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Case3:13-cv-04339-MMC Document4 Filed09/20/13 Page1 of 1

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

Tolupene Tavai,

v.

Plaintiff,

Carolyn W. Colvin, Acting Commissioner,
Social Security Administration,


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Defendant.

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Case No. C 13-4339 MMC

ORDER GRANTING APPLICATION
TO PROCEED
IN FORMA PAUPERIS

( X )

IT IS ORDERED that the application to proceed in forma pauperis is

GRANTED and that the Clerk issue summons. IT IS FURTHER ORDERED that the
U.S. Marshal for the Northern District of California serve, without prepayment of fees, a
copy of the complaint, any amendments, the Procedural Order for Social Security
Review Actions, and this order upon defendant.

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IT IS ORDERED that the application to proceed in forma pauperis is
DENIED, and that the filing fee of $400.00 be paid no later than .
Failure to pay the filing fee by that date will result in dismissal of the above-entitled
action without prejudice. The plaintiff is hereby apprised of her responsibility to serve
defendant with the complaint and any amendments, and the Procedural Order for Social
Security Review Actions, pursuant to Rule 4 of the Federal Rules of Civil Procedure.
Plaintiff has a continuing obligation to keep the Court informed of her current address.
Failure to do so may result in dismissal.

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IT IS ORDERED that the application to proceed in forma pauperis is

DENIED and that plaintiff is further ordered to make partial payment of the filing fee in
the amount of $ ____ no later than ___________. Failure to pay this amount will result
in dismissal of the above-entitled action without prejudice. Plaintiff is hereby apprised of
her responsibility to serve defendant with the complaint and any amendments, and the
Procedural Order for Social Security Review Actions, pursuant to Rule 4 of the Federal
Rules of Civil Procedure. Plaintiff has a continuing obligation to keep the Court
informed of her current address. Failure to do so may result in dismissal.

Dated: September 20, 2013


UNITED STATES DISTRICT JUDGE