Fill and Sign the Inmate F Orm for C Ivil a Ction Form

INMATE FORM FOR CIVIL ACTION I NSTRUCTIONS - R EAD CAREFULLY (NOTE: O.C.G.A.§9-10-14(a) requires the proper use of this form, and failure to use this form will resul t in the clerk of any court refusing to accept the action for filing.) 1. Any action filed by an inm ate of a sta te or local panel or correctional institution against the state or a local gove rnmen t or agains t any age ncy or office r of a state or loca l gover nme nt mu st be fil ed on the appropriate form or forms promulgated by the Administrative Office of the Courts. 2. This application must be legibly handwritten or typewritten, and signed by the petitioner. Any false sta tement of a material fact may serve as the basis for prosecution for perjury. All questions must be answ ered c oncis ely in the proper space on the form. 3. O.C.G.A .§42-12-1 et. seq. provides that an inma te’s inst itutiona l accou nt sha ll be subject to seizure for the filing of frivolous litigation. 4. Any inmate may submit with the complaint or other initial pleading any additional matter in any form if the pleading includes the form or forms attached hereto. Materials attached to the forms should be legibly handwritten, typewritten or copied. 5. Upon receipt of the appropriate filing fee or if permission to proceed in forma paup eris has been granted, your petition will be filed if it is in the proper order. 6. If the inmate wishes to file an affidavit of indigency, it must be accompanied by a certification from the institution wherein the inmate is incarcerated that the financial statement correc tly states the amount of funds in any and all custodial accounts held with the institution. 7. Any Inma te Form for Civil Action w hich doe s not con form to these instructions will be returned with a n otation as to the de ficiency. 8. These forms m ay be ob tained from the Adm inistrative O ffice of the C ourts through the head of the institution in which the inmate is incarcerated.