Motion And Affidavit To Proceed In Forma Pauperis

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STATE OF SOUTH CAROLINA,
)
)
IN THE MAGISTRATE COURT
COUNTY OF
___________________ )
)
_________________________________ )
Plaintiff )
MOTION AND AFFIDAVIT TO
)
PROCEED IN FORMA PAUPERIS
vs.
)
)
_________________________________ )
Defendant. )
FILE NO.
_________________________________
I, __________________________________________Error! Reference source not found., being
duly sworn, state that I am the Plaintiff and that I do not have the funds available to pay the costs of
filing and service in the present matter. I hereby request that the complaint be filed and service made
without costs.
Sworn to and Subscribed before me
)
this ____ day of ________________, 2______.
)
)
)
Notary Public for South Carolina
)
Signature of Plaintiff or
)
Person Filing Complaint on Behalf of
My Commission expires
_________________ )
Plaintiff
ORDER
Leave is granted to proceed in forma pauperis without payment of the filing fee.
Leave is granted to proceed in forma pauperis without payment of the service cost.
Leave is denied to proceed in forma pauperis.
Dated:
____________________
, 2_____
JUDGE/CLERK OF COURT
______________________ ,
South Carolina
NOTICE TO PLAINTIFF:
The Court may assess costs against either party at hearing.
SCCA/741 (Amended 10/2010)

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