Case: 3:13-cv-00387-wmc Document #: 3 Filed: 06/04/13 Page 1 of 3
IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF WISCONSIN
DERRICK L. SMITH,
WARDEN MICHAEL MEISNER, et al.,
Plaintiff Derrick L. Smith is a state inmate at Columbia Correctional Institution in
Portage, Wisconsin. He has submitted a handwritten complaint for relief under 42 U.S.C.
§ 1983, alleging violations of his civil rights by Warden Michael Meisner, a Jane Doe physician,
and a Jane Doe health service manager. The pleadings are deficient, which means this case
cannot proceed, for two reasons.
First, plaintiff has neither paid the $400 filing fee for a civil action in federal district court
nor submitted a request for leave to proceed in forma pauperis without prepayment of fees.
Assuming that plaintiff wishes to proceed in forma pauperis, he must comply with the Prison
Litigation Reform Act of 1996 (the “PLRA”), 28 U.S.C. § 1915(a)(2), by submitting a certified
copy of his inmate trust account statement for the six-month period preceding the date of his
complaint. Once plaintiff has provided the necessary statement, the court will calculate and
assess an initial partial filing fee payment according to a formula described in 28 U.S.C.
§ 1915(b)(1). Plaintiff must pay the initial partial filing fee for his case to proceed and he must
thereafter pay the remainder of the filing fee in monthly increments. See 28 U.S.C.
Case: 3:13-cv-00387-wmc Document #: 3 Filed: 06/04/13 Page 2 of 3
Second, plaintiff has not filed his complaint on a form approved for use by state
prisoners. Regardless of whether he pays the filing fee or any portion thereof, the PLRA requires
the court to review every complaint in a civil action in which a prisoner seeks redress from a
governmental entity, officer or employee, to determine if the complaint is (1) frivolous,
malicious, or fails to state a claim upon which relief may be granted; or (2) seeks monetary relief
from a defendant who is immune from such relief. 28 U.S.C. § 1915A. Before this court can
entertain plaintiff’s claims, he must file a complaint pursuant to 42 U.S.C. § 1983, setting out
a short and plain statement of the facts underlying his claim for relief. See Fed. R. Civ. P. 8(a).
If possible, he must also identify the Jane Doe defendants by name. To assist plaintiff, the
clerk’s office will provide along with this order an approved form for use by state prisoners filing
a civil rights lawsuit. Similar forms also are available at the prison law library.
IT IS ORDERED that plaintiff Derrick L. Smith may have until June 18, 2013 to submit
a complaint on the form provided by the clerk’s office or similar
form from the prison law library; and
the filing fee ($400) or a request for leave to proceed in forma
pauperis that includes a certified copy of his trust fund account
statement for the period beginning approximately September 19,
2012 and ending approximately March 19, 2013.
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If plaintiff fails to respond or comply as directed by June 18, 2013, the court will assume
that he wishes to withdraw this action voluntarily. In that event, his case will be dismissed
under Fed. R. Civ. P. 41(b) without further notice.
Entered this 4th day of June, 2013.
BY THE COURT: