Petition for Writ of Certiorari — Cassandra McGuire, Petitioner v. Tennessee, et al.
Supreme Court briefApr 6, 2023
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In the Supreme Court of the United States Petitioners,
Plaintiff, Cassandra McGuire, Pro Se
Supreme Court, U.S.
FILED
APR 0 6 2023
v.
offip.F of the clerk
Respondents:,
Defendant, Judge Allan Kern; State of Tennessee,
Lauren Kisner Attorney for the State of TN.
Motion to Proceed Forma Pauperis in Regards to Petition for a.
Writ of Certiorari to the
United States Court of Appeals for the Sixth Circuit
Federal Case 3:22-cv-00275; Appeals Docket No. 22-5614
27 E. Chandler Ave. Apt. B
Evansville, IN 47713
615-482-6897
caveritt2000@yahoo.com
RECEIVED
JUL -5 2023
OFFICE OF THE CLERK
SUPREME COURT. U.S.
AFFIDAVIT OR DECLARATION
IN SUPPORT OF MOTION FOR LEAVE TO PROCEED IN FORMA PAUPERIS
I
, am the petitioner in the above-entitled case. In support of
my motion to proceed in forma pauperis, I state that because of my poverty I am unable to pay
the costs of this case or to give security therefor; and I believe I am entitled to redress.
1. 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 amount during
the past 12 months
Amount expected
next month
Spouse
You
Spouse
$
$.
$.
$.
$.
Employment
$
Self-employment
$
Income from real property
(such as rental income)
$.
$.
$.
$.
Interest and dividends
$.
$.
$.
$.
Gifts
$.
$.
$.
$.
Alimony
$.
$.
$.
$.
Child Support
$.
$.
$.
$.
Retirement (such as social
security, pensions,
annuities, insurance)
$.
$.
$.
$.
Disability (such as social
$.
security, insurance payments)
$.
$.
$.
Unemployment payments
$.
$.
$:
$.
Public-assistance
(such as welfare)
$.
$.
$.
$.
Other (specify):
$.
$.
$.
$.
5399^
$.
$.
$.
Total monthly income:
$
*
2. List your employment history for the past two years, most recent 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
$.
$.
$.
X
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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.
Type of account (e.g., checking or savings)
Amount you have
Amount your spouse has
$ ftfiTr-CO
$
$
$.
$
$.
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5. List the assets, and their values, which you own or your spouse owns. Do not fist clothing
and ordinary household furnishings.
□ Home
□ Other real estate
Value________
Value
□ Motor Vehicle #1
_
. ^ ,
Year, make & model XoOlo Wf^L
Value
p'TX
Motor Vehicle #2
Year, make & model
Value ISOQ. 0 ^
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1*5* c/ut -fa, her*$
□ Other assets
Description _
Value_____
jj,j_
You
j pji rt^
Your spouse
'■t-
Transportation (not including motor vehicle payments)
Lf&'— $.
Recreation, entertainment, newspapers, magazines, etc.
$ )
$.
/
Insurance (not deducted from wages or included in mortgage payments)
JJ£ . lOSSV't
Homeowner’s or renter’s
Life
$-
$.
Health
$.
Motor Vehicle
$.
$.
jpfl A (it ft a jj I}) h% *1 Iji/trtThiIS lU&r 90£>
Other:
$.
Taxes (not deducted from waages or included in mortgage payments)
(specify):
du ‘fp vUu. CcAjtr*i [oflwvHt'y $ L'33^
Installment payments
$
^fbucl . TH^| f<LpoMM FrcuotPoper^^IpLS .
Motor Vehicle
$.
Credit card(s)
$.
$.
$.
r^tur
Department store(s)
Other:
C rtlfe j t
$.
$.
$.
$.
Alimony, maintenance, and support paid to otheFs
'gl fib
$.
Regular expenses for operation of business, profession,
or farm (attach detailed statement)
Other (specify):
Total monthly expenses:
61
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fYlon.
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$.
$.
$
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$
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6. State every person, business, or organization owing you or your spouse money, and the
amount owed.
Of!
Person owing you or
your spouse .money
I,
Amount owed to you
Amount owed
$.
$.
$.
$.
$.
$.
your spouse
\
7. State the persons who rely on you or your spouse for support. For minor children, list initials
instead of names (e.g. “J.S.” instead of “John Smith”).
Name
Ci^frel
Relationship
(AJLhVj- TTr
Age
LH
U
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join nr-C/co]
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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, or
annually to show the monthly rate.
You
Your spouse
Rent or home-mortgage payment
(include lot rented for mobile home)
Are real estate taxes included? QYes Q?No
Is property insurance included? □ Yes
No
$.
Utilities (electricity, heating fuel,
water, sewer, and telephone)
\
iW.$
Home maintenance (repairs and upkeep)
Food
i
1 \
\
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1 Mhftg
$.
Clothing
T
$.
Laundry and dry-cleaning
$. C(0
Medical and dental expenses
$.
m
twdh;
L)b(pj^n^/L-
$.
I
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9. Do you expect any major changes to your monthly income or expenses or in your assets or
liabilities during the next 12 months?
untnCsiun ,
□ Yes
□ No
If yes, describe on an attached sheet.
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10. Have you paid - or will you be paying - an attorney any money for services in connection
with this case, including the completion of this form? □ Yes [WNfo
If yes, how much?______________________
If yes, state the attorney’s name, address, and telephone number:
11. Have you paid—or will you be paying—anyone other than an attorney (such as a paralegal or
a typist) any money for services in connection with this case, including the completion of this
form?
□ Yes
No
If yes, how much?
If yes, state the person’s name, address, and telephone number:
12. Provide any other information that will help explain why you cannot pay the costs of this case.
If hcu^L Kiftom/t
jj^s\od
I declare under penalty of perjury that the foregoing is true and correct.
Executed on:
A/ /3 ^
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(Signature)
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