Free INSTRUCTIONS - WAIVER OF COURT FEES AND COSTS - Minnesota

INSTRUCTIONS - WAIVER OF COURT FEES AND COSTS (IN FORMA PAUPERIS) Minnesota Statutes § 563.01
If you cannot afford to pay court fees and costs, you may be able to have these fees and costs waived. Under the law, the court can waive these fees and costs if: 1. You are receiving public assistance under one or more of the following programs: Minnesota Family Investment Plan (MFIP), MFIP-Emergency Assistance, or MFIPDiversionary Assistance; General Assistance or Emergency General Assistance; Medical Assistance or General Assistance Medical Care; Food Stamps; Supplemental Security Income; Minnesota Supplemental Assistance (MSA) or MSA-Emergency Assistance; Energy Assistance. OR 2. You are represented by a legal services or volunteer attorney on behalf of a civil legal services program or a volunteer attorney program based on indigence.

OR 3. Your annual family income before taxes is less than 125% of the Federal Poverty Guidelines for your family size as indicated below.

Maximum Income Level ­ 125% of Poverty Please Check Your Size of Family Size Family Unit 1 2 3 4 5 6 7 8 $ $ $ $ $ $ $ $ Annual Family Income Before Taxes 13,538 18,213 22,888 27,563 32,238 36,913 41,588 46,263 Monthly Family Income Before Taxes $ 1,128 $ 1,518 $ 1,907 $ 2,297 $ 2,687 $ 3,076 $ 3,466 $ 3,855 Weekly Family Income Before Taxes 260 350 440 530 620 710 800 890

$ $ $ $ $ $ $ $

More than 8 members, add $4,675 annually for each additional family member (or $390 monthly or $89 weekly) Number of family members: Calculate and enter figure here: $ _____________ OR 4. Your income is not enough to pay for the common necessities of life for yourself and the people you support and also to pay court fees and costs.

IFP101

State

ENG

Rev 02/09

www.courts.state.mn.us/forms

Page 1 of 2

If you believe you meet one of the categories above, you can apply to proceed In Forma Pauperis (the Latin title used to describe the procedure for waiver of court fees and costs). STEP 1: Complete the Affidavit for Proceeding In Forma Pauperis. Do not sign the form until you are in front of the court administrator or notary public. Make sure you attach copies of any documents requested on the form, such as proof of public assistance, etc. STEP 2: Complete the case heading for the Order Denying / Granting In Forma Pauperis. The case heading (name of Plaintiff/Petitioner and Defendant/Respondent, etc.) should match your Affidavit for Proceeding In Forma Pauperis. The rest of the order can be left blank. The judge will decide whether to sign the section denying or granting the order based on the information you provide. STEP 3: File these documents with the Court Administrator. You can sign the Affidavit for Proceeding In Forma Pauperis in front of the court administration staff. The staff person will tell you the procedures for having a judge review your application. If you have any questions and cannot afford an attorney, you may wish to consult the legal aid office, legal services office, or lawyer referral service in your county (listed in the yellow pages under "Attorneys"), or by going to www.lawhelpmn.org.

Helpful materials may be found at your public county law library. For a directory, see http://www.lawlibrary.state.mn.us/cllppubdir.rtf . For more information, contact your court administrator or call the Minnesota State Law Library at 651-296-2775.
IFP101 State ENG Rev 02/09 www.courts.state.mn.us/forms Page 2 of 2