Opinion
CV 122-061
06-21-2022
RICHARD J. BARTLETT, Plaintiff, v. RICHARD DOUGLASS, Captain, et. al., Defendants.
PRISONER TRUST FUND ACCOUNT STATEMENT
Under the Prison Litigation Reform Act, a prisoner seeking to bring a civil action without prepayment of fees must obtain from the appropriate prison official a certified copy of the prisoner's trust account statement for the six-month period immediately preceding the submission of the complaint to the Court. The plaintiff in this case has been instructed by the Court to furnish this form to the trust officer of each institution where he has been confined for the last six months.
Please complete this form, attach the supporting ledger sheets, and return these documents to the prisoner for mailing to this Court.
DATE COMPLAINT RECEIVED: 5/17/2022
AVERAGE MONTHLY DEPOSITS during the six months prior to receipt of the complaint: ___
AVERAGE MONTHLY BALANCE during the six months prior to receipt of the complaint: ___
I certify that the above information accurately states the deposits and balances in the plaintiff's trust account for the period shown and that the attached ledger sheets are true copies of the account records maintained by this institution.