Form Ifp102 PDF Details

The Ifp102 form is a critical document used within the Minnesota judicial system, particularly designed for individuals seeking to have court fees and costs waived due to financial inability. This affidavit, supporting proceedings In Forma Pauperis, enables natural persons—not corporations or other entities—to request an exemption from these fees so they can access the court system without the financial burden. Eligibility hinges on the applicant's financial situation, including family income being below 125% of the Federal Poverty Line, recipient status of public assistance or Supplemental Security Income (SSI), and other income and debt considerations. The form requires detailed personal information, including family size, income sources, monthly expenses, and assets, to assess the applicant's financial standing. Additionally, the applicant must list any public assistance programs they are a part of, further substantiating their request for waiver. By signing the form, plaintiffs or petitioners declare under penalty of perjury that their statements are true, acknowledging that providing false information or failing to supply necessary records may lead to a denial of their motion to proceed without charge. This form not only offers a means for financially constrained individuals to seek justice but also includes safeguards to verify the accuracy of the information provided.

QuestionAnswer
Form NameForm Ifp102
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesminnesota ifp102, minnesota court form ifp102, minnesota ifp102 form, mn form ifp102

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CONFIDENTIAL

State of Minnesota

District Court

County of:

Judicial District:

Court File Number:

Case Type:

 

Affidavit for Proceeding

 

In Forma Pauperis

Plaintiff/Petitioner (first, middle, last)

 

(Minn. Stat §563.01)

vs/and

Defendant/Respondent (first, middle, last)

1.I am a party in this action. I am a natural person (not a corporation, partnership or other entity). In good faith, I request a court order waiving court fees and costs. I cannot support my family and myself and also pay or give security for costs.

2.I believe that I have valid reasons for pursing this action. My pleadings (the Petition, Complaint, Answer, Appeal or other pleading) are attached.

3. a.

b.

c.

I am receiving public assistance under one or more of the following means-tested programs.

MSA (Minnesota Supplemental Assistance Programs);

MFIP (Minnesota Family Investment Program);

Food Stamps;

General Assistance or Discretionary Work Program;

MinnesotaCare, Medical Assistance, or General Assistance Medical Assistance;

Energy Assistance;

I am receiving public assistance under some other means-tested programs. (Name the program)

I have attached proof that I receive public assistance (such as MFIP card or canceled check from agency) or I will provide proof if requested.

I receive Supplemental Security Income (SSI) as a resource for meeting my expenses.

4.

I am represented by attorney

 

on behalf of

 

 

 

a civil legal services program or

volunteer attorney program, based on indigency.

5. My family size is . (Include yourself, your spouse, your minor children, and

other dependents in your household. For my family size, I counted myself and (list all others):

IFP102

State

ENG

Rev 7/15

www.mncourts.gov/forms

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CONFIDENTIAL

Name

Age:

Relationship to you

6.

My gross annual family income (before taxes and deductions) is

 

 

which is less than 125% of the Federal Poverty Line for my family size of

 

members. I have attached proof of my family income or I will provide proof if requested.

7.My gross monthly income (before taxes and deductions) is

My net (take home) monthly income is

 

 

and the source of that

income is:

Job/wages

Unemployment

Spousal Support Trust Income

Social Security

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

8.My spouse's gross monthly income (before taxes and deductions) is

My spouse's net (take home) monthly income is

 

 

and the source of that

income is

OR, I do not know my spouse's

 

 

 

 

 

 

 

income because:

 

 

.

OR

9.

I am not married.

All other family members and dependents living with me have net monthly income as follows:

Name of person

 

Age

Net (take home) monthly income

Source of Income

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10.

I receive

 

per month in child support (includes medical support and/or

 

child care support.

 

 

 

11.

I pay

 

per month in child support (includes medical support and/or

 

child care support.

 

 

 

12.

I pay

 

per month in court-ordered spousal support.

13.

I pay

 

per month for

rent

mortgage payment.

IFP102

State

ENG

Rev 7/15

www.mncourts.gov/forms

Page of

CONFIDENTIAL

14.

I own:

Cash

 

 

Checking, savings, and credit union accts

Cars, other vehicles (list make, year and equity value ([market value minus unpaid loans])

Real Estate (market value minus unpaid mortgage/loans)

Homestead:

Other Real Estate:

Other personal property (jewelry, stocks, bonds, etc. list separately)

15.

I am presently

 

in debt, excluding car loans and real estate mortgage/loans.

16.Other factors which support your request are (explain unusual medical expenses, emergencies, reasons that the family money is not available to you, or other circumstances to help the Judge understand your situation):

By signing this Affidavit, I am certifying that these statements are true under penalty of perjury. I understand that if I provide false information on the form it may lead to criminal charges. I understand that failure to execute the form or failure to provide information or requested records may result in denial of my motion to proceed In Forma Pauperis. I am authorizing that the facts contained in this Affidavit may be verified by any means required.

IFP102

State

ENG

Rev 7/15

www.mncourts.gov/forms

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How to Edit Form Ifp102 Online for Free

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With regards to the fields of this particular document, here is what you should know:

1. The minnesota court form ifp102 usually requires specific details to be entered. Make certain the following blank fields are complete:

Ways to fill out minnesota ifp102 stage 1

2. Now that the last array of fields is complete, you'll want to include the essential details in Complaint Answer Appeal or other, I am receiving public assistance, MSA Minnesota Supplemental, MFIP Minnesota Family Investment, Food Stamps, General Assistance or, MinnesotaCare Medical Assistance, Energy Assistance, I am receiving public assistance, I have attached proof that I, I receive Supplemental Security, I am represented by attorney, on behalf of, volunteer attorney program based, and My family size is allowing you to move forward to the third step.

Step number 2 in submitting minnesota ifp102

3. Your next stage is normally straightforward - complete all the empty fields in Name, Age, Relationship to you, My gross annual family income, which is less than of the Federal, members I have attached proof of, My gross monthly income before, My net take home monthly income is, and the source of that, income is, Jobwages, Unemployment, Spousal Support, Trust Income, and Social Security to complete this part.

Writing segment 3 in minnesota ifp102

People frequently make mistakes while filling in Unemployment in this area. Remember to review everything you enter right here.

4. This next section requires some additional information. Ensure you complete all the necessary fields - Name of person, Age, Net take home monthly income, Source of Income, I receive, child care support, I pay, child care support, I pay, I pay, per month in child support, per month in child support, per month in courtordered spousal, per month for, and rent - to proceed further in your process!

Writing segment 4 in minnesota ifp102

5. Since you come near to the last parts of the file, you'll notice a few more points to undertake. In particular, I own, Cash, Checking savings and credit union, Real Estate market value minus, Homestead, Other Real Estate, Other personal property jewelry, I am presently, in debt excluding car loans and, and Other factors which support your must all be done.

Filling out segment 5 in minnesota ifp102

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