Ability To Pay In Traffic And Other Infraction Cases (Traffic) | Pdf Fpdf Docx | California

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Ability To Pay In Traffic And Other Infraction Cases (Traffic) | Pdf Fpdf Docx | California

Ability To Pay In Traffic And Other Infraction Cases (Traffic)

This is a California form that can be used for Civil within Local County, Kings.

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SUPERIOR COURT OF CALIFORNIA COUNTY OF KINGS 1640 Kings County Drive Hanford, CA 93230 FOR COURT USE ONLY Name: Address: Telephone/cell phone number: Ability to Pay in Traffic and Other Infraction Cases Case number(s) 1. What type of income do you have? I get public benefits (Check all that apply , then skip to #2.) Food stamps (CalFresh) Medi - Cal County Relief/General Assistance Cal WORKS or Tribal TANF Supplemental Security Income (SSI ) State Supplementary Payment (SSP) In - Home Supportive Services (IHSS) Cash Assistance Programs for Immigrants (CAPI) I do not get public benefits, but I have other income. a. How much money do you earn (take - home pay) or get from other sources (including income received in your family from a husband, wife, or live - in roma n tic part ner)? $every: Year Month Twice a month Week 2 weeks Season b . This money helps support me and (number of) other people. c. If I pay the ticket, I would: (Check all that apply, if any.) Not have enough money to pay for basic living expenses. Basi c living expenses are things like: housing food, utilities, child care, child support, transportation, medication, insurance (medical, car, house and rental), and student loans. Not have enough money to pay my debt for other court cases. Have other problems: 2. Do you have anything that shows your pub l ic benefits or income or expenses? Things like a EBT card, pay stubs , tax returns, rent or mortgage checks or utility bills. Yes, I have attached copies to this form. (DO NOT give the court your original documents.) No, I do not have any papers to show because: (Continued on reverse) American LegalNet, Inc. www.FormsWorkFlow.com Name: Case Number Yes No If no, skip to question #4. If yes, answer both questions: What did the court do? since then? Reduced the amount I owed. Lost job or reduced hours at work. Let me pay in monthly payments. Started to receive public benefits. Let me do community service. Suffered a serious illness or disability. Other: 4. What are you asking the court to do? ( Check all that you are willing and able to do ) Reduce the amount I owe. Let me make monthly payments. Reduce payments to $ per month. Give me more time to pay. 6. Read all your answers and attachmen ts again. Make sure everything is correct. Date and sign the statement below. I promise that this is TRUE. I swear under penalty of perjury, under the laws of the State of California, that all information on or attached to this form is true. Date: Print Name Signature: 7. File this form with the K ings County Superior Court located at 1640 Kings County Drive., Hanford, CA 93230 8. NOTE: Did you miss a court date? Did you fail to pay your ticket on time? If so, then court might be charging you extra money. Filling out this form will not take care of that extra charge. Contact your court to find out what you can do about that extra charge. American LegalNet, Inc. www.FormsWorkFlow.com

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