Affidavit In Support Of An Application To Proceed As Poor Person And For State To Pay For Transcript Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Affidavit In Support Of An Application To Proceed As Poor Person And For State To Pay For Transcript Form. This is a New York form and can be use in New York Local County.
Loading PDF...
Tags: Affidavit In Support Of An Application To Proceed As Poor Person And For State To Pay For Transcript, CIV-GP-16, New York Local County, New York
CIVIL COURT OF THE CITY OF NEW YORK
County of
Part
in the matter of the Application of
Index No.:
AFFIDAVIT IN SUPPORT OF
AN APPLICATION TO PROCEED
AS A POOR PERSON
AND AUTHORIZING THE STATE
TO PAY THE COSTS
FOR THE PRODUCTION OF
A STENOGRAPHIC TRANSCRIPT
to prosecute as a poor person against
State of New York, County of
ss:
, being duly sworn, deposes and says:
in the above titled action.
1. I am the party named as
2. The case was tried before Judge
.
3. 1 request that an Order be granted:
AUTHORIZING THE STATE TO PAY THE COSTS FOR THE STENOGRAPHIC TRANSCRIPT.
The estimate* of the costs for the production of the transcript is $
[*Attach estimate(s) and total them if more than one.]
If no Notice of' Appeal is to be filed, but a request for the State to pay the costs for the production of a transcript is being submitted,
please state why the transcript is needed
.
4. 1 make this application based on CPLR ยง1101. I do not have, nor am I able to obtain, the funds needed to file a
Notice of Appeal and/or to pay for the stenographic transcript. I will be unable to proceed unless the Order is granted.
5. 1 am/am not a recipient of Public Assistance from the Department of Social Services of the City of New York.
(strike one).
per
6. 1 have no income other than the sum of $
from
.
7. 1 own no property of any kind except necessary personal wearing apparel and
.
8. No other person is beneficially interested in the recovery sought.
a) I have not made a previous application for this or similar relief
9.
b) I have made previous application(s) for this or similar relief, but I am making this further application
because
Sworn to before me this
day of
20
Sign your name
Print your address
Signature of Court Employee and Title
Telephone Number
CIV-GP-16-i (Revised 1/04)
American LegalNet, Inc.
www.USCourtForms.com