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My affidavit or sworn statement is attached. I believe I am entitled to relief.A party may file a motion to proceed on appeal in forma pauperis in the court of appeals within 30 days after service of the notice prescribed in Rule 24(a)(4). 40-2; and (b) the trial court's order denying or revoking my motion to proceed in forma pauperis. Respectfully submitted,. Signature. Date. Complete the case caption as you did on the motion for leave to proceed in forma pauperis. Plaintiff's Motion to Proceed on Appeal In Forma Pauperis (Doc. Motion For Leave To Proceed In Forma Pauperis And Supporting Affidavit Form. This is a Wyoming form and can be use in District Court Federal. Defendant: A person who is sued in a civil or criminal proceeding.