Application To Sue As A Poor Person (Page 2 of 2) in pdf

Application To Sue As A Poor Person Page 2

7. I own no real estate. The total value of all my personal property does not exceed

$___________ in value and consists of clothing and furniture, and other household

items, including a 20____, ____________ motor vehicle, valued at $____________.

8. I filed no applications for leave to sue or defend as a poor person during the

preceding year, and none were filed on my behalf.

9. I am unable to pay the costs of commencing and prosecuting this action.

10. I have a meritorious claim.

WHEREFORE, Applicant prays the Court to permit her/him to commence and prosecute

this action as a poor person under 735 ILCS 5/5-105 of the Code of Civil Procedure.

__________________________________

Plaintiff

STATE OF ILLINOIS

}

} SS.

COUNTY OF ________________ }

I, the undersigned, a Notary Public, in and for said County, in the State

aforesaid, do hereby certify that ____________________, personally known to me to be

the same person whose name is subscribed to the foregoing instrument, appeared before

me this day in person and acknowledged that he/she signed, sealed, and delivered the

said instrument as a free and voluntary act, for the uses and purposes therein set forth.

Given under my hand and notarial seal this day of _________________, 200__.

_________________________________________

NOTARY PUBLIC

Application To Sue As A Poor Person Page 2