Application To Proceed In Forma Pauperis Relating To
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5JUSTICE COURT, LAS VEGAS TOWNSHIP
CONFIDENTIAL
_______________________________
(your name)
_______________________________
(your street address)
_______________________________
(your city, state, and zip code)
_______________________________
(your phone number)
IN PROPER PERSON
JUSTICE COURT, LAS VEGAS TOWNSHIP
CLARK COUNTY, NEVADA
____________________________ )
Case No.
________________________
____________________________ )
Dept. No.
________________________
Plaintiff
)
)
vs.
)
)
)
APPLICATION TO PROCEED
____________________________ )
IN FORMA PAUPERIS
____________________________ )
RELATING TO________________
Defendant.
)
_____________________________
)
______________________________)
Pursuant to NRS 65.040 and NRS 12.015, and based on the following Affidavit, I request
permission from this Court to proceed without paying court costs or other costs and fees as
provided in NRS 12.015 because I lack sufficient financial ability.
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