For INS Detainees Only: Just like prisoners, INS detainees who file suit with this court may also file for IFP status. However, the Prison Litigation Reform Act does not apply to INS detainees. Therefore, INS detainees who are granted IFP status do not pay any of the $350.00 filing fee and are only required to pay $5.00 for a habeas corpus action. An INS Detainee who is denied IFP status in a civil action must pay the entire filing fee of $350.00. 2. FILL OUT THE FORM: To file an application to proceed In Forma Pauperis, the applicant must submit the following forms: a. An affidavit that includes a statement of all assets the applicant possesses; and b. A certified copy of the applicant's account statement for the last six months, obtained from the appropriate official at the prison or correctional facility; and c. A signed form authorizing the institution of incarceration to forward from the applicant's account to the Clerk of Court any filing fee or initial partial filing fee assessed by the Court and if a prisoner and not an INS detainee to forward monthly payments thereafter of 20 percent of the prisoner's preceding month's income credited to the prison account until the full amount of the filing fee is paid. All information must be clearly and concisely written in the appropriate space on the form. If additional space is needed to provide information about the case, attach additional blank pages. DO NOT WRITE ON THE BACK OF ANY OF THE PAGES; any writing on the back of any page might not be considered by the court. 1 American LegalNet, Inc. www.FormsWorkFlow.com 3. TYPE OR PRINT THE COMPLAINT. The in forma pauperis application must be typed or legibly handwritten in pen (not pencil) and only on one side of the page. PAPER SIZE. The in forma pauperis application must be on 8½" x 11" letter size paper. SIGN THE FORM. The applicant applying for pauper status must sign and declare under penalty of perjury that the information provided is correct. In addition, the applicant must sign authorizing the institution where the applicant is in custody to forward certified copies of the applicant's account and any payments to the Clerk of Court. Applications must contain an original signature and not a copy. ASSESSMENT OF FILING FEES FOR PRISONERS (NOT INS DETAINEES) IN A CIVIL RIGHTS ACTION. If the court determines that a prisoner is unable to pay the full filing fee, the court will allow the applicant to proceed in forma pauperis. The court will then assess and, when funds exist, collect an initial partial filing fee of 20 percent of the greater of the average monthly deposits to the applicant's account or 20 percent of the average monthly balance in the applicant's account for the 6 month period immediately preceding his or her application to proceed in forma pauperis. See 28 U.S.C. §1915(b)(1). Thereafter, a prisoner is required to make monthly payments of 20 percent of the preceding month's income which is credited to the prison account to the Clerk of Court until the fees are paid in full. Such payments shall be forwarded to the Clerk of Court by the prison official each time the amount in the prisoner's account exceeds $10.00. See 28 U.S.C. §1915(b)(2). If an applicant has no assets and no means to pay the initial partial filing fee, the applicant will not be prohibited from bringing an in forma pauperis action. See 28 U.S.C. §1915(b)(4). However, prisoners who do not pay an initial partial filing fee will still be required to make monthly payments as described above from the money the prisoner collects at a later date. Note: Once a filing fee is assessed for a prisoner, the full filing fee must be eventually paid regardless of the outcome of the case! THREE OR MORE SUITS. An applicant who has filed three or more civil actions and/or appeals while incarcerated or detained, and the actions have been dismissed on grounds that they were frivolous, malicious, or failed to state a claim upon which relief may be granted, may not proceed in forma pauperis in bringing a new civil action or in appealing a judgment absent a threat of imminent, serious physical injury. See, 28 U.S.C. § 1915(g). WHERE TO MAIL. Inmates, who reside in or who are transferred into Louisiana Department of Corrections facilities participating in the Electronic Filing Pilot Program, shall provide the completed IFP form to be scanned and emailed to the court. Inmates at all other facilities shall mail the original to the Clerk of the United States District Court for the Western District of Louisiana, 300 Fannin Street, Suite 1167, Shreveport, LA 71101-3083. DEFICIENT APPLICATIONS. In Forma Pauperis applications which do not conform to these instructions will be returned with a notation as to deficiency. 4. 5. 6. 7. 8. 9. 2 American LegalNet, Inc. www.FormsWorkFlow.com UNITED STATES DISTRICT COURT WESTERN DISTRICT OF LOUISIANA _____________ DIVISION ____________________________ DOC NO. _____________ VERSUS _____________________________ CIVIL ACTION NO. _____________SEC. P JUDGE _________________________ MAG. JUDGE ____________________ AFFIDAVIT TO PR
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