REQUIRING PLAINTIFF TO FILE LONG FORM APPLICATION TO PROCEED IN FORMA PAUPERIS
BARBARA A. McAULIFFE, Magistrate Judge.
Plaintiff Donald Warner, appearing pro se, filed this action challenging his Medicaid and pension benefits on June 5, 2017. Plaintiff did not pay the filing fee in this action and instead filed an application to proceed in forma pauperis pursuant to 28 U.S.C. § 1915. However, Plaintiff's application was not adequately completed. Plaintiff's application does not reflect all the amount of income which is being received by his household. For that reason, the Court is unable to determine if he is able to proceed in this action without prepayment of fees.
Accordingly, the Court will order Plaintiff to complete and file an Application to Proceed in District Court Without Prepaying Fees or Costs (Long Form) — AO 239. If Plaintiff is unwilling to complete and submit the long form application, Plaintiff must pay the filing fee in full.
Accordingly, IT IS HEREBY ORDERED THAT:
IT IS SO ORDERED.