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Motion and Affidavit in Support of Request to Proceed As a Poor Person. Marital Status: If Married, Spouse's name: Number of dependents:.The Applicant submits the following information in support of said request. Motion And Affidavit In Support Of Request To Proceed As A Poor Person Form. This is a Missouri form and can be use in Circuit Court Statewide. Some fee waivers use poor person or pauper in the title. Order to Proceed as a Poor Person. You need only complete the Poverty Affidavit if you are requesting to proceed IFP and do NOT receive Department of Human Services (DHS) assistance or SSI. Instructions: Complete this form and file it with the court. The Applicant submits the following information in support of said request.