Khron, Miles v. Pitzen, Kevin et al

IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF WISCONSIN
MILES KHRON,
Plaintiff,
v.
KEVIN PITZEN et al,
Defendants.
ORDER
Case No. 26-cv-1026-jdp
Plaintiff Miles Khron has filed a proposed civil complaint, but has neither paid the filing
fee, nor requested leave to proceed without prepayment. 	For this case to proceed, plaintiff
must pay the $405 filing fee1 or submit a properly supported motion for leave to proceed
without prepayment by November 4, 2026.
A motion for leave to proceed without prepayment must be accompanied by a certified
copy of plaintiff’s inmate trust fund account statement (or institutional equivalent) for the six-
month period immediately preceding the filing of the complaint. 28 U.S.C. § 1915(a)(2). If I
find that plaintiff is indigent, I will calculate an initial partial payment of the filing fee that
plaintiff must pay before the court can screen the complaint on the merits under 28 U.S.C. §
1915(e)(2). Thereafter, plaintiff must pay the balance of the filing fee in installments.
ORDER
IT IS ORDERED that plaintiff Miles Khron may have until November 4, 2026 to
submit the $405 filing fee or a motion for leave to proceed without prepayment and a trust
fund account statement for the period beginning approximately April 9, 2026 and ending
1 Effective December 1, 2023, the cost to file a civil action in federal court is $405 — a $350 statutory
fee plus a $55 administrative fee that does not apply to persons granted in forma pauperis status under
28 U.S.C. § 1915.
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approximately October 8, 2026. If plaintiff fails to respond to this order by November 4, 2026,
then I will assume that plaintiff wishes to withdraw this action voluntarily. In that event, the
case will be dismissed without prejudice to plaintiff refiling at a later date.
Entered this 14th day of October, 2026.
BY THE COURT:
s/
ANDREW R. WISEMAN
United States Magistrate Judge
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UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF WISCONSIN
MILES KHRON,
Plaintiff,
v.
KEVIN PITZEN ET AL,
Defendants.
ORDER
Case No. 26-cv-1026-jdp
PRISONER REQUEST TO PROCEED IN DISTRICT COURT
WITHOUT PREPAYING THE FULL FILING FEE
Answer the following questions to the best of your ability.
Note: If you do not tell the truth, the court may dismiss your lawsuit.
I. 	Personal Information
1) 	Your name: ___________________________________________________________
(a) 	State the place of your incarceration and provide your prisoner identification
number:
_______________________________________ 	_____________________________
(place) 	(number)
(b) 	Are you employed at the institution? 	□Yes 	□ No
(c) 	Do you receive any payment from the institution? 	□Yes 	□ No
Attach a printout of your prison trust account statement showing transactions for the six-
month period immediately preceding the filing of this request and showing the current
balance of your account.
2) 	Do you have any dependents that you are responsible for supporting?
□ Yes 	□ No
If “yes,” list them below.
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Name or initials (for 	Relationship to You 	Age 	Amount of Support
minor children only) 	Provided per Month
________________________ 	_________________ 	________ 	$____________
________________________ 	_________________ 	________ 	$____________
________________________ 	_________________ 	________ 	$____________
II. 	Property or Assets: - If you are married, your answers must include your spouse's
property.
1 ) 	Do you own a car?
□ Yes 	□ No 	If “yes,” list the car(s) below:
Make and Model 	Year 	Approximate Current
Value
_______________________________________________ __________ 	$________________
_______________________________________________ __________ 	$________________
2) 	Do you own your home(s)? 	□ Yes 	□ No
If “Yes,” state the approximate value(s). 	$ ____________________
What is the amount of equity (assessed value of residence minus outstanding
mortgage balance) in the home(s)? 	$ ____________________
3) 	Do you have any cash or checking, savings, or other similar accounts?
□ Yes 	□ No
If “Yes,” state the total of such sums. 	$ ____________________
4) 	Do you own any other property of value, such as real estate, stocks, bonds, trusts, or
individual retirement accounts (e.g., IRA, 401 k), artwork, or jewelry?
□ Yes 	□ No
If “Yes,” describe the property and the approximate value(s).
______________________________________________________________________
______________________________________________________________________
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III. 	Litigation History
For each federal lawsuit that you recall having filed, list as much of the following
information that you remember about each case: The name of the case (that is, the plaintiffs and
the defendants), the case number or year of filing, and the federal district in which you filed the
case. Use more paper if needed.
Case Name 	Case number 	Federal district
(Plaintiffs and defendants) 	(or year of filing)
________________________ 	____________________ 	_______________________
________________________ 	____________________ 	_______________________
________________________ 	____________________ 	_______________________
________________________ 	____________________ 	_______________________
IV. 	Other Circumstances - Describe any other financial circumstance(s) that you would
like the court to consider when reviewing this petition.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
I, ____________________, declare that I am the plaintiff bringing this complaint. I declare that
I am unable to prepay the full filing fee and that I am entitled to the relief sought in the
complaint.
___________________________ 	_________________________________________
Date 	Signature - Signed Under Penalty of Perjury
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