Inability Pay Form PDF Details

Embarking on legal action often comes with a plethora of costs that can be daunting, especially for individuals navigating financial hardships. This is where the Affidavit of Inability to Pay Costs steps in as a critical lifeline for those in need. Primarily utilized by plaintiffs in the justice court system who find themselves unable to shoulder the financial burden of filing and service fees—typically around $100—it offers an avenue to defer these costs. To qualify, one would generally need to be receiving benefits such as SSI, TANF, residing in public housing, or considered indigent. The form requires detailed information about the plaintiff’s financial circumstances—ranging from income sources and monthly expenses to assets and liabilities. It further extends to disclosing dependents, vehicle ownership, and the balance of any bank accounts, emphasizing the necessity of full transparency regarding financial status. This process culminates in a declaration, signed under oath, attesting to the truthfulness of the provided information, which is then solidified by a notary public’s stamp. Accurately completing and submitting this form empowers individuals, granting them the right to pursue legal action without the prohibitive barrier of cost. It embodies the legal system’s acknowledgment that justice should be accessible, regardless of an individual’s economic standing.

QuestionAnswer
Form NameInability Pay Form
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesinability pay costs, inability pay form, affidavit of inability to pay costs texas, affidavit inability form

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Affidavit of Inability to Pay Costs

Normally the filing and service fees for filing a lawsuit in justice court are around $100. You should contact the court to get the precise figures. If you receive SSI, TANF, or are in public housing or indigent and cannot afford to pay these costs, you can file an Affidavit of Inability to Pay Costs to defer the costs for filing and serving the lawsuit. The courts do not always have these forms available, but if you are truly indigent it is your right to file a lawsuit without paying the costs.

How to fill in the blanks in the form:

1 The first blank at the top of the form is the Case Number. You do not need to file that in, the clerk will assign the case number when you file the case.

2 On the right side at the top is the court information. Put the County of suit in the blank and put which Precinct and Place of the justice court where the suit was filed (e.g., Precinct 1, Place 2, Dallas County, Texas).

3 Since you filed the suit, then you are the Plaintiff. Put the landlord's name in the blank for the Defendant.

4 Fill in the county you are living in on the left side of the form.

5 Then fill in all the sources of income you receive and the amount you receive each month. List only sources you have access to (do not list the income of a spouse if the spouse does not live with you and does not provide you with income for household expenses). Also list the approximate monthly expenses you are supposed to pay each month.

6 List the number of dependents (people) you support (not including yourself).

7 List how many vehicles you own or operate as your own. This form was created for a truly indigent person. If you have any significant assets, you must list these and make corrections to the form. Remember, this affidavit is a sworn statement to the court that you do not have sufficient resources to pay the court costs. You must disclose whether you have signficant income or assets that would indicate whether you can afford to pay court costs. While you may not want to pay the costs, this is not the issue.

8 Disclose the balance of any checking account or savings account you have. Also disclose the cash you have on hand.

9 Then sign your name at the bottom. Print your name, complete address and phone number below your signature.

10 You are further required to sign the document and swear that everything on the affidavit is true before a notary public. These are persons that are authorized by the state of Texas to administer oaths. Notaries can be found in banks, title companies and other locations. Unless you are a customer of the business, a notary may charge you a small fee to notarize a document. The fee should be around $5 or $10 at the most.

11 Then make two copies of the signed form and take them, with the original to the justice court for filing. The court will keep the original, and give you back one copy to serve on the landlord and one for your records. For more information on proceeding with the case, see Representing Yourself.

a. Housing

NO. _________________

(cause number)

_________________________________,

)

IN THE JUSTICE COURT

PLAINTIFF (Your Name),

)

 

vs.

)

 

 

)

PRECINCT ___, PLACE ___

 

)

 

_________________________________,

)

 

DEFENDANT (Landlord).

)

_________ COUNTY, TEXAS

AFFIDAVIT OF INABILITY TO PAY COSTS

Pursuant to Rule 145 of the Texas Rules of Civil Procedure, Plaintiff hereby files this affidavit of inability to pay costs and requests this Court file this cause of action against Defendant without payment of any fee, and provide all service, writs and processes necessary to enable Plaintiff to prosecute this cause of action.

STATE OF TEXAS

)

 

 

)

 

COUNTY OF ____________)

 

 

 

1.

My approximate monthly income consists of the following:

 

AMOUNT

SOURCE OR DESCRIPTION

a) Public Benefits

_________

_________________________

b) Net Employment

_________

_________________________

c) Other Income

_________

_________________________

d) Child Support

_________

_________________________

e) Spouse Income

_________

_________________________

(if available)

 

 

My approximate monthly expenses consist of the following:

AMOUNT

_________

Affidavit of Inability to Pay Costs -- Page 1

b. Transportation

_________

c. Food

_________

d. Clothing

_________

e. Utilities

_________

f. Child Care

_________

g. Medical Expenses

_________

h. Other

_________

 

2.

I have the following dependents living with me ___________________________

(list names and ages)

_______________________________________________________________________.

3.

I have no substantial property other than my clothes, personal effects and

household furnishings. I have ____ vehicle(s): ______________________.

(list make, model, year)

The balance of any checking account I have is $______. The balance of any

savings account or other account I have is $______. I have $_______ in cash in my

possession.

4.

I am unable to pay the court costs and other fees. Nevertheless, I wish to file and serve my case against Defendant under Rule 145 of the Texas Rules of Civil Procedure. I verify that the statements made in this affidavit are true and correct.

__________________________

(Your Signature)

__________________________

(Your Printed Name)

__________________________

(Your Address)

__________________________

(Your City, State, Zip)

__________________________

(Your Phone Number)

Affidavit of Inability to Pay Costs -- Page 2

Before me, the undersigned authority, on this day personally appeared

_________________________, who after being duly sworn, on oath states the foregoing

statements are within his or her personal knowledge and true and correct. SUBSCRIBED AND SWORN to this _____ day of ________________, 20___.

__________________________

Notary Public, State of Texas

Affidavit of Inability to Pay Costs -- Page 3

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This document will require some specific information; in order to ensure accuracy, please be sure to take note of the next steps:

1. You will need to fill out the texas statement of inability to afford payment of court costs correctly, hence take care when working with the sections that contain these particular fields:

paperwork for inability to pay ticket completion process detailed (part 1)

2. After this selection of blanks is done, go to type in the suitable details in these - COUNTY OF, My approximate monthly income, AMOUNT, a Public Benefits, b Net Employment, c Other Income, d Child Support, e Spouse Income if available, SOURCE OR DESCRIPTION, and My approximate monthly expenses.

Tips on how to prepare paperwork for inability to pay ticket portion 2

Those who work with this form frequently make some errors while filling in a Public Benefits in this part. You should definitely review what you enter right here.

3. This step is straightforward - complete all the form fields in a Housing, AMOUNT, and Affidavit of Inability to Pay in order to complete this process.

a Housing, Affidavit of Inability to Pay, and AMOUNT of paperwork for inability to pay ticket

4. The subsequent subsection requires your involvement in the subsequent parts: b Transportation, c Food, d Clothing, e Utilities, f Child Care, g Medical Expenses, h Other, I have the following dependents, list names and ages, I have no substantial property, household furnishings I have, list make model year, The balance of any checking, savings account or other account I, and possession. Make certain to fill out all required details to move onward.

Stage no. 4 of submitting paperwork for inability to pay ticket

5. Finally, this last part is what you'll want to finish before finalizing the document. The blank fields in this case include the next: verify that the statements made in, Your Signature, Your Printed Name, Your Address, Your City State Zip, and Your Phone Number.

paperwork for inability to pay ticket writing process clarified (step 5)

Step 3: Reread the details you have entered into the blank fields and then hit the "Done" button. Right after starting afree trial account at FormsPal, it will be possible to download texas statement of inability to afford payment of court costs or send it through email at once. The form will also be accessible in your personal cabinet with your adjustments. Here at FormsPal.com, we do our utmost to ensure that all of your information is stored protected.

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