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Request For Leave To Proceed Without Pre-Payment Of Costs And Affidavit And Points And Authorities In Support Thereof - District Of Columbia
| Request For Leave To Proceed Without Pre-Payment Of Costs And Affidavit And Points And Authorities In Support Thereof Form. This is a District Of Columbia form and can be used in Family Superior Court Statewide . |
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COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : : Plaintiff(s) : Index No. Calendar No. JUDICIAL SUBPOENA 3/99 -against: SUPERIOR COURT OF THE DISTRICT OF COLUMBIA FAMILY DIVISION : DOMESTIC RELATIONS BRANCH : Defendant(s) ): . . . . . . . . . . . . . (FULL. NAME) . . . . . . . . . . . . . . . . . . . . . . . . . . ) ...... ....... . ) ) ) THE PEOPLE OF THE STATE OF NEW YORK (CITY, STATE, ZIP CODE) ) TO PLAINTIFF, ) ) CASE NO. V. ) ) GREETINGS: ) (FULL NAME) that all business and excuses being laid aside, you and each of you attend before ) WE COMMAND YOU, ) Court , the Honorable at the located County of (STREET ADDRESS) at ) in room , on the day of , 20 , at ) o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this ) action on the part of the (CITY, STATE, ZIP CODE) DEFENDANT. ) (STREET ADDRESS) Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a WITHOUT PRE-PAYMENT OF COSTS AND a REQUEST FOR LEAVE TO PROCEED maximum penalty of $50 and all damages sustained as result of your failure to comply. AND POINTS AND AUTHORITIES IN SUPPORT THEREOF AFFIDAVIT Witness, Honorable Court in County, , one of the Justices of the day of , 20 respectfully moves this Court for leave to proceed in (YOUR NAME) proceed in forma pauperis, and does depose and say: (Attorney must sign above and type name below) 1. I am the (plaintiff or defendant) in this case. Attorney(s) for 2. In support of my request to proceed without being required to pre-pay fees, costs, or give security therefore, I state that, because of my poverty, I am unable to pay the costs of said proceeding or to give security therefor and still provide myself with the necessities of life. 3. I believe I am entitled to redress. Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com Office and P.O. Address COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : : Index No. Calendar No. 4. The issue(s) which I desire to present are set out in the attached : Plaintiff(s) -against: : JUDICIAL SUBPOENA (complaint, answer, motion, subpoena) 5. I further swear that the following information, relating to my ability to pay, is true: : I receive the following: (FILL IN ANY SPACES THAT APPLY) Defendant(s) : ...................................................... a. Temporary Assistance to Needy Families (TANF) income per month $ 5 THE PEOPLE OF THE STATE OF NEW YORK TO b. Food Stamps received per month $ c. *Wages/salary per month $ ; ; ; GREETINGS: d. *Other income per month $ * (List gross income per month). WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before 6. I have no other source of income. , the Honorable at the Court located at County of in room , on have , 20 , at cash (including the amounts and at any recessed o'clock in any noon, in a savings or in 7. I the $ day of or adjourned date, to testify and give evidence as a witness in this action on the part of the checking account). 8. own the with this subpoena is punishable as a contempt of court and Your failureIto comply following real estate, stocks, bonds, or automobiles: will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 9. I owe the following amounts of money. (State the name of the person or organization you owe money to, the amount owed, (Attorney must sign above and type namemonth). and the amount you pay each below) Attorney(s) for 10. The following persons are dependent upon me for support. (list names, dates of 2 Facsimile No.: Telephone No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com Office and P.O. Address COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : : Plaintiff(s) Index No. Calendar No. birth, and if over twenty-one, reason for dependency): : -against: : : JUDICIAL SUBPOENA 11. My expenses for Defendant(s) my dependents are $ myself and : ...................................................... includes $ costs for babysitters. per month; this THE PEOPLE OF THE STATE OF NEW YORK TO WHEREFORE, for the reasons cited in this affidavit and the attached points and authorities, I respectfully request this Court grant my Request to Proceed Without Pre-Payment of GREETINGS: Costs. WE COMMAND YOU, that all business and excuses beingRespectfully submitted, you attend before laid aside, you and each of , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the (YOUR NAME) Your failure to complyand sworn to before me this as a contempt of court and will make you liable to , Subscribed with this subpoena is punishable day of the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a 20 . result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 Notary Public, D.C. My Commission expires: (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Telephone No.: Facsimile No.: 3 E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com
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