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HAMILTON COUNTY MUNICIPAL COURT STATE OF OHIO Plaintiff CASE NO. -vs- AFFIDAVIT OF INDIGENCY Defendant After being duly cautioned and sworn I hereby state the following information is true to the best of my knowledge and belief. I understand I am subject to criminal charges for providing false information. I. II. INCOME Net Monthly Pay 1. Employer yrs. mos. Position Spouse s employer 2. Alimony/child support received 3. Public benefits received ADC SS SSI WC etc* 4. Other income pension interest etc* TOTAL INCOME ASSETS 1. Cash on hand Cash in bank Cash at home TOTAL CASH 2. Own motor vehicle Y/N Make Year Value 3. Own house Y/N How long 4. Other property Y/N MAJOR DEBTS Monthly Payments IV. FAMILY COMPOSITION 1. Number of persons you are required to support 2. Ages of such persons 3. Their relationship to you spouse child parent etc* I further state I am indigent at this time unable to pay the expungement application fee in the within matter and hereby request an indigency hearing bef....

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How to fill out the Affidavit Of Indigency online

The Affidavit Of Indigency is a vital document for individuals seeking a fee waiver due to financial hardship. This guide provides step-by-step instructions to assist you in completing the form accurately and efficiently online.

Follow the steps to complete the Affidavit Of Indigency online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering your personal information in the designated fields. Fill in your name, address, and contact details. Ensure that all information is accurate and reflects your current circumstances.
  3. Proceed to the income section. List your net monthly pay, including details about your employer and position. Include any additional sources of income such as alimony, child support, or public benefits.
  4. In the assets section, provide information regarding your cash on hand, bank account balance, and any cash stored at home. Additionally, indicate whether you own a vehicle or house, providing their make, year, and value.
  5. Complete the major debts section by detailing your monthly payments and any outstanding financial obligations you have.
  6. In the family composition section, specify the number of individuals you support, their ages, and relationships to you. This information is essential for assessing your financial responsibilities.
  7. Review all the provided information for accuracy. Once completed, indicate your acknowledgment of indigency status and the need for a hearing, before signing the document.
  8. Finally, save your changes, and choose whether to download, print, or share the completed Affidavit Of Indigency as necessary.

Start filling out your Affidavit Of Indigency online today!

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Related content

Affidavit of Indigency - Mass.gov
AFFIDAVIT OF INDIGENCY. AND REQUEST FOR WAIVER, SUBSTITUTION. OR STATE PAYMENT OF FEES &...
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affidavit of indigency - Maryland Attorney General
Maryland Public Information Act Manual (15th ed., November 2020) Appendix D-1. AFFIDAVIT...
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the Supreme Court Rules, 1966
shall, if practicable, be served personally upon him with copies of any affidavit...
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If you can't afford the bond or a cash deposit, you can file an Affidavit of Inability to Pay (also called a Sworn Statement of Inability to Pay, or a fee waiver). The Justice Court should provide you a form Affidavit upon request. If you appeal with a fee waiver, you are not responsible for County Court filing fees.

If a Statement of Inability to Afford Payment of Court Costs is approved, you do not have to pay for any costs charged by the court. This includes costs for issuance of service and copies. Court fees vary by county.

You must fill out a form called an Affidavit of Indigency. This form tells the court you cannot afford the fees related to your case.

An applicant who is committed to a public mental health facility or who is incarcerated in a state penitentiary at the time of application may be presumed to be indigent and eligible for court-appointed counsel.

Use this form to ask the court not to charge you for court fees. This form is also called an “Affidavit of Inability to Pay Court Costs” or a “Pauper's Oath.” You can only use this form if: (1) you get public benefits because you are poor or (2) you can't pay court fees.

General Affidavits must be signed in front of a notary public. A notary must verify your identification before you sign the document. Make sure to bring ID (like a driver's license or other form of identification) for the notary before you sign the affidavit.

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