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Request For Leave To Proceed Without Pre-Payment Of Costs And Affidavit And Points And Authorities In Support Thereof Form. This is a District Of Columbia form and can be use in Superior Court Statewide.
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Tags: Request For Leave To Proceed Without Pre-Payment Of Costs And Affidavit And Points And Authorities In Support Thereof, District Of Columbia Statewide, Superior Court
COUNTY . .
. . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:
Index No.
:
:
Plaintiff(s)
Calendar No.
JUDICIAL SUBPOENA
3/99
-against:
SUPERIOR COURT OF THE DISTRICT OF COLUMBIA
FAMILY DIVISION
:
DOMESTIC RELATIONS BRANCH
:
Defendant(s)
):
. . . . . . . . . . . . . (FULL. NAME) . . . . . . . . . . . . . . . . . . . . . . . . . . )
...... .......
.
)
)
)
THE PEOPLE OF THE STATE OF NEW YORK
(CITY, STATE, ZIP CODE)
)
TO
PLAINTIFF,
)
) CASE NO.
V.
)
)
GREETINGS:
)
(FULL NAME) that all business and excuses being laid aside, you and each of you attend before
)
WE COMMAND YOU,
) Court
,
the Honorable
at the
located
County of
(STREET ADDRESS) at
)
in room
, on the
day of
, 20
, at )
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this )
action on the part of the
(CITY, STATE, ZIP CODE)
DEFENDANT.
)
(STREET ADDRESS)
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a WITHOUT PRE-PAYMENT OF COSTS AND a
REQUEST FOR LEAVE TO PROCEED maximum penalty of $50 and all damages sustained as
result of your failure to comply. AND POINTS AND AUTHORITIES IN SUPPORT THEREOF
AFFIDAVIT
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
respectfully moves this Court for leave to proceed in
(YOUR NAME)
proceed in forma pauperis, and does depose and say:
(Attorney must sign above and type name below)
in this case.
1. I am the
(plaintiff or defendant)
Attorney(s) for
2. In support of my request to proceed without being required to pre-pay fees, costs,
or give security therefore, I state that, because of my poverty, I am unable to pay the costs of said
Office and P.O. Address
proceeding or to give security therefor and still provide myself with the necessities of life.
3.
I believe I am entitled to redress. Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
COUNTY . .
. . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:
:
4.
Index No.
Calendar No.
The issue(s) which I desire to present are set out in the attached
:
JUDICIAL SUBPOENA
Plaintiff(s)
-against-
:
(complaint, answer, motion, subpoena)
:
5. I further swear that the following information, relating to my ability to pay, is true:
:
I receive the following: (FILL IN ANY SPACES THAT APPLY)
Defendant(s)
:
......................................................
a. Temporary Assistance to Needy Families (TANF) income per month
$
5
THE PEOPLE OF THE STATE OF NEW YORK
b. Food Stamps received per month $
;
TO
c. *Wages/salary per month $
GREETINGS:
;
d. *Other income per month $
* (List gross income per month).
;
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
6. I have no other source of income.
,
the Honorable
at the
Court
located at
County of
in room
, on have
, 20
, at cash (including the amounts and at any recessed
o'clock in any
noon, in a savings or
in
7. I the $ day of
or adjourned date, to testify and give evidence as a witness in this action on the part of the
checking account).
8. own the with this subpoena is punishable as a contempt of court and
Your failureIto comply following real estate, stocks, bonds, or automobiles: will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
9. I owe the following amounts of money. (State the name of the person or
organization you owe money to, the amount owed, (Attorney must sign above and type namemonth).
and the amount you pay each below)
Attorney(s) for
Office and P.O. Address
10. The following persons are dependent upon me for support. (list names, dates of
Telephone No.:
2 Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
COUNTY . .
. . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
:
:
Index No.
Calendar No.
birth, and if over twenty-one, reason for dependency):
:
JUDICIAL SUBPOENA
Plaintiff(s)
-against-
:
:
:
11. My expenses for Defendant(s) my dependents are $
myself and
:
......................................................
includes $
per month; this
costs for babysitters.
THE PEOPLE OF THE STATE OF NEW YORK
WHEREFORE, for the reasons cited in this affidavit and the attached points and
TO
authorities, I respectfully request this Court grant my Request to Proceed Without Pre-Payment
of
GREETINGS: Costs.
WE COMMAND YOU, that all business and excuses beingRespectfully submitted, you attend before
laid aside, you and each of
,
the Honorable
at the
Court
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
(YOUR NAME)
Your failure to complyand sworn to before me this as a contempt of court and will make you liable to ,
Subscribed with this subpoena is punishable
day of
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
20
.
result of your failure to comply.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
Notary Public, D.C.
My Commission expires:
(Attorney must sign above and type name below)
Attorney(s) for
Office and P.O. Address
Telephone No.:
Facsimile No.:
3
E-Mail Address:
Mobile Tel. No.:
American LegalNet, Inc.
www.USCourtForms.com
