State of [State]

County of [County]

Introduction

I, [Your Name] hereby present this affidavit with the purpose to formally declare my inability to pay for any or all legal costs, court fees, or other related expenses due to financial hardship.

Statement of Fact:

1. I, [Your Name], declare under oath that I am financially unable to afford the costs associated with [specific legal service, court fees, or other financial obligations].

3. As of [Date], I am [employed/unemployed] and earn a gross income of [Amount] per [week/month/year], which barely covers my basic living expenses, including housing, utilities, food, and transportation.

4. I have [Number] dependents relying on my income for support. My current checking and savings account balances total less than [Amount], and I do not possess significant assets, savings, or other financial resources.

5. The cost of [specific service or fee] represents a substantial financial burden that I am unable to meet due to my current economic situation.

6. I respectfully request [specific relief, e.g., waiver of fees, appointment of counsel] based on my indigence.

Statement of Indigency:

I hereby declare that the above information is true and accurate to the best of my knowledge and belief. I am unable to afford the costs associated with the legal proceedings in which I am involved.

Sworn Oath

I affirm that all statements made herein are true and accurate to the best of my knowledge and belief.

Signature

[Your Name]

[Date]

Affidavit Templates @ Template.net