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Affidavit of Indigency

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Commonwealth of Massachusetts

AFFIDAVIT OF INDIGENCY

AND REQUEST FOR WAIVER, SUBSTITUTION

OR STATE PAYMENT OF FEES & COSTS

(Note: If you are currently confined in a prison or jail and are not seeking immediate release under G.L. c. 248 §1, but you are suing correctional staff and wish to request court payment of “normal” fees (for initial filing and service), do not use this form. Obtain separate forms from the clerk.)

SECTION 1:

Under the provisions of General Laws, Chapter 261, Sections 27A-27G, I swear (or affirm) as follows:

I AM INDIGENT in that (check only one ):

which income is at or below the court system's poverty level; (Note: The court system's poverty levels for households of various sizes must be posted in this courthouse. If you cannot find it, ask the clerk or check online at: http://www.mass.gov/courts/sjc/docs/povertyguidelines.pdf. The court system's poverty level is updated each year.)

or my dependents of the necessities of life, including food, shelter and clothing.

IF YOU CHECKED (C), YOU MUST ALSO COMPLETE THE SUPPLEMENT TO THE AFFIDAVIT OF INDIGENCY.

SECTION 2:

(Note: In completing this form, please be as specific as possible as to fees and costs known at the time of filing this request. A supplementary request may be filed at a later time, if necessary.)

I request that the following NORMAL FEES AND COSTS be waived (not charged) by the court, or paid by the state, or that the court order that a document, service or object be substituted at no cost (or a lower cost, paid for by the state): (Check all that apply and, in any "$ " blank, indicate your best guess as to the cost, if known.)

SECTION 3:

I request that the following EXTRA FEES AND COSTS either be waived (not charged), substituted or paid for by the state:

represented by Committee for Public Counsel Services (CPCS-public defender).

By order of the Supreme Judicial Court, all information in this affidavit is CONFIDENTIAL. Except by special

order of a court, it shall not be disclosed to anyone other than authorized court personnel, the applicant,

applicant's counsel or anyone authorized in writing by the applicant.

This form prescribed by the Chief Justice of the SJC pursuant to G.L. c. 261, § 27B. Promulgated March , 2003. Fillable PDF created August 2013.

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What an Affidavit of Indigency Is and when it’s used

An Affidavit of Indigency is a sworn written statement a person files to declare inability to pay court costs, filing fees, or other legal expenses. Courts, tribunals, and some administrative agencies accept the affidavit to grant fee waivers or reduced-cost processing when the filer demonstrates limited income, assets, or financial hardship. The form typically collects identity, household composition, income sources, monthly expenses, and an oath before a notary or authorized official. Requirements and acceptable evidence vary by jurisdiction and by court type.

Why this affidavit matters for access to justice

An Affidavit of Indigency allows qualified filers to seek waivers of fees that might otherwise block access to court processes or administrative remedies.

Why this affidavit matters for access to justice

Who commonly completes an Affidavit of Indigency

Individuals and representatives file these affidavits when cost is a barrier to accessing courts or filing administrative claims.

  • Self-represented litigants seeking fee waivers for civil filings or appeals.
  • Public defenders and criminal defendants requesting appointment or reduced costs.
  • Legal aid organizations and clinics preparing filings for low-income clients.

Step-by-step: preparing and filing an Affidavit of Indigency

Follow these steps to prepare a complete affidavit and reduce processing delays.

  • 01
    Gather documents: Collect IDs, pay stubs, benefit letters, and bank statements.
  • 02
    Complete form: Enter full answers; avoid abbreviations and estimate where noted.
  • 03
    Attach proof: Include supporting documents referenced on the affidavit.
  • 04
    File and notarize: Sign before the required official and submit per court rules.

Typical e‑submission and review workflow

A clear digital workflow shortens review time and helps courts verify eligibility without extra requests.

  • Prepare PDF: Scan completed affidavit and supporting documents into a single PDF.
  • Add signatures: Sign and notarize, or apply permitted electronic signatures per court rules.
  • Submit to clerk: Upload via court e‑filing portal or deliver to clerk's office.
  • Await decision: Clerk or judge reviews and issues a fee waiver or denial.

Recommended digital form settings for online completion

When configuring an online affidavit, include required fields, conditional prompts, and a secure signing flow to capture consent and intent.

Field Configuration
Required Fields Mark name, income, household, and signature as mandatory.
Conditional Logic Show extra expense fields when household size exceeds thresholds.
Signature Capture Enable typed or drawn signatures with timestamped audit trail.
Authenticator Use email plus optional SMS code for signer verification.

Technical considerations for eSigning and submission

Ensure the platform you use supports secure upload, notarization workflows, and audit trails suitable for court review.

  • File formats: PDF, DOCX accepted by most courts.
  • Authentication: Email plus code or ID verification recommended.
  • Audit Trail: Capture IP, timestamps, and signer actions.

Platforms with integrated notarization or robust audit records ease clerk review; ensure the chosen service meets local court rules and evidence standards.

Essential elements to include in a professional Affidavit of Indigency

A well-structured affidavit presents clear facts under oath and attaches corroborating evidence to support the claim of inability to pay.

Affiant Identity

Full legal name, date of birth, and current address to reliably identify the person swearing the affidavit and match court records.

Household Composition

List all household members, relationships, and whether they contribute financially to establish the economic unit for means testing.

Income Breakdown

Itemize income sources and amounts (wages, benefits, child support) with frequency to allow clerks to evaluate total resources.

Monthly Expenses

Show typical monthly costs (housing, utilities, medical, transportation) to demonstrate obligations that impact ability to pay.

Supporting Evidence

Attach recent pay stubs, benefit letters, bank statements, or eviction notices to substantiate claims on the affidavit.

Oath and Signature

Signed under penalty of perjury and completed before a notary or authorized official to satisfy statutory authenticity requirements.

Document security and privacy considerations

Encryption in transit: TLS 1.2/1.3
Encryption at rest: AES-256
HIPAA support: BAA available
Audit trail: IP and timestamps
Access controls: Role-based permissions
Standards: SOC 2 Type II

Penalties and risks of incorrect or false affidavits

Perjury risk: Criminal penalties under state perjury laws
Fee denial: Application may be rejected by clerk
Case delays: Proceedings can be postponed
Civil liability: Potential sanctions or contempt
Immigration impact: Affects discretionary benefits in some contexts
Tax consequences: Incorrect financial reporting may trigger audits

Common mistakes to avoid when preparing the affidavit

  • Incomplete income detail: listing only net or only gross income without frequency causes confusion and may prompt requests for clarification.
  • Missing supporting documents: failing to attach pay stubs, benefit letters, or bank statements commonly results in denial or return for supplementation.
  • Unsigned or improper signature: signing without the required notary or authorized official invalidates the affidavit in many jurisdictions.
  • Inconsistent household info: differing household composition across filings (e.g., separate filings with contradictory membership) can trigger verification inquiries.

Timing expectations and typical deadlines

Processing times and deadlines vary by court; submit the affidavit as early as possible to avoid disruption of case filing or hearing schedules.

At time of filing:

File the affidavit with the initial case documents to request immediate fee relief.

Before hearing:

Submit at least several days before a scheduled hearing when possible to allow clerk review.

After denial:

Follow court instructions; some courts permit expedited reconsideration or supplemental documentation.

For appeals:

Affidavits for appellate filing fees should follow the appellate court's submission rules and timelines.

Clerk response time:

Expect variable response times; some clerks rule same day, others require multiple business days.

Key milestones from completion to decision

A simple milestone sequence clarifies what to expect between filing and the court’s decision on fee relief.

01

Prepare affidavit

Complete form and gather documentation before submission.

02

File with clerk

Submit affidavit with original case filing or as directed.

03

Clerk review

Clerk examines documentation and may request more information.

04

Waiver decision

Court or clerk issues fee waiver, partial waiver, or denial.

Representative use cases showing how affidavits enable access

These scenarios illustrate common contexts where an Affidavit of Indigency changes the filing outcome and preserves access to legal processes.

Civil Small Claims

A renter files an affidavit to waive court costs

  • Clerk requests recent pay stubs to confirm income
  • The clerk issues a fee waiver, allowing the tenant to pursue a defense without upfront payment and preserving access to relief.

Appeal Filing

An appellant requests an appellate fee waiver using an affidavit

  • The appellate clerk reviews attached benefit letters
  • The court grants in forma pauperis status, enabling the appeal to proceed despite limited funds.

Comparing eSignature providers for affidavit workflow integration

Cost and capability matter for high-volume affidavit processing; signNow appears first in the table to show a baseline of features and price.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies Varies Varies Varies
Bulk Send Yes Yes Yes Yes Varies
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No cap 100 envelopes/user/year Varies Varies Varies

Frequently asked questions about affidavits of indigency

Answers address signature validity, notarization, corrections, and retention to reduce common points of confusion.


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