CONFIDENTIALIFP103 State ENG Rev 7/15www.mncourts.gov/formsPage 1 of 2State Of Minnesota District Court County of: Select County Judicial District: Court File Number: Case Type: vs. Plaintiff/Petitioner (first, middle, last) Respondent (first, middle, last)Supplemental Affidavit for Proceeding In Forma Pauperis (Minn. Stat. 247563.01) 1. I am a party in this action and make this request in good faith. 2. (Check one of the following:)service and publication fees, and copy fees has previously been issued in this case. OR I have completed and attached an "Affidavit for Proceeding In Forma Pauperis." An order allowing me to proceed in forma pauperis without paying filing fees, 3. I am asking for an order directing payment of the following costs by the state courts:a. Witness/expert for: Trial Deposition Name and address of witness: I expect this witness to provide the following evidence or testimony (please give a general description): I estimate the costs for this witness to be: Subpoena Service Fee Mileage Attendance Fee Other b. Transcript expenses: American LegalNet, Inc. www.FormsWorkFlow.com CONFIDENTIALIFP103 State ENG Rev 7/15www.mncourts.gov/formsPage 2 of 2 Date of hearing, trial or deposition:I need a copy of this transcript for the following reasons: I estimate the costs of obtaining this transcript to be: Court reporter fees Copy fees Other c. Other expenses: These expenses are necessary because: Estimated costsI declare under penalty of perjury that everything that I have stated in this document is true and correct. Minn. Stat. 247 358.116. Dated: Signature County and State where signed Name: Address: City/State/Zip: Telephone: E-mail address: American LegalNet, Inc. www.FormsWorkFlow.com