Bracamonte v. Sheridan et al

OCR transcription for search; preserved printed pages are authoritative

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28

Case 2:26-cv-04917-JAT--CDB Document6 Filed 10/16/26 Page1of8

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IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF ARIZONA

Tara Jane Bracamonte, No. CV-26-04917-PHX-JAT (CDB)

Plaintiff,
Vv. ORDER
Gerard A. Sheridan, et al.,

Defendants.

Plaintiff Tara Jane Bracamonte, who was formerly confined in a Maricopa County
Jail, has filed a pro se civil rights Complaint pursuant to 42 U.S.C. § 1983 and an
Application to Proceed In Forma Pauperis (Doc. 2). In seeking leave to proceed in forma
pauperis, Plaintiff used the court-approved Application to Proceed In Forma Pauperis for
use by prisoners. On August 21, 2026, Plaintiff filed a Notice of Change of
Address (Doc. 5) indicating she is no longer in custody.

Because Plaintiff has been released since she filed her prisoner Application to
Proceed In Forma Pauperis, the Court will deny as moot the Application to Proceed and
will grant Plaintiff leave to file a non-prisoner application to proceed in forma pauperis.
Because Plaintiff is no longer a prisoner, to be granted leave to proceed in forma pauperis,
she only needs to satisfy the indigency requirements for a non-prisoner and, if she does so,
she will not be required to pay the filing fees that she would have been required to pay as

a prisoner.' Plaintiff will be given 30 days from the date this Order is filed to either pay

' Pursuant to 28 U.S.C. § 1915(b)(1), “if a prisoner brings a civil action or files an

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the $350.00 filing fee and the $55.00 administrative fee or file a non-prisoner Application
to Proceed in District Court Without Prepaying Fees or Costs using the form included with
this Order.
Plaintiff is advised that whether she pays the filing fee and administrative fee or is
granted leave to proceed in forma pauperis, the Court is required to screen complaints
brought by prisoners seeking relief against a governmental entity or an officer or an
employee of a governmental entity. 	28 U.S.C. § 1915A(a). 	The Court must dismiss a
complaint or portion thereof if the plaintiff has raised claims that are legally frivolous or
malicious, that fail to state a claim upon which relief may be granted, or that seek monetary
relief from a defendant who is immune from such relief. 	28 U.S.C. § 1915A(b)(1)–(2).
The Court must screen Plaintiff’s Complaint under this provision because Plaintiff filed
her Complaint while she was incarcerated and is seeking relief against a governmental
entity or an officer or an employee of a governmental entity. 	Moreover, pursuant to 28
U.S.C. § 1915(e)(2), the Court is required to review complaints brought by all plaintiffs
who are proceeding in forma pauperis and must dismiss a complaint or portion thereof if
the plaintiff has raised claims that are legally frivolous or malicious, that fail to state a
claim upon which relief may be granted, or seek monetary relief from a defendant who is
immune from such relief.
If Plaintiff fails to timely comply with every provision of this Order, including these
warnings, the Court may dismiss this action without further notice. See Ferdik v. Bonzelet,
963 F.2d 1258, 1260-61 (9th Cir. 1992) (a district court may dismiss an action for failure
to comply with any order of the Court).
IT IS ORDERED:
(1) 	Plaintiff’s Application to Proceed In Forma Pauperis (Doc. 2) is denied as
moot.
appeal in forma pauperis, the prisoner shall be required to pay the full amount of a filing
fee,” 28 U.S.C. § 1915(b)(1), even if she is permitted to proceed in forma pauperis. There
is no requirement that non-prisoners pay the full amount of the filing fee if they are
permitted to proceed in forma pauperis.
Case 2:26-cv-04917-JAT--CDB Document 6 Filed 10/16/26 Page 2 of 8

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(2) 	Within 30 days of the date this Order is filed, Plaintiff must either pay the
$350.00 filing fee and $55.00 administrative fee or file a non-prisoner Application to
Proceed in District Court Without Prepaying Fees or Costs.
(3) 	If Plaintiff fails to either pay the $350.00 filing fee and $55.00 administrative
fee or file a non-prisoner Application to Proceed in District Court Without Prepaying Fees
or Costs within 30 days, the Clerk of Court must enter a judgment of dismissal of this
action without prejudice and without further notice to Plaintiff and deny any pending
unrelated motions as moot.
(4) 	The Clerk of Court must mail Plaintiff a court-approved non-prisoner
Application to Proceed in District Court Without Prepaying Fees or Costs form.
Dated this 16th day of October, 2026.
Case 2:26-cv-04917-JAT--CDB Document 6 Filed 10/16/26 Page 3 of 8

Case 2:26-cv-04917-JAT--CDB

Document 6 ~~ Filed 10/16/26

AO 239 (Rev. 01/15) Application to Proceed in District Court Without Prepaying Fees or Costs (Long Form)

UNITED STATES DISTRICT COURT

for the

Plaintiff/Petitioner
v.

Defendant/Respondent

— Se

Civil Action No.

Page 4 of 8

Page 1 of 5

APPLICATION TO PROCEED IN DISTRICT COURT WITHOUT PREPAYING FEES OR COSTS
(Long Form)

Affidavit in Support of the Application

I am a plaintiff or petitioner in this case and declare
that I am unable to pay the costs of these proceedings

and that I am entitled to the relief requested. I declare

under penalty of perjury that the information below is

true and understand that a false statement may result in

a dismissal of my claims.

Signed:

Instructions

Complete all questions in this application and then sign it.
Do not leave any blanks: if the answer to a question is “0,”
“none,” or “not applicable (N/A),” write that response. If
you need more space to answer a question or to explain your
answer, attach a separate sheet of paper identified with your
name, your case's docket number, and the question number.

Date:

E. For both you and your spouse estimate the average amount of money received from each of the following
sources during the past 12 months. Adjust any amount that was received weekly, biweekly, quarterly,
semiannually, or annually to show the monthly rate. Use gross amounts, that is, amounts before any deductions

for taxes or otherwise.

Income source Average monthly income Income amount expected
amount during the past 12 next month
months

You Spouse You Spouse
Employment $ $ $
Self-employment $ $ $
Income from real property (such as rental income) $ $ $
Interest and dividends $ $ $
Gifts $ $ $
Alimony $ $ $
Child support $ $ $

Page 2 of 5
AO 239 (Rev. 01/15) Application to Proceed in District Court Without Prepaying Fees or Costs (Long Form)
Retirement (such as social security, pensions, annuities,
insurance) $ 	$ 	$ 	$
Disability (such as social security, insurance payments) $ 	$ 	$ 	$
Unemployment payments $ 	$ 	$ 	$
Public-assistance (such as welfare) $ 	$ 	$ 	$
Other (specify): $ 	$ 	$ 	$
Total monthly income: $ 	$ 	$ 	$
2. 	List your employment history for the past two years, most recent employer first. (Gross monthly pay is before taxes or
other deductions.)
Employer 	Address 	Dates of employment 	Gross
monthly pay
$
$
3. 	List your spouse's employment history for the past two years, most recent employer first. (Gross monthly pay is before
taxes or other deductions.)
Employer 	Address 	Dates of employment 	Gross
monthly pay
$
$
$
4. 	How much cash do you and your spouse have? $
Below, state any money you or your spouse have in bank accounts or in any other financial institution.
Financial institution 	Type of account 	Amount you have 	Amount your
spouse has
$ 	$
$ 	$
$ 	$
If you are a prisoner, you must attach a statement certified by the appropriate institutional officer showing all receipts,
expenditures, and balances during the last six months in your institutional accounts. If you have multiple accounts,
perhaps because you have been in multiple institutions, attach one certified statement of each account.
0.00	0.00	0.00	0.00
Case 2:26-cv-04917-JAT--CDB Document 6 Filed 10/16/26 Page 5 of 8

Page 3 of 5
AO 239 (Rev. 01/15) Application to Proceed in District Court Without Prepaying Fees or Costs (Long Form)
5. 	List the assets, and their values, which you own or your spouse owns. Do not list clothing and ordinary
household furnishings.
Assets owned by you or your spouse
Home (Value) 	$
Other real estate (Value) $
Motor vehicle #1 (Value) 	$
Make and year:
Model:
Registration #:
Motor vehicle #2 (Value) 	$
Make and year:
Model:
Registration #:
Other assets (Value) 	$
Other assets (Value) 	$
6. 	State every person, business, or organization owing you or your spouse money, and the amount owed.
Person owing you or your spouse
money
Amount owed to you 	Amount owed to your spouse
$ 	$
$ 	$
$ 	$
7. 	State the persons who rely on you or your spouse for support.
Name (or, if under 18, initials only) 	Relationship 	Age
Case 2:26-cv-04917-JAT--CDB Document 6 Filed 10/16/26 Page 6 of 8

Page 4 of 5
AO 239 (Rev. 01/15) Application to Proceed in District Court Without Prepaying Fees or Costs (Long Form)
8. 	Estimate the average monthly expenses of you and your family. Show separately the amounts paid by your
spouse. Adjust any payments that are made weekly, biweekly, quarterly, semiannually, or annually to show the
monthly rate.
You 	Your spouse
Rent or home-mortgage payment (including lot rented for mobile home)
$ 	$	Are real estate taxes included? 	’ Yes 	’ No
Is property insurance included? ’ Yes 	’ No
Utilities (electricity, heating fuel, water, sewer, and telephone) 	$ 	$
Home maintenance (repairs and upkeep) 	$ 	$
Food 	$ 	$
Clothing 	$ 	$
Laundry and dry-cleaning 	$ 	$
Medical and dental expenses 	$ 	$
Transportation (not including motor vehicle payments) 	$ 	$
Recreation, entertainment, newspapers, magazines, etc. 	$ 	$
Insurance (not deducted from wages or included in mortgage payments)
Homeowner's or renter's: 	$ 	$
Life: 	$ 	$
Health: 	$ 	$
Motor vehicle: 	$ 	$
Other: 	$ 	$
Taxes (not deducted from wages or included in mortgage payments) (specify): $ 	$
Installment payments
Motor vehicle: 	$ 	$
Credit card (name): 	$ 	$
Department store (name): 	$ 	$
Other: 	$ 	$
Alimony, maintenance, and support paid to others 	$ 	$
Case 2:26-cv-04917-JAT--CDB Document 6 Filed 10/16/26 Page 7 of 8

Case 2:26-cv-04917-JAT--CDB Document6- Filed 10/16/26 Page 8of8

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AO 239 (Rev. 01/15) Application to Proceed in District Court Without Prepaying Fees or Costs (Long Form)
Regular expenses for operation of business, profession, or farm (attach detailed $ S
statement)
Other (specify): $ $
Total monthly expenses: 0.005 —_
a. Do you expect any major changes to your monthly income or expenses or in your assets or liabilities during the
next 12 months?
OYes ONo If yes, describe on an attached sheet.
10. Have you spent — or will you be spending — any money for expenses or attorney fees in conjunction with this
lawsuit? OF Yes ONo
If yes, how much? $
11. Provide any other information that will help explain why you cannot pay the costs of these proceedings.

12. Identify the city and state of your legal residence.

Your daytime phone number:

Your age: Your years of schooling: