Free Microsoft Word - Document3 - South Carolina


File Size: 8.1 kB
Pages: 1
Date: October 28, 2008
File Format: PDF
State: South Carolina
Category: Court Forms - State
Author: WClark
Word Count: 131 Words, 1,131 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.judicial.state.sc.us/forms/pdf/SCCA741.pdf

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STATE OF SOUTH CAROLINA, COUNTY OF ___________________

_________________________________ Plaintiff vs. _________________________________ Defendant.

) ) ) ) ) ) ) ) ) ) )

IN THE _________________________ COURT ____________ JUDICIAL CIRCUIT MOTION AND AFFIDAVIT TO PROCEED IN FORMA PAUPERIS

FILE NO.

_________________________________

I, __________________________________________, being duly sworn, state that I am the Plaintiff and that I do not have the funds available to pay the costs of filing and service in the present matter. I hereby request that the complaint be filed and service made without costs. Sworn to and Subscribed before me this ____ day of ________________, 2______. ) ) ) ) Notary Public for South Carolina ) ) My Commission expires _________________ )

Signature of Plaintiff or Person Filing Complaint on Behalf of Plaintiff

ORDER Leave Dated: (granted) / (denied) to proceed in forma pauperis. , 2_____
JUDGE/CLERK OF COURT

____________________

______________________ ,

South Carolina

NOTICE TO PLAINTIFF:

The Court may assess costs against either party at hearing.

SCCA/741 (Amended 05/2008)