Free Instructions for Affidavit and Order Waiving Fees - All

Instructions for Affidavit of Indigency (Waiver of Filing Fees and Order)
An affidavit for indigency is a request to the Court asking it not to charge you the fee for filing a divorce and to direct the Sheriff not to charge you for service of process. The affidavit is a statement that you are making to the Judge explaining your financial situation and help the Judge decide whether to waive the fees in your case. You are telling the Judge that you cannot afford to pay the filing fee and the service of process fee. · · Read paragraphs 1 and 2. You do not need to fill in anything in these paragraphs, but you must agree with what they say. Fill in the blanks for paragraphs 3-8. You may want to have a copy of your last tax return to help you. If you do not know an answer then place a question mark "?" in the blank. If you know for certain that you don't have or receive the item in a paragraph then enter a zero "0". Fill in the blanks for sections I, II, and III. If you don't have something listed in those sections enter a zero. You must sign and date the Affidavit in the presence of a notary public or clerk of court. Make sure to bring identification to show the notary public or clerk of court. A notary public can usually be found at the bank and sometimes at the courthouse.

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WARNING: By signing your name, you are telling the court that you are telling the truth and that you have a good faith reason for your requests. If you are not telling the truth or if you are misleading the court or if you are serving or filing this document for an improper purpose, the court could find you in contempt or you could be prosecuted for not telling the truth. DO NOT FILL OUT ANYTHING ON THE ORDER WAIVING FEES! THIS IS FOR THE JUDGE TO FILL OUT. GIVE BOTH THE COMPLETED AND SIGNED AFFIDAVIT AND THE BLANK ORDER TO THE CLERK OF COURTS WHEN YOU FILE YOUR DIVORCE.

Form UJS-305 Rev. 11/08

STATE OF SOUTH DAKOTA ) :SS COUNTY OF _______________)

IN CIRCUIT COURT ________ JUDICIAL CIRCUIT

_________________________, Plaintiff, vs. _________________________, Defendant

DIV _______

AFFIDAVIT OF INDIGENCY

Comes now the Plaintiff named above, and after first being duly sworn on oath states and alleges as follows: 1. I am the Plaintiff named above; and I make this affidavit pursuant to and in accordance with SDCL 16-2-29.2 and 16-2-29.3 for the purposes of supporting my request to waive the filing fee in my action for divorce. 2. I do solemnly swear that I am unable to pay the filing fee and the service of process fee of the legal proceedings which I am about to commence for the following reasons; and that I verily believe I am justly entitled to the relief sought by such legal proceedings. 3. 4. 5. 6. 7. 8. 9. I. I am (check one): ______ Employed ______ Unemployed ___ Self-employed. If employed, my weekly take-home pay is $_____________. Retirement, disability, or insurance benefits: $____________ per ____________. Total income before deductions for 20____ was $____________ (prior). Total income before deductions for 20____ is $____________ (current). Including myself, I have the following number of dependents: __________. The following amounts accurately represent my assets and liabilities:

ASSETS (Things I own or am buying): A. B. CASH (on hand or in banks) ................. $_________ ACCOUNTS AND NOTES RECEIVABLE (IOUs and other money payable to me) ....... $_________ INVESTMENTS (Stock, bonds, savings bonds, etc.) ............................... $_________ REAL ESTATE (Houses, land, tribal lease land, real property, etc.) ................. $_________

C.

D.

Form UJS-305 Rev. 11/08

E.

AUTOMOBILE(S) - make, model, & year: ________________________________________ ________________________________________ ________________________________________ $_________

F.

HOUSEHOLD GOODS (Furniture, appliances, TV, stereo, etc.) .......................... $_________ OTHER PERSONAL PROPERTY (Tools, sports equipment, etc.) ........................... $_________ ANY OTHER ASSETS (Anything else I could sell or borrow money on) ................... $_________ TOTAL ASSETS ......................... $_________

G.

H.

II.

LIABILITIES (Money that I owe): A. REGULAR MONTHLY EXPENSES: (Housing, utilities, food, etc.) ..................... $_________ LOANS: Amounts owed to: ______________________________________ ..... $_________ ______________________________________ ..... $_________ ______________________________________ ..... $_________ ______________________________________ ..... $_________ ______________________________________ ..... $_________ TOTAL LIABILITIES .................... $_________

B.

III.

ANTICIPATED INCOME (Money or property I expect to receive from sale of house or land, alimony, gifts, inheritances, allotments, trust funds, lease money, etc.) ................ $_________

Form UJS-305 Rev. 11/08

WHEREFORE, based upon the foregoing statements and allegations, I respectfully request that the Court enter its Order to waive payment of the filing fee and the fees for service of process upon the Defendant in this matter, pursuant to SDCL 16-2-29.2.

Dated this _______ day of __________________, 20___.

_________________________________________ Plaintiff Name: (Printed) ___________________________ Address: _________________________________ City/State/Zip: ____________________________ Telephone: (_____)_________________________

Subscribed and sworn to before me this _________ day of _______________________, 20___.

_________________________________________ Notary Public/Clerk of Courts If Notary, my commission expires: (SEAL)

Form UJS-305 Rev. 11/08

STATE OF SOUTH DAKOTA ) :SS COUNTY OF _______________)

IN CIRCUIT COURT ________ JUDICIAL CIRCUIT

_________________________, Plaintiff, vs.

DIV _______

ORDER WAIVING FILING FEE AND SERVICE OF PROCESS FEE

_________________________, Defendant

The Plaintiff named above having moved the Court to enter its order to waive payment of the filing fee and service of process fee of Divorce action; the Court having reviewed and considered said motion and the Plaintiff's supporting affidavit attached hereto; the Court being satisfied that the Plaintiff is unable to pay the filing fee and service of process fee herein based upon circumstances of poverty; and good cause having been shown; now, therefore, it is hereby ORDERED that payment of the filing fee by the Plaintiff in the action herein be and is hereby waived. It is further ORDERED that the Sheriff in the County in which the Defendant is served shall waive the fees charged for service of process in this matter. Dated this ________ day of _____________________, 20___. BY THE COURT: _________________________________________ CIRCUIT COURT JUDGE ATTEST: _____________________________________ CLERK OF COURTS _____________________________________ DEPUTY (SEAL)

Form UJS-305 Rev. 11/08