Form Ifp102 PDF Details

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Form NameForm Ifp102
Form Length3 pages
Fillable fields0
Avg. time to fill out45 sec
Other namesminnesota ifp102, minnesota court form ifp102, minnesota ifp102 form, mn form ifp102

Form Preview Example


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)


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.



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.


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):




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Relationship to you


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:



Spousal Support Trust Income

Social Security















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:






I am not married.

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

Name of person



Net (take home) monthly income

Source of Income





























I receive


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


child care support.





I pay


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


child care support.





I pay


per month in court-ordered spousal support.


I pay


per month for


mortgage payment.




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I own:




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)


Other Real Estate:

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


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.




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How to Edit Form Ifp102 Online for Free

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Step 1: Click on the "Get Form" button above on this webpage to open our PDF editor.

Step 2: As you open the PDF editor, there'll be the form all set to be filled in. Apart from filling in different blank fields, you might also perform other sorts of actions with the PDF, specifically putting on your own textual content, changing the original textual content, adding illustrations or photos, putting your signature on the form, and much more.

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

Step 3: Reread the details you have typed into the blanks and hit the "Done" button. Go for a 7-day free trial option at FormsPal and acquire direct access to minnesota court form ifp102 - download, email, or change from your FormsPal account page. If you use FormsPal, you'll be able to complete forms without the need to be concerned about personal information leaks or records being distributed. Our protected software helps to ensure that your private data is stored safely.