Affidavit Of Indigency And Entry Authorizing Payment Of Court Costs {117.00}

PROBATE COURT OF HAMILTON COUNTY, OHIO RALPH WINKLER, 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 (proposed) 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 (proposed) 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 AUTHORIZING PAYMENT OF COURT COSTS Upon consideration of the Affidavit of Indigency, the Court finds the (proposed) ward is indigent and orders the costs of this action to be paid from the Indigent Guardianship Fund. Any assets, beyond those disclosed in the affidavit, which come into the possession of the guardian, shall be reported to the Court and may be used to reimburse said fund for the costs of this action. Ralph Winkler, Judge/ Magistrate H.C. FORM 117.00 - AFFIDAVIT OF INDIGENCY AND ENTRY AUTHORIZING PAYMENT 02/28/12 American LegalNet, Inc. www.FormsWorkFlow.com