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1 u -C ^ ^ S uPre3 une
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VEDMAR I 2 2012
CLERK OF COURTSUPREfUE CUURT OP OHIO
'IAR 12 7o1z
Ci_EH9! UF OURTSUPREME C®Uil'w UF ®HIO
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CONNECTIONS: Health * Wellness' AdvocacyREQUEST/AUTHORIZATION TO DISCLOSE INFORIl4ATIONO
authorize CONNECTIONS to (check all that apply):
^.I f)tU1 i n (Z^n^ 1 a lon to/ frS
born on o2 l1 ^J V1(Date of Birth)
disclose, ® receives r[^ verbally exchL J
a?ge my individually identifiable health inform t•
Authorized Indroldual/Organzatto andfull address J, f•R4Ovk ch
Purpose of Disclosure•, g er assessment informationgoing treatment 0 t o d ^ for treatment planning^ to gather information forcoor mate benefits and entftlements
Type of Information to be DI 1 d L^J other purposes (specify): a ( t,^sc ose :1.) information on mental illness and/or treat
q tr t t I ^ ent, specifically 6 psychiatric notes,ea men p ans, progress notes (other infor,mation s ee' ^lab results,
2.) Information on druolalcohottreatment, specificall ( p ^) i^ 1 n h^o^( ^ ^ 6^SY^I Progress notes, QClqf, (]progress in treatment,Olab results, Durine testing, Qattendance, []HIV/AIDS testing or status , Oprenatalcare, Qdiagnosis Qother information (specify) 0Pregnancy testing,
3•) Qother information (specify):
Type of Information Requested:1.) q information on mental illness
and/or treatment, specifically Q psychiatric notes, []lab results,q treatment plans, ^]progress notes [I other information
(specify)2.) q information on drug/alcohol treatment, specifically 0 progress notes, QCIAI, Oprogress in treatment,Olab results, Qurine testing, ^]attendance, E]HIVLAIDStesting or status, (]pregnancy testing,^prenatal care,
[]diagnosis Dother information (spc°^;fy)3.) Dother information ls^ecif„).„•
Speciffc Dates or Amount of Information to be Disclosed: p n ^
This authorization to Disclose/Receive or Verbally Exchange confidential informionwill u omatically expire one hundred
eighty (180) days after the date of authorization unless I ationan earlier condition, date, or event.
Condition, date or event of expiration earlier than 180 days:1t . I
rJ
or p one number.
q to coordinate treatment 0 to ath
aAj_j_M10,6T1-cv.
Date and.lgnature of Client orOther Person Authorized to Permit Disclosure Date a d Signature of wi ne s
If this authorization has been signed by anyone other than client, parent of minor child, or minor chfld (see 42 CFR 2.14b),documents must be submitted to show authority to request information on the client. If this authorization has been signedby anyone other than client or parent of minor child, please print name and indicate relationship
My refusal to sign this authorization will not affect my ability to obtain treatment, payment, enrollment oreligibility.
q This release has been revoked effective:(authorizing signature on reverse side of this form)
Please return requested i fn ormation to the following location:Connections-The Office Placeq Connections- Rockefeller Pointe^\ 24200 Chagrin Blvd. 2490 Lee Bfvd., 3uite 103 El Connections
Beachwood, Ohio 44122-5429 3104 West 250, 2nd floorFax (216) 766-6084 Cleveland Hits., Ohio 44118
Fax (216) 371-5312 Cleveland, Ohio 44109Fax (218) 737-0440
Original - chart Copy - receiver/requestor ,copy-
No. I I - srlq®
IN THE
U.S. POSTHO
CLEVELRF^O.OH49I05
^w^rosrerez OCT 17, II
ioas $5=65
SUPREME COURT OF THE UNITED STATES
--',®AU for Re.hef4c ► 113
^qr^! ltilELZo10 ® PETITIONER(Your Name)
VS.
&-PT%lo r ANtzr42yAs C L- RESPONDENT(S)
PROOF OF SERVICE
&Orrk! n'" L--Tb/d , do swear or declare that on this date,(5 til 117 , 20-Li, as required by Supreme Court Rule 29 I have
served the enclosed MOTION FOR LEAVE TO PROCEED IN FORMA PAUPERISand PETITION FOR A WRIT OF CERTIORARI on each party to the above proceedingor that party's counsel, and onevery other person required to be served, by depositingan envelope containing the above.documents in the United States mail properly addressedto each of them and with firstclass postage prepaid, or by delivery to a third-partycommercial carrier for delivery within 3 calendar days.
The names and addresses of those served are as follows:
At/ ^-n l-# AA.LC c-) n l ` a,`3 C4(,<2, s] c/ n lAC2, 5-1-•2 3R6
Cle<<P,I4jur1 0 14r'n qL6//3
I declare under penalty of perjury that the foregoing is true and correct.
Executed on ^-1(14"" ti , 20ii
RECEIVE
OC'f 2 q 2011OFFICE OF T71E G(:ERK3UPREME COURr US:
Supr®ITO Courf
No& .1i®_5.7q®
SuPPOEi"1C C-®URr
(.7'C TH_e ulu2-'r0-.^ ^TPr.l t;^
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OCT 1 T 2®11^FFieEO_^
^Cli"^i n ^A Assoc°AfQ
Mr^oP,n G.RobethS
^ ► f^e C^re^^nols c^^ etreums4-4 n.c,e,s o,i D '1 , & . A b°1XvDPsc(^ir^-'nA-A-°oAJ AN Eq^1°^-y t^c 1^ Gr^r^' P^ ^`tur.s f^^s
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G
WAIVER
Gary Melton
SUPREME COURT OF THE UNITED STATES
Supreme Court Case No. 11-5740
(Petitioner)
v GER Taylor Gardens LLC
(Respondent)
RECEIVED
SEP 13 2011OFFICE OF Tl^IE CLEi1KSJPREME COURT, U.B.
I DO NOT INTEND TO FILE A RESPONSE to the petition for a writ of certiorari unless one is requestedby the Court.
Please check one of the following boxes:
0 Please enter my appearance as Counsel of Record for all respondents.
q There are multiple respondents, and I do not represent all respondents. Please enter myappearance as Counsel of Record for the following respondent(s):
I certify that I am a member of the Bar of the Supreme Court of the United States (Please explain ifyour name has changed since your admission):
S 0-'--
(Type or print) Name Jay S. Hanson
m Mr. q Ms. 13 Mrs. q Miss
Firm Staff Counsel, American Family Insurance Company
Address 323 Lakeside Place, Suite 380
City & State Cleveland, OH Zip 44113
Phone (216) 912-4070
A COPY OF THIS FORM MUST BE SENT TO PETITIONER'S COUNSEL OR TO PETITIONERIF PRO SE. PLEASE INDICATE BELOW THE NAME(S) OF THE RECIPIENT(S) OF A COPYOF THIS FORM. NO ADDITIONAL CERTIFICATE OF SERVICE IS REQUIRED.
SEE REVERSE FOR INFORMATION CONCERNING THE STATUS OF A CASE ON THEDOCKET.
CC: Gary Melton
No.
1L-5 74 o,IN THE
SUPREME COURT OF THE UNITED STATES
C;-Ak M t3LTOour Name)
vs.
- PETITIONER
t9P.r ^A^ l Ic11^ 19A1tdef'1S - RESPONDENT(S)
ON PETITION FOR A WRIT OF CERTIORARI TO
Oh;OsUprertie - Cor..rt,+ CIdSts Ki U a0lo-a 9-9 O^L-(NAME OF COU T THAT LAST RULED ON MERITS OF YOUR CASE)
PETITION FOR WRIT OF CERTIORARI
G fr^ 1`^^LTo r^(Your Name)
Ca29l:3 ferris AyL=
(Address)
(^Jev%e-l6tiJ oh^^ 451os(City, State, Zip Code)
6a uD J 3aa-Cf a3s(Phone Number)
C
STATEMENT OF THE CASE
C>n ^^v^rc^ 3traao$ G, rneW=DKa^ wr^5 Pv ^.,^r
^. ^^bne^ S ¢ du+j ^'vTres,^ors p4+he Fo^BSt TAY lor° Rora^ ^'p.S-^-
Cle,rel p,^ o ^' cea`Fra,J
^'l°r< Gwrr1e,^r
^l^lua, ^pt- Yay,iresIde^-f
Sal^er APt Yby,^/^^ I 1 zf"Is.t^r^,eh Ga,-rr^el^@ cu,^s(e^in
^^.I +' c"(,t ^^ ^^+e Per^r Srk;r 3 Edao^^/^l/<rvtc^ ^(aw^ "s 0-p4hC' Ap,3r,^^ri
. e"-^ 6 t1` lc^t^ .^a^^^,^ ^©+^he m^9^1 - S+A`^s l,e s+ ^ +he `/r^+
r`^c Fhe ^CAseQ,A s4y<^ . h^ (sT^loc^k
^ he SsI^, o^ e s Fa/,s ^^ retN^p 1,y ^^Ec^
Jar^ °^' -fl,e ow^/he4d o'4 ^ r1 ^^ ^he ^^ ^Zoe2 ^'iA'd^` S ^q yyz$ o c^ ^hQ^^
^ p ^ 54 ^v n^ ^^ 7`^,^ ^ps ;. - ^
^A 1 I /^ Iso ^" $ i/ ^o fiec j4
^oU1 l! 6r^v;7 S^il( ^r
t^ry ^ el "S^s^tp ^ S a ^ri ss t^ 7G^e,x^^ y 'xJ
4-r,,, ,^^ ^neY s41^e4, ^u^
^^S y 3 , a^o o6 J
e^ edn ^^^ e s-^`te
^^GN^ uE ^^^ hos y he Ws;^ ^^an/evel,mc( w1^en
y p^1 sqljer pN
Zy^lo2o0^hl/^^e^ f^ 7e ve iq Y^•1 Y,,elfC^.l^
CIPveI^r.^( C(lA,,' °^0 8.A^ c^e^e ja^a(C
REASONS FOR GRANTING THE PETITION
To °t'I-ve F-IonorArlole U,u4-eJ S+A+e,s ChpeS,Sus+°ce. auJ Jus-f^ceg
ixJ -F-h-e Low^^ Courz ^-^oo„i 3urjge Pt^^-r^^ k r<e,cty 4 tj D+ Ie.+ eg^rr► el^o,t^ Pc^ur^ Cv°cJenee ^tuc^ [3uat^^n^C f^ot^sln t/ro;oAr {0lpen^o^e^X,hr(^,•-^--^p ^^2J^
^OSKo om^}^FF^ ^rv3 beea^rqe pro^„br-^s c^rsr^rr+-^^
r^ud i I S^r ^e ( A . w pro4e41to n4o pe rsons w1,o pre el°s K4biee! .u; A^ep^a`im^airmenlr 4ha^ReJ,v^^7 S ubsfck,-^'r'ally in,^-F-s Oh2 z^r,,,ore,-rn^a-^oF tSiae
es` Zvdye AA-1-riek h^e(ly Jicln^4- provicfe CprYmero 1fon f^^s9^^Lr r9 }^^S ^-^ea-{-io n. Gp er6Yj Sa ^"[ ^el^on ^Ove A menfNl rrnpn;rrnenE-^;ga6^li^'Ad
(ILhQ-{- 4-,As.
^otn 7 Aclm"" O'Slra !-tpan,Aud Ga2Y mai-Fo-n9 ^'1 ^ n--F-h,^Caurv^-r Unejer^^+^na^^^^1 ^el-Ebn r:s oo m ^-h,^-k- be-cr+r^e. ^.nc.csr,^^e-Fence,^^Jp^eC^ ^gCr+ n-1-sFf <
_jCovr-1 A40US a:
^mer ^^ ^,r^i`^yjnsuraNCe (2or,r'/447<^ en^ n
ti6n^sconar»,'C ^or^ `^ ^ Y C^t}r rnek^on C(qr`m or, Tnsv-^eIt F^^(3ad ^a , F^^ on eonsa?r.^ ci 4rf-n herf^.er,C^ e^ S Insur-,.n
A Cf' o A-^+opr^ ^^a l^wu^M n ^ `l seilAbuseo^ Pr^oCess O..P Den^
Pro per ^7 +rr^ '^ U^^',rSe^Flemeri-1;Au ; ni-F-be ^v r4roay,., 3ra
^"h'q 1^,e s^ ^^ r,^ / jy©^ S^,ow y Nanson 4Acc1ON J
aoC/Ca ury^tis t3r^hc^:`4-ipn
lqS IUO^ rnr.^ke, 44o
1,^^So+h^^e^^ndn ^edWy `s ^0 c^`6'7" bel^euel,-F-^h ''4S }
^'^=Cvbyh YJj ,t(17'#.I',g P--t•' -^he
^xe 9 ^^^^^ sytrrUreS"^"'
,4^ 1 ^'^S -rev+e
O 4.071^v5e sa ,^^a-f
^vY-e Lia Sn°d-ere^r ^ OA-WYAJe.S'r:
+^ e O r Tn ^^kroel ^ ^c^ meri`^° ^u ^S s eJ 6,,, '•}-44-ome-q ^ fi'-ve• -
C-K $'^e 14mcsurv+ c3f Cej(j4rC)vers^
PrMer Avh oUY4 1,15 j000 rn eS c. +a-r-^-,
CONCLUSION
The petition for a writ of certiorari should be granted.
R^spectfully submitted,
^^ ^ ' • ^^•-^ ,
Date: 6IJqUS4-5 .,a21.)1l
TABLE OF AUTHORITIES CITED
CASES Cd/-oq> rjo593 I PAGENUMBER
CN^t4C L"GoAl ws - C, LR TAVIor C,a-kcJff-xlS
X,s"GME8 :^ud6e. i•I^A4-r^C,k Kellc^^^sig)Jrnen-f°
STATUTES AND RULES -Jt, rors -i r^ ^ Ik^ o'-i ^a `71ao1o = o^1/a$ faata
Jurq re1-urns Am unAn°mouS ve,-^^c E-`Fo
Yhe6-Iroau lb'ec,AUs2 0^ E^e f^re^oncaLSr^^oe o^-^-he I:v+°ie.nc,e_°nXtavoF\- o+-N.e. be-Feoc3kl4* A u4 / 5A-ins4 +he ptnYS n4-"-'P-R^
^t^qmen 1- en+e.rec^ ^or t^^'e^K^ ►^iu^4-^E^c?^ °C^y^or (^Yq-rrjewsj Anic{ A90,'nS$
'We-tDtA`P^{^19`^ ije!$ry 11^e^11^ T Y(lL^'1
OTHER i -T0^ C0 L)^T^OOYV1
C^Y\f^4 Ve. ^'14M ^5
{^STon^[af^a^^ `^-^P`^i3o^ - ^erynr}g ^N5U1'P^µC^ G^xlrmr^ ^
D44
Q^oy ^^:t ptiJ -
V7e^r^^^iru^ P^PerFy-l-^r} S c^lArna^e8^^e^Y,t ^ GseszY^r^e^+-C u,^,dc^^o^h
S Ebe+^E^ ^^SAL+^ -^Lw;weC6(.^ i k/,1f55.j ^ ^
CONSTITUTIONAL AND STATUTORY PROVISIONS INVOLVED\fPo I^,'C °®,^i
'r64e 4-'®ur4eer1-^h Am-end m-e,n`r
Un^^ecj S#-A^fes C®ns^^-^vl-r®n®
p'P-n7e 8 *^,-e. r-^,+ +-o h-,we (,+^s eq t Pho-Fee-l-l6n e,J-AVse Aw M-4,o^
rtpresen-l- (',Rry M-t-7^ C4-o-dA-+- +cr-M AgA`in s+ 7ay 4Af4a,0AJs ^
Kere-Fo('e GarY MEL re„4j ^clas c^enN c : k°s C°6er-tv i^mj proPe`r-ty1-3 45 w4hau++ke r`,Fs 4rrg
pr6ce.85CiArrge lA^l e9 uhr^ ^^Sec-F;b,j Fi,e ^y^4► A mendrne44 _V, 4e o'n
u c^ PkeJectsron no-F -#-o Aflow G^ry Mel^oAI
Cen^n ous +v o6tR^^^ P
Mr'. ME 1^o^!^5 1) Coonsa/ -^o
represer,l !,- m^^-r^ a1 de,n,? ^
PLrsua,u c.lµuse o+ -F-he /clws, p,g se-E -F0r44^o s^C-^;o^ ( ►^ oF +-he fyYU^men^men-^ ^ ^
'oflS'^i^-v^;o ^[ ti e- Vn4ecl S4p4BS
geC4-;an(s) -rbkL:- Congre"'s 5"I! have ower k,! rg[^s^rs^! â enPorce,6y A^PP^#^riA-+e`z3 ^4ke provrs^olls a-f +h;s ^rF^'ele.
OuJ ^^uemery-l- - AMendmeN-4 dtl'- gl,4 s I n ci V^l cA ses
TABLE OF AUTIiORIT1ES CITED
CASES PAGE NUMBER
C t^c^/^ ^v c^ ^ e om¢n®,zL PLcAs Ca v-CT Lo uramC,® e9-a'ZT .rewtl
Appemcs€ oc,.Fc5 L^:6k4'h b;^ I
su're`qe, Gouc^t ^ ^ f^^o ^ec^S^a^
STATUTES AND RULES
-,^vdje PP4-rdclC KGlc` jJn-^ re,-1- 09Pq('S/rr)e 14'o.v 9e-(- 1e'3A-( Covse l^'rm^
R^ cm^y Us1-f67,fs A t-1-t-4-^-preces o^ ev:d^r,c^ r^^d A-tsa I^td ^r^ ►^/^^,r
f D f!3 Ke 4°F,^^^a e^ ae ^o{GA^ a^ ^^ Frorn rFe'P+ A44a ne^ T7ky *06^
5rr i 's1<, ! 4-6 w4'w `my Case, Fn-^'h^ Covr-lrr^ ►.^:.^,u^-Fh2^ury!s ^^'-A e°P,
CP.P-t rv^ 461"j tz^ "beaAvse ^,^3u^^'s dh^n'-^ see ^^ ^e^FvGi^ff}^Nll^e, S^s
PP.tra-r ^Cs^enota^w f S. 06+q! A4 1-h2 C6ur-k-cs{'App5w(^"y ►^ ^ t^ ^„p^r
^Sr
^ ^(V a ^ h e^ r Fe^ ^eer^c^s e- o P
4 he ^(^e^( i'' cLeL A ^Sb ^A^ f4rkwS® ^C dl^G^ ov uyu !- 4-s ge+^(e^ ►^e,^, eac^r nq ^ori ^e.r•e,.UC„^ So ^ p
OTHER r^TwP^1^a.1 C,t^B^ ^ve^v^ ^a ^lve Qar^6r^en.^e(3ocx^CF-P 0 6Fo p-KLd "eyd&,r,e°sseo^
'^^P^--4a prto ae ^S Cems4 ^^ hr^^^r ^I t^^^ ^s i crr^s+^P-
v o i ta^_^ c>neleK
QUESTION(S) PRESENTED
MiE,I+ok( -vs- &^ y/foiz 6 Li..^c dw^ X7J ®parA-^-C2^r-
^^(oK C^^azcf^v ^pA^rne^g toGR^e^1Pr^
WiY P^^; T 4e- prcrp e4 y m nq-L.E A34?,r -rlkT* *5oy Cyo as dt"C AX`e, Nwper nl n'^ste a"s -^6
rn m C-{`^' ^ ^j '^J(JN 0&1 4-ti e
^6 ds ^ ^ TA-i-g 5^'( ttyt" h,, 4. elrclwAr l k Fr^sP ^ s^au4 e^ o^^r•e^►^s^ ^P ^" -I1,eL^
^u^UweeL®,v ^2^e^^` ^ A,ud^o^:I-,^e^z`^e ^ J (,^6udlap ►^4
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4t'_Q- -9-•^-!^, ^s 4S 4e^+ira ^6 ^
4-he d!d P ro kmi4 e P ra peY^PfAdj^
ted^e^n"c3^^l ^lY^,r^(4^ iNVi4 -^'i'9^e s4/^rrcc.^se ft-)!O( {^,V F^ I^T
G fbf „1 ^, ^ "'V r ^!(/'(+1 f+_tS
e- pr75r^^^ erm^e A,
^o a t f^+ rd n e cle^'e,„^ , 8 '^ melfn.r
Qr^t^s h p raPeP L ^^ s reS o ^ h e^rt't'er
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b^ ^erhv^,^^'ra,^ / rnef^°" w^ne^S'^ psk N^^defe,,d^^s ^°P"r L
AA``d ke SA V e1 ^"y ^ ^nsoN de Y Av^der^^^ hes unF,^p^^ _ 4
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STji r^ S ^u'^-
ID,W^ONd,4r_r3s
Supreme Court of the United StatesOffice of the Clerk
Washington, DC 20543-0001
August 9, 2011
ClerkCourt of Appeals of Ohio, Cuyahoga CountyCuyahoga County Courthouse1200 Ontario StreetCleveland, OH 44113
Re: Gary Meltonv. LLC Ger Taylor GardensNo. 11-5740(Your No. 95010)
Dear Clerk:
William K. SuterClerk of the Court(202) 479-3011
The petition for a writ of certiorari in the above entitled case was filed on June16, 2011 and placed on the docket August 9, 2011 as No. 11-5740.
Sincerely,
William K. Suter, Clerk
by
Ruth JonesCase Analyst
SUPREME COURT OF THE UNITED STATES
OFFICE OF THE CLERKWASHINGTON, DC 20543-0001
June 21, 2011
Gary MeltonP. 0. Box 605186Cleveland, OH 44105-0186
RE: Gary Melton v. Ger Taylor Gardens, LLC
Dear Mr. Melton:
The above-entitled petition for writ of certiorari was postmarked June 16, 2011 andreceived June 21, 2011. The papers are returned for the following reason(s):
The notarized affidavit or declaration of indigency does not comply with Rule 39 inthat all of the questions have not been answered.
The petition fails to comply with the content requirements of Rule 14, in that thepetition does not contain:
The questions presented for review. Rule 14.1(a).
The appendix to the petition does not contain the following documents required byRule 14.1(i):
The lower court opinion(s) must be appended in its entirety.
The order denying rehearing`must be appended. Rule 14. 1 (i)(iii).
lt is impossible to determine thetimeliness ui t'fie petition without the lower eoi:."t
opinions.
The aforementioned documents must be contained in anappendix immediatelyfollowing the petition.
Please correct and resubmit as soon as possible. Unless the petition is submitted tothis Office in corrected form within 60 days of the date of this letter, the petition willnot be filed. Rule 14.5.
A copy of the corrected petition must be served on opposing counsel.
When making the required corrections to a petition, no change to the substance of thepetition may be made.
Sincerely,William K. Suter, ClerkBy:
Ruth Jones(202) 479-3022
Enclosures
57901879
GARY MELTONPlaintiff
IN THE COURT OF COMMON PLEASCUYAHOGA COUNTY, OHIO
I Case No: CV-08-670947
Judge: JOSE' A VILLANUEVA
GER TAYLOR GARDENS LLCDefendant
JOURNAL ENTRY
87 DIS. W/O PREJ - FINAL
PLAINTIFF HAVING FILED A NOTICE OF DISMISSAL, CASE DISMISSED WTTHOUT PREJUDICE.
FINAL
O.S.J.
COURT COST ASSESSED TO THE PLAINTIFF(S).
Judge Signature Date
VROCESSED
,JUid ^ 5 2G"v9
GERFtt Q E E.Im^g1GG QEFP,R
- 8706/09/2009
Page 1 of 1
Jay S. Hanson, Attorneii, Law
323 Lakeside Place, Suite 3801Cleveland, OH 44113(216) 912-40701 Ext. 43836 1 Fax: (877) [email protected]
September 2, 2011
Supreme Court of the United States1 First Street, NEWashington, DC 20543
RE: Melton, Gary v. Ger Taylor Gardens LlCClient: Ger Taylor Gardens LLCClaim No.: 00-221-127821Date of Loss: January 31, 2008Case No.: CV09705931
Dear Sir:
Licensed in Ohio
Enclosed please find an original and one copy of my Waiver. Please file the originaland return a time-stamped copy to me in the enclosed, self-addressed stamped envelope. Ithank you for your assistance in this matter.
If you have any questions, please do not hesitate to contact me.
Very truly yours,
Jay S. Hanson
JSH/kleEnc.
RECEIVEDSEP 13 2011
OMOc ° ^^e T^u s
The above-named attorney is a full , time employee ofAmerican Family Insurance Company.
ORI61NAlNo.
11 -5740IN THE
SUPREME COURT OF THE UNITED STATES
M.-,-L'TD rj - PETITIONER(Your Name)
' VS.
00 LSiZ- TAb Id IZ Afir e S` RESPONDENT(S)
MOTION FOR LEAVE TO PROCEED.IN FORMA PAUPERIS
The petitioner asks leave to file the attached petition for a writ of certiorariwithout prepayment of costs and to proceed in forma pauperis.
[] Petitioner has previously been granted leave to proceed in forma pauperisin the following court(s):
I-E-4] Petitioner has not previously been granted leave to proceed in formapauperis in any other court.
Petitioner's affidavit or declaration in support of this motion is attached hereto.
(Signature)
Gary MeltonP.O. Box 605186Cleveland, OH 44105