Motion To Proceed In Forma Pauperis With Affidavit And Supporting Documentation

APPENDIX A (L.R. 2.04, fka 1.09) IN THE COMMON PLEAS COURT, BUTLER COUNTY, OHIO Petitioner/Plaintiff CASE NO: vs Respondent/Defendant MOTION TO PROCEED IN FORMA PAUPERIS WITH AFFIDAVIT AND SUPPORTING DOCUMENTATION :::::::::::::::::::::::::: I declare that I am the (check appropriate status) ______ petitioner/plaintiff ______ respondent/defendant ________movant __________________ (other) in the above-entitled proceeding. In support of my request to proceed without being required to prepay fees and costs, I state that because of my poverty, I am unable to pay the costs of said proceeding and I believe I am entitled to relief. In further support of this application, I submit the attached affidavit. I declare under penalty of perjury that the foregoing is true and correct. Executed on: _______________________________ (date) _______________________________ (signature of applicant) American LegalNet, Inc. www.FormsWorkFlow.com