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Affidavit Of Indigency 117.00 - Ohio
| Affidavit Of Indigency Form. This is a Ohio form and can be used in Guardianship Probate Shelby County (Court Of Common Pleas) . |
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PROBATE COURT OF SHELBY COUNTY, OHIO WILLIAM R. ZIMMERMAN, JUDGE GUARDIANSHIP OF CASE NO. , INCOMPETENT AFFIDAVIT OF INDIGENCY , being first duly cautioned and sworn, states the following facts are true: 1. 2. 3. 4. The proposed ward lives at and has lived there for The source of said income is The monthly expenses of proposed ward are To the best of affiant's knowledge, the ward owns no assets other than: Real Estate Bank Accounts Automobile(s) Other (stocks, bonds, IRA, etc.) TOTAL OF ASSETS 5. $ $ $ $ years/months. The monthly income of proposed ward is $ To the best of affiant's knowledge, none of the ward's assets have been transferred for less than fair market value in the past three years, except: Affiant Sworn to before me and subscribed in my presence this day of . Notary Public ENTRY Upon consideration of the Affidavit of Indigency, the Court finds the proposed ward is indigent and orders the costs of this action waived. Any assets, beyond those disclosed in the affidavit, which come into the possessionof the guardian, shall be reported to the Court and may be used to reimburse the Court/County for the costs of this action. William R. Zimmerman, Judge H.C. FORM 117.00 - AFFIDAVIT OF INDIGENCY AND ENTRY 02/10/03 American LegalNet, Inc. www.FormsWorkflow.com
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