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    Poverty Affidavit

    Uploaded by

    Thomas Bull Rearden
    This document is a poverty affidavit filed in the Superior Court of Cobb County, Georgia. It contains information about a plaintiff seeking to have filing fees waived due to poverty. The plaintiff swears under oath that due to their poverty they are unable to pay court costs. They provide personal details such as their monthly household income, rent amount, number of people in the household, and monthly bills. The plaintiff requests to proceed with their civil case without having to pay filing fees or associated costs.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Poverty Affidavit

    Uploaded by

    Thomas Bull Rearden
    10 views2 pages
    This document is a poverty affidavit filed in the Superior Court of Cobb County, Georgia. It contains information about a plaintiff seeking to have filing fees waived due to poverty. The plaintiff swears under oath that due to their poverty they are unable to pay court costs. They provide personal details such as their monthly household income, rent amount, number of people in the household, and monthly bills. The plaintiff requests to proceed with their civil case without having to pay filing fees or associated costs.

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    PovertyAffidavit

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    This document is a poverty affidavit filed in the Superior Court of Cobb County, Georgia. It contains information about a plaintiff seeking to have filing fees waived due to poverty. The plaintiff swears under oath that due to their poverty they are unable to pay court costs. They provide personal details such as their monthly household income, rent amount, number of people in the household, and monthly bills. The plaintiff requests to proceed with their civil case without having to pay filing fees or associated costs.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    10 views2 pages

    Poverty Affidavit

    Uploaded by

    Thomas Bull Rearden
    This document is a poverty affidavit filed in the Superior Court of Cobb County, Georgia. It contains information about a plaintiff seeking to have filing fees waived due to poverty. The plaintiff swears under oath that due to their poverty they are unable to pay court costs. They provide personal details such as their monthly household income, rent amount, number of people in the household, and monthly bills. The plaintiff requests to proceed with their civil case without having to pay filing fees or associated costs.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    IN THE SUPERIOR COURT OF COBB COUNTY

    STATE OF GEORGIA

    Plaintiff: ___________________________________

    and Civil Action File No.: __________________________

    Defendant: _________________________________

    POVERTY AFFIDAVIT

    Comes now _____________________________________, the Plaintiff in the above styled


    _____________________________________ [Enter the name of the Petition], being first duly sworn, deposes and says:

    1. That I, by reason of my poverty, am unable to pay the cost deposit required by O.C.G.A. § 5-6-77 to file a civil case,
    in the courts of Cobb County.

    2. That I am ____________ years of age, and my monthly household income is $____________. A copy of my last
    two pay stubs/unemployment checks/other proof of income source is attached.

    3. That I live at _____________________________________________________________________________, and


    pay $____________ per month as rent.

    4. My household consists of ____________ number of people.

    5. That I pay the following bills each month:

    Name of Bill Amount of Bill

    ____________________________________________________________________________________________________
    “Poverty Affidavit” Page 1 of 2
    Provided by the Superior Court of Cobb County. rev 1. 05/2008
    6. That I hereby request that I be able to proceed in this action without having to pay filing fees and associated costs.

    Signed this _________________ day of ________________________________________.


    [day] [month] [year]

    _________________________________________________________
    (Sign your name here before Notary) Petitioner, Pro se

    Petitioner’s name (print or type): ______________________________


    Petitioner’s Address: ________________________________________
    ________________________________________
    Petitioner’s Telephone Number: _______________________________

    Sworn to and affirmed before me, this


    _______ day of _________________.

    ______________________________
    NOTARY PUBLIC
    My commission expires: __________
    (Notary Seal)

    ____________________________________________________________________________________________________
    “Poverty Affidavit” Page 2 of 2
    Provided by the Superior Court of Cobb County. rev 1. 05/2008

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