The opinion of the court was delivered by: Kendall J. Newman United States Magistrate Judge
Plaintiff, who appears to be proceeding without counsel,*fn1 has not paid the fee ordinarily required to file an action in this court. See 28 U.S.C. § 1914(a). She has filed an incomplete application to proceed without the prepayment of fees and costs, also known as an application to proceed "in forma pauperis" (Dkt. No. 2). See 28 U.S.C. § 1915(a). First, plaintiff's application indicates that plaintiff receives money from the following sources:
(1) "Rent payments, interest or dividends"; (2) "Pensions, annuities or life insurance payments"; (3) "Disability or workers compensation payments"; (4) "Gifts or inheritances"; and (5) "Any other sources." (Dkt. No. 2 at 1.) Plaintiff's application is incomplete, however, because it does not describe: (a) each source of money, (b) the amount of money received, and (c) the amount of money plaintiff expects to continue to receive. Second, plaintiff has not responded to any of the questions on the second page of the application. For example, she has not indicated whether she has "any cash or checking or savings accounts" and, if so, the total amount of cash or money in her accounts. Likewise, she does not state whether she owns "any real estate, stocks, bonds, securities, other financial instruments, automobiles or any other thing of value." Finally, plaintiff did not sign or date her application to proceed in forma pauperis.
Without a completed application, the court is unable to properly evaluate whether plaintiff should be granted leave to proceed in forma pauperis. Plaintiff will be provided with an opportunity to submit either (1) a completed application to proceed in forma pauperis, or (2) the appropriate filing fee.
For the reasons stated above, IT IS HEREBY ORDERED that:
1. Plaintiff shall submit, within twenty (21) days of the date of this order, either a completed application in support of her request to proceed in forma pauperis on the form provided by the Clerk of Court, or the appropriate filing fee. Plaintiff's failure to comply with this order will result in a recommendation that her application to proceed in forma pauperis be denied.
2. The Clerk of the Court is directed to send to plaintiff a new Application to Proceed Without ...