Affidavit In Support Of Application For Permission To Proceed Without Deposit On Costs
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Affidavit In Support Of Application For Permission To Proceed Without Deposit On Costs Form. This is a Missouri form and can be use in 7th Circuit (Clay County) Local Circuit Courts.
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Tags: Affidavit In Support Of Application For Permission To Proceed Without Deposit On Costs, 235, Missouri Local Circuit Courts, 7th Circuit (Clay County)
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
Index No.
CIRCUIT COURT OF CLAY COUNTY, MISSOURI
:
Calendar No.
PROBATE DIVISION
Case No.
:
Plaintiff(s)
Matter of
-against-
JUDICIAL SUBPOENA
:
AFFIDAVIT IN SUPPORT OF APPLICATION
:
FOR PERMISSION TO PROCEED WITHOUT A DEPOSIT ON COSTS
Being first duly sworn to tell the truth, I make the following statements in support of my application to proceed without a
:
deposit on costs:
Defendant(s)
:
. . . . .1. . . Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .......
2.
Employment:
Wages: $
THE PEOPLE OF THE STATE OF NEW YORK
3.
Spouse’s employment:
Wages: $
TO
4.
Dependents (names & age):
GREETINGS:
5.
Real Property (land & buildings):
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court Net Value: $
located at
County of
6.
in room Householdon the furniture,of
, goods,
day clothes, and jewelry: , at
, 20
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
7.
Motor vehicles (cars, trucks, motorcycles, motor homes):
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
8. Cash on hand: $
, Deposit in banks, savings & loans, credit unions etc. $
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.
9.
Stocks & Bonds: $
Witness, Honorable
Court in
County,
, one of the Justices of the
10. All other property of value:
day of
, 20
11. All other sources of income
(Attorney must sign above and type name below)
12. Debts:
Attorney(s) for
I UNDERSTAND THAT ANY INTENTIONALLY FALSE STATEMENT ON THIS AFFIDAVIT MAY SUBJECT ME TO
THE PENALTIES OF THE CRIME OF PERJURY.
Signature of applicant
Office and P.O. Address
Subscribed and sworn to before me this ____________ day of _____________________________________, 20______.
Clerk
Deputy Clerk
Form 235
Revised 3/14/2003
Page 1 of 1
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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