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Home My WebLink About02-3016270 Pro~ (p~gc 1) IN THE COURT OF COMMON PLEAS OF couter¥, pmrssvLv ,a_ CIVIL DIVISION (Plaintiff)/ (Defendant) ~ PETITION FOR LEAVE TO PROCEED IN FORMA PAUPERI~q AND NOW, comes the (plaintiff,~ ...... I I ~U~J4^J l%TZCLb/;qOD , and respectfully requests this Honorable coSrt'~br leave t6 ~oceed 'fn Forma Pauperis in the above captioned case. In support of this Petition, (plainti~~ avers as follows: 1. desires to (Commence a Civil Action~s~ to the Court of Common Pleas but is without the funds to pay the filing fee. 2. (Plaintiff's~ I I I financial affairs are set forth in a Verified Statement, a copy of which is attached to this petition as Exhibit A. 3. If is not permitted to (Commence a Civil Action~ in Forma Pauperis, h~will be denied due process of Law ~nd/or hi~ rights under the Constitution of the United States and the Constitution of the Commonwealth of Pennsylvania. WHEREFORE, (F this Petition and to allow fees. prays this Honorable Court to grant proceed without payment of the required RESPECTFULLY SUBMITTED, COMMONWEALTH OF PENNSYLVANIA Department of Corrections SCI-Pittsburgh 412/761-1955 June 21,2002 CERTIFICATION CASE # I, Dian Detwiler, certify that the attached inmate account records are a copy of the inmate account records of: John R. Jae, #BQ3219 and that this is a true and correct copy of the document used during the normal course of business at the State Correctional Institution at Pittsburgh. The present balance on this account is minus -$683.63cr. There are no known outside bank accounts or other assets according to institution records. Dian Detwiler Inmate Accounting Supervisor SCl Pittsburgh 2?0 ?ro~h <page 1) IN TI~ COURT OF COM/VION PLEAS OF Cvr0t;¢4 ¢,lOl) cotnvr¥, pmqNSXa VANXA CIVIL DIVISION v$ (Plaintiff)/ PETITION FOR LEAVE TO PROCEED IN FORMA PAUPERIS AND NOW, comes the (pAaln and respectfully requests this Honorable Co~rt'f6r leave t6 ~oceed Xn Forma Pauperis in the above captioned case. In support of this Petition, (plaintif~_h _ -) avers as follows: the Court of Comanon Pleas but is without the funds to pay the filing fee. 2. (Plaintiff'~[ I I ] financial affairs are set forth in Verified Statement, a copy of which is attached to this petition as Exhibit A. desires to (Commence a Civil Action) to 3. If is not permitted to (Conu~ence a Action~ in Forma Pauperis, h~ will be denied due process ~nd/or hi~ rights under the Constitution of the United Constitution of the Com/nonwealth of Pennsylvania. a Civil of Law States and the WHEREFORE, (plaintif~ this Petition and to allow fees. prays this Honorable Court to grant proceed without payment of the required RESPECTFITLLY SUBMITTED, IN THE COURT OF COM](ON PLEAS OF ~~ COUNTY, PENNSYLVANIA CIVIL DIVISION Plaintiff NO. IN FORMA PAUPERIS VERIFIED STATEMENT I am the (plaintiff) in the above matter and because of my financial condition am unable to pay the fees and costs of prosecuting or defending the action or proceeding. I a~ unable to obtain funds from anyone, including my family and associates, to pay the costs of litigation. I represent that the information below relating to my ability to pay the fees and costs is true and correct If pres~!ntly empl~ed the following: address: city: monthly sat If you are date last type of wages: $ :ly monthly :ode: (c) OTHER WITH2 Business profe~ Other .f-emplo earned:$ Divider s:$ and Soc Support Disability Unemployment supplementa~ Workmen's Public As Lstance:$ Other (~ )lain):$ TWELVE and explain) % If CONTRIBUTIONS TO HOUSEHOI /S) (husband's) name: fe or husband is $ $ ?PORT city: monthl salary or wages from chi from Other com Jibutions complete the pho: :ype of ng: code: {e) (f) PROPERTY Cash: $ Checking savings accou Certificates c Real estate ( Motor vehicl~ Stocks; ~nds: $ Other )lain): model vear: purcha~ )rice: $ amouu $. Make model:__ vear: Purch~ ~ price: $ owed: $ $ Rent: $ Loans: $ Other (explain): (g) ~ PERSONS DEPENDENT YOU FOR (wife's} (husband's) na~e: Children, if any: Name: Name: Name: Other persons: Name: Name: Relationship: / / 4. I understand that I have a continuing obligation to inform the Cou~t of improvement in my financial circumstances which would permit me to pay the costs incurred herein. I verify that the statements made in this affidavit are true and correct, i understand that false statements herein are made subject to the penalties of 18Pa. C.S., paragraph 4904, relating to unsworn falsification to authorities. Date:~ COMMONWEALTH OF PENNSYLVANIA Department of Corrections SCI-Pittsburgh 412/761-1955 June 21, 2002 CERTIFICATION CASE # I, Dian Detwiler, certify that the attached inmate account records are a copy of the inmate account records of: John R. Jae, #BQ3219 and that this is a true and correct copy of the document used during the normal course of business at the State Correctional Institution at Pittsburgh. The present balance on this account is minus -$683.63cr. There are no known outside bank accounts or other assets according to institution records. Dian Detwiler Inmate Accounting Supervisor SCl Pittsburgh PA DEPT. OF CORRECTIONS BUREAU OF COMPUTER SERVICES REMOTE PRINT TIME 14:25 INMATE ACCOUNTS SYSTEM PARTIAL ACCOUNT LISTING FROM ACTIVE FILE RUN IAS365 DATE 6/21/2002 PAGE 1 INMATE NAME NUMBER LAST BQ3219 JAE FIRST MI JOHN R STARTING BALANCE -640.65 BATCH DATE # MO DY YEAR TRANSACTION DESCRIPTION TRANSACTION BALANCE AFTER AMOUNT TRANSACTION 1796 04-02-2002 1806 04-03-2002 1821 04-04-2002 1875 04-10-2002 0 04-22-2002 0 04-22-2002 2563 04-22-2002 0 04-22-2002 0 04-22-2002 0 04-26-2002 0 04-26-2002 2626 04-26-2002 0 04-26-2002 0 04-26-2002 2668 05-06-2002 2668 05-07-2002 2669 05-15-2002 2862 05-15-2002 2945 05-30-2002 2933 05-31-2002 2964 06-10-2002 3027 06-12-2002 37 POSTAGE 37 POSTAGE 37 POSTAGE 37 POSTAGE 92 TRANSFER OUT GREENE 91 TRANSFER IN PITTSBURGH 41 MEDICAL SICK CALL - 04/16/02 92 TRANSFER OUT PITTSBURGH 91 TRANSFER IN GREENE 92 TRANSFER OUT GREENE 91 TRANSFER IN PITTSBURGH 37 POSTAGE POSTAGE - 4/26/02 92 TRANSFER OUT PITTSBURGH 91 TRANSFER IN PITTSBURGH 37 POSTAGE POSTAGE - 5/03/02 37 POSTAGE POSTAGE - 05/06/02 41 MEDICAL SICK CALL - 5/13/02 37 POSTAGE POSTAGE - 5/14/02 41 MEDICAL SICK CALL - 5/28/02 37 POSTAGE POSTAGE - 5/30/02 41 MEDICAL SICK CALL - 6/06/02 37 POSTAGE POSTAGE 6/11/02 -3 95 -644.60 80 -645.40 03 -646.43 06 -661.49 O0 -665.49 -.80 -.46 -.23 -2.00 -6.70 -4.00 -.69 -666.29 -666.75 -668.01 -670.01 -670.24 -672.24 -678.94 -682.94 -683.63 BALANCE AFTER THESE TRANSACTIONS ...... > -683.63 ~A DEPT. OF CORRECTIONS BUREAU OF COMPUTER SERVICES REMOTE PRINT TIME 14:25 INMATE ACCOUNTS SYSTEM PARTIAL ACCOUNT LISTING FROM PURGE FILE RUN IAS368 DATE 6/21/2002 PAGE 2 INMATE NAME NUMBER LAST FIRST MI BQ3219 JAE JOHN R BATCH DATE # MO DY YEAR TRANSACTION DESCRIPTION 1509 03-04-2002 37 POSTAGE -.80 1509 03-04-2002 37 POSTAGE TRANSACTION BALANCE AFTER AMOUNT TRANSACTION BALANCE AFTER THESE TRANSACTIONS ...... · -625 39 -626 19 -626 76 -627 33 -629 28 -630 65 -631.45 -636,65 -638.65 -640.65 -640,65 ~A DEPT. OF CORRECTIONS BUREAU OF COMPUTER SERVICES REMOTE PRINT TIME 14:25 INMATE NAME NUMBER LAST BQ3219 JAE BATCH DATE # MO DY YEAR 0 01-07-2002 0 01-07-2002 1737 01-07-2002 0 01-07-2002 0 01-07-2002 0 01-08-2002 0 01-08-2002 1737 01-08-2002 1737 01-08-2002 1737 01-08-2002 1737 01-08-2002 0 01-08-2002 0 01-09-2002 1148 01-22-2002 INMATE ACCOUNTS SYSTEM PARTIAL ACCOUNT LISTING FROM PURGE FILE FIRST MI JOHN R TRANSACTION DESCRIPTION 92 TRANSFER OUT GREENE 91 TRANSFER IN PITTSBURGH 37 POSTAGE POSTAGE 01-03-02 92 TRANSFER OUT PITTSBURGH 91 TRANSFER IN GREENE 92 TRANSFER OUT GREENE 91 TRANSFER IN PITTSBURGH 37 POSTAGE POSTAGE 01-07-02 86 ADJUST PAYMENT 37 ENTERED WRONG AMOUNT 37 POSTAGE POSTAGE 01-07-02 37 POSTAGE POSTAGE 01-08-02 92 TRANSFER OUT PITTSBURGH 91 TRANSFER IN GREENE 37 POSTAGE 1174 01-24-2002 41 MEDICAL MEDICAL FEES 1/22/02 1201 01-28-2002 37 POSTAGE 1226 01-30-2002 37 POSTAGE 1236 01-31-2002 37 POSTAGE 1320 02-11-2002 37 POSTAGE 1320 02-11-2002 37 POSTAGE 1379 02-15-2002 37 POSTAGE 1391 02-19-2002 37 POSTAGE HUN IAS365 DATE 6/21/2002 PAGE 1 STARTING BALANCE -605.06 TRANSACTION BALANCE AFTER AMOUNT TRANSACTION -1.03 -606.09 -.45 -606.54 .45 -606.09 -1.26 -607.35 -.46 -607.81 -.34 -608.15 -2.00 -610.15 -.34 -610.49 -.57 -611.06 -3.50 -614.56' -2.64 -617.20 -3.95 -621.15 -2.64 -623.79 -.80 -624.59 iA DEPT. OF CORRECTIONS BUREAU OF COMPUTER SERVICES REMOTE PRINT TIME 14:25 INMATE ACCOUNTS SYSTEM PARTIAL ACCOUNT LISTING FROM PURGE FILE RUN IAS365 DATE 6/21/2002 PAGE 1 INMATE NAME NUMBER LAST BQ3219 JAE FIRST MI JOHN R STARTING BALANCE -578.95 BATCH DATE # MO DY YEAR TRANSACTION DESCRIPTION TRANSACTION BALANCE AFTER AMOUNT TRANSACTION 242 10-01-2001 37 POSTAGE 242 10-01-2001 37 POSTAGE 302 10-09-2001 37 POSTAGE 387 10-18-2001 37 POSTAGE 416 10-22-2001 37 POSTAGE 514 11-01-2001 37 POSTAGE 517 11-01-2001 41 MEDICAL MEDICAL FEES 538 11-05-2001 37 POSTAGE 595 11-13-2001 37 POSTAGE 595 11-13-2001 37 POSTAGE 0 12-17-2001 92 TRANSFER OUT GREENE 0 12-17-2001 91 TRANSFER IN PITTSBURGH 1627 12-17-2001 37 POSTAGE POSTAGE 12-14-01 0 12-17-2001 92 TRANSFER OUT PITTSBURGH 0 12-17-2001 91 TRANSFER IN GREENE 0 12-31-2001 92 TRANSFER OUT GREENE 0 12-31-2001 91 TRANSFER IN PITTSBURGH 1693 12-31-2001 37 POSTAGE POSTAGE 12-28-01 0 12-31-2001 92 TRANSFER OUT PITTSBURGH 0 12-31-2001 91 TRANSFER IN GREENE -3.10 -582.05 -3.95 -586.00 -1.26 -587.26 -1.26 -588.52 -.34 -588.86 -3.95 -592.81 -4.00 -596.81 -3.90 -600.71 -.80 -601.51 -2.18 -603.69 -.23 -603.92 -1.14 -605.06 BALANCE AFTER THESE TRANSACTIONS ...... > -605.06 II _ Name and address of Plaintif£: Full name, title, and business address of each defendant in this action: · PP_ VI_ 9, hTq Use additional sheets, if necessary Number each defendant. Plaintiffbrings this action against the above named and identified defendants on the following cause of action: 9 tm, I. Where are you now confined. What sentence arc you scrving?/~ ) (")~-~0 What court imposed the sentence?~/~V I [ ' A. Describe any and all lawsuits in which you are a plaintiffwhich deal with the same hcts involved in this action. (If there is more than one lawsuit, deschbe ~e additional lawsuits on another piece of paper, using the same outline.) 1. Parties to this previous lawsuit Plaintiffs ~~ Defendants 2. Court (if federal court, name case was 6. B. Prior III. What federal law do you claim was violated? IV. Statement of Claim (State here as briefly as possible the facts of your case. Do not give any legal arguments or cite any cases or statutes. If you intend to allege a number of related claims, number and set forth each claim in a separate paragraph. Use as much space as you need. Attach extra sheet if necessary.) V. Did the incidel!t of which you complain occur in an institution or place of custody in this District9 ana answer th~'foHowing quektiOfi~.' ...... / .- -, .... ~ A. Is there a prisoner grievance procedure in this institution? Yes~ No ( ) Did you present the facts relating to your complaint in the state prisoner grievance procedure? Yes () No~ If your answer is YES, What steps did you take? / \// 2. What was the result?' / D_. Ifyou_r answer is NO, .explain .why~n.ot: E. Ifthve is no phson ~evance procedure in the institution aia ~d~fm%~g~{~B~ a. Y~sM No ( ) ~ ~ ' F. If your answeris YES, 1. What steps did you take?._'~_./1.~-0.~ lO ~"~..-.~_ ~~ ,~1:~ t~j~[ ~.~¢~ ~ w~ ~2~7%~~%%~,2 ,~/a ~ ~ -. · ' _.-,, .~ ~,~,,,~ State bheflv exactly what you want the cou~ to do for you. Make no legal argummts. Cite no cases or S~eS. I DECLAKE UNDER PENALTY OF PER3URY THAT THE FOREGOING IS TRUE AND CORRECT. Name and address of Plaintiff: ,~! Full name, title, and business address of each defend~t in ~is action: - Use additional sheets, if necessary Number each defendant. Plaintiff brings this action against the above named and identified defendants on the following cause of action: I. Where are you now confined? ~ h[-Q What sentence are you serving? ~ ~at cou~ imposed the sentence9 ~))~kmV. _ ~. Previous Lawsuits Describe any and all lawsuits in which you are a plaintiffwhich deal with the same facts involved in this action. (If there is more than one lawsuit, describe the additional lawsuits on another piece of paper, using the same outline.) l. Parties to this previous lawsuit - ¢ 2. Court (if federal court, nam 4. Di~ e to whom case was assigned the case di~ Was it it still pending?) 6. position B. with the involved i Whe4 m. What c,aim was violated? q~U. ~,~0~!~<~, ~./~~ ~. Statement of Claim (State here as briefly as possible the facts of your case. Do not give any legal arguments or cite any cases or statutes. If you intend to allege a number of related claims, number and set forth each claim in a separate paragraph. Use as much space as you need. Attach extra sheet if necessary.) ~J ' LJ .... ~ L/ ' /b'r23 ' ' " ..... " " C. Persons revolve --d~a~am~e ea~.~ persgn aLd te~w%~that pe;~ }~ .) V. Did the incident of which you complain~occur in an i~nstitution or plgce of custody in this DjstIict? and ~ins~,er the followmg~q§eshbni: Yes ( ) No~ C. lfyour answer is YES, 1. What steps did you take? Is there a pri,so, ner grievance procedure in this institution? Yes() No(~ Did you present the facts relating to your complaint in the state prisoner grievance procedure? E. If there is no prison ~evance procedure in the institution, did you complain to prison anthofities? Yes~ No ( ) F. If your answer is YES ..... I. What steps did you take?Ct ~_7-~- State briefly exactly what you want the court to do for you. Make no legal arguments. Cite no 1 DECLARE UNDER PENALTY OF PERIURY THAT THE FOREGOING IS TRUE AND CORRECT. , _ · 'm -_ Ir:l.R al JOHN RICHARD JAE, PLAINTIFF IN THE COURT OF COMMON PLEAS OF · CUMBERLAND COUNTY, PENNSYLVANIA THOMAS L. JAMES, SECRETARY'S OFFICE OF INMATE GRIEVANCE AND APPEAL, : 02-3016 CIVIL TERM DEFENDANT ORDER OF COURT AND NOW, this_ \~,.k . day of July, 2002, pursuant to 42 Pa. C.S. §§ 6601- 6608, IT IS ORDERED that before a determination is made of whether to allow plaintiff to proceed in forma pauperis, he shall file of record a statement listing every civil suit he has instituted in any state or federal court except Cumberland County, with the docket number, and set forth either the disposition and the reasons thereof, or status of such litigation.~ This shall include the disposition and reasons thereof, or the status of the suit transferred from this court to the United States District Court on February 24, 2000. Edgar B Bayley, J ~ Plaintiff has filed the following prisoner litigation in the Court of Common Pleas of Cumberland County. (1) A complaint on January 5, 2000 at 00-0057 Civil. The case was transferred to the United States Court in the Middle District of Pennsylvania on February 24, 2000. (2) A complaint on May 18, 2000 at 00-3092 Civil. On May 25, 2000, the petition to proceed in forma pauperis was denied. The Commonwealth Court of Pennsylvania dismissed an appeal on December 19, 2000· (3) A complaint on November 1, 2000 at 00-7746 Civil. On November 9, 2000, the petition to proceed in forma pauperis was denied because the underlying claim was frivolous. An appeal was filed in the Commonwealth Court on December 15, 2000. (4) A complaint on August 7, 2001 at 01-4697 Civil. On May 9, 2002, the complaint was dismissed on preliminary objections. (5) A complaint on June 4, 2002 at 02-2720 Civil. The case is pending. VINVA']ASNi'~d 'il'Ir ~0 I I I I I John Richard Jae, #BQ-3219 SCI Pittsburgh P.O. Box 99901 Pittsburgh, PA 15233-0901 Pennsylvania Department of Corrections Office of Chief Counsel 55 Utley Drive Camp Hill, PA 17011 :saa JOHN RICHARD JAE, PLAINTIFF IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA THOMAS L. JAMES, SECRETARY'S OFFICE OF INMATE GRIEVANCE AND APPEAL, DEFENDANT · 02-3016 CIVIL TERM ORDER OF COURT AND NOW, this ~ day of August, 2002, the within suit may be filed without the payment of filing fee and the costs of service. The suit IS DISMISSED under 42 Pa.C.S. Section 6602(f)(1) in that three or more prior civil actions have been dismissed on the grounds that the litigation was frivolous. / /John Richard Jae, #BQ-3219 SCI Pittsburgh P.O. Box 99901 Pittsburgh, PA 15233-0901 v/Pennsylvania Department of Corrections Office of Chief Counsel 55 Utley Drive Camp Hill, PA 17011 :saa