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https://www.supremecourt.gov/search.aspx?filename=/docketfiles/16-68...

11/17/2016 4:39 AM

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AFFIDAVIT OR DECLARATION
IN SUPPORT OF MOTION FOR LEAVE TO PROCEED IN FORMA PAUPERIS
I, STANLEY J. CATERBONE, Pro Se , 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

You

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

$ 1,357.00
security, insurance payments)

Unemployment payments

Public-assistance
(such as welfare)

Other (specify):

Total monthly income:

U.S.C.A. 16-1149 To US Supreme Court

1,357.00

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1,357.00

1,357.00

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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 spouses 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

Members1st
TD Ameritrade

Checking
Money Market

Amount you have

$ 1,000.00
$ 12,000.00
$

Amount your spouse has

$
$
$

5. List the assets, and their values, which you own or your spouse owns. Do not list clothing
and ordinary household furnishings.
X Home
M
Value 25% of 80,000.00

M Other real estate

Value

M Motor Vehicle #1
Year, make & model
Value

M Motor Vehicle #2
Year, make & model
Value

M Other assets
Description
Value

997,000 Shares of NON-MARKETABLE Stock in Advanced Media Group, Ltd.,

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You
Transportation (not including motor vehicle payments)

Recreation, entertainment, newspapers, magazines, etc.

Your spouse

100.00

200.00

Insurance (not deducted from wages or included in mortgage payments)

48.00

Homeowners or renters

Life

Health

Motor Vehicle

Other:

Office/Computer/Copying/Printing/Postage

300.00

Taxes (not deducted from wages or included in mortgage payments)

$

Motor Vehicle

Credit card(s)

Department store(s)

Other:

Alimony, maintenance, and support paid to others

Regular expenses for operation of business, profession,

or farm (attach detailed statement)

(specify):
Installment payments

Other (specify):

Home Improvement

Total monthly expenses:

U.S.C.A. 16-1149 To US Supreme Court

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500.00

2,658.00

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DRAFT COPY

No.

IN THE
SUPREME COURT OF THE UNITED STATES

STANLEY J. CATERBONE

PETITIONER

(Your Name)
vs.
Superintendent Framingham MCI, et al

RESPONDENT(S)

ON PETITION FOR A WRIT OF CERTIORARI TO

U.S. THIRD CIRCUIT COURT OF APPEALS

(NAME OF COURT THAT LAST RULED ON MERITS OF YOUR CASE)

PETITION FOR WRIT OF CERTIORARI

Stanley J. Caterbone

(Your Name)
1250 Fremont Street

(Address)
Lancaster, PA 17603

(City, State, Zip Code)

(717) 669-2163

(Phone Number)

U.S.C.A. 16-1149 To US Supreme Court

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TABLE OF CONTENTS
12
OPINIONS BELOW ........................................................................................................ 1

JURISDICTION...................................................................................................................13
CONSTITUTIONAL AND STATUTORY PROVISIONS INVOLVED .................................14
STATEMENT OF THE CASE ............................................................................................ 24
REASONS FOR GRANTING THE WRIT .......................................................................... 26
CONCLUSION.................................................................................................................... 27

INDEX TO APPENDICES

APPENDIX A .............................................................................................................. 36

APPENDIX B ............................................................................................................... 41
APPENDIX C .............................................................................................................. 43
APPENDIX D .............................................................................................................. 47

APPENDIX E .............................................................................................................. 55
APPENDIX F .............................................................................................................. 60
APPENDIX G .............................................................................................................. 64
APPENDIX H .............................................................................................................. 71

APPENDIX I ............................................................................................................... 73

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TABLE OF AUTHORITIES CITED

CASES

PAGE NUMBER

Pointer v. Texas, 380 U.S. 400, 85 S.Ct. 1065, 13 L.Ed.2d 923 (1965);

Appendix B -

STATUTES AND RULES

OTHER

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IN THE
SUPREME COURT OF THE UNITED STATES
PETITION FOR WRIT OF CERTIORARI
Petitioner respectfully prays that a writ of certiorari issue to review the judgment below.

OPINIONS BELOW
[X] For cases from federal courts:
The opinion of the United States court of appeals appears at Appendix
the petition and is

to

[ X] reported at U.S.C.A. THIRD CIRCUIT 16-1149 July 18, 2016

; or,
[ ] has been designated for publication but is not yet reported; or,
[ ] is unpublished.
The opinion of the United States district court appears at Appendix
the petition and is

to

[ ] reported at
; or,
[ ] has been designated for publication but is not yet reported; or,
[ ] is unpublished.
[ ] For cases from state courts:
The opinion of the highest state court to review the merits appears at
Appendix
to the petition and is
[ ] reported at
; or,
[ ] has been designated for publication but is not yet reported; or,
[ ] is unpublished.
The opinion of the
appears at Appendix

court
to the petition and is

[ ] reported at
; or,
[ ] has been designated for publication but is not yet reported; or,
[ ] is unpublished.

1.

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JURISDICTION
[ X] For cases from federal courts:
The date on which the United States Court of Appeals decided my case
was June 15, 2016
.
[ ] No petition for rehearing was timely filed in my case.
[ ] A timely petition for rehearing was denied by the United States Court of
Appeals on the following date: July 18, 2015
, and a copy of the
A
order denying rehearing appears at Appendix
.
[ ] An extension of time to file the petition for a writ of certiorari was granted
to and including
(date) on
(date)
in Application No.
A
.
The jurisdiction of this Court is invoked under 28 U. S. C. 1254(1).

[ ] For cases from state courts:

The date on which the highest state court decided my case was
A copy of that decision appears at Appendix
.

[ ] A timely petition for rehearing was thereafter denied on the following date:
, and a copy of the order denying rehearing
appears at Appendix
.
[ ] An extension of time to file the petition for a writ of certiorari was granted
to and including
(date) on
(date) in
Application No.
A
.
The jurisdiction of this Court is invoked under 28 U. S. C. 1257(a).

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