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Signature of Plaintiff. The motion must include a copy of the affidavit filed in the district court and the district court's statement of reasons for its action.☐ Leave is denied to proceed in forma pauperis. Motion and Affidavit for Permission to Proceed in Forma Pauperis. The court has considered the appellant's motion to proceed in forma pauperis on writ and his supporting affidavit: IT IS ORDERED that the motion be. In support of this I state the following:. 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. If you fill out a form on a webpage, you will lose your progress. You need only complete the Poverty Affidavit if you are requesting to proceed IFP and do NOT receive Department of Public Welfare (DPW) assistance or SSI.