In The United States District Court For The District Of New Mexico Form printable pdf download

In The United States District Court For The District Of New Mexico Form

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF NEW MEXICO

Plaintiff(s),

No.

Defendant(s),

MOTION TO PROCEED IN FORMA PAUPERIS WITH

FINANCIAL AFFIDAVIT PURSUANT TO 28 U.S.C. § 1915

I, ______________________________, make under oath the following

statement regarding my financial, residential, marital and employment status, and since

I am unable to prepay fees and costs in the above-entitled cause, make application to

proceed as a pauper in accordance with 28 U.S.C. § 1915:

BACKGROUND AND RESIDENCE

Full Name:________________________________________________

Age:____________ Sex___________

Present address:___________________________________________

How long at this address:_________

Phone No:________________

Married?_____ Single?_____ Divorced?_____ Separated?_____

Number of dependents:_____________

Ages of children living with you:________________________________

List of relationship of other dependents living with you:

_________________________________________________________

List any dependents in items 7 and 8 depending on you for support:

_________________________________________________________

In The United States District Court For The District Of New Mexico Form