Applicant
Full legal name, contact details, date of birth and any case number to link the request to the court record, plus current mailing address.
A properly completed application preserves access to justice when a litigant cannot immediately pay filing and service fees. It prevents dismissal for nonpayment, establishes an official record of financial hardship, and may reduce or eliminate cost barriers that would otherwise delay case progress.
This form is used by individuals, guardians, and some nonprofit or public-interest litigants seeking relief from court costs.
Full legal name, contact details, date of birth and any case number to link the request to the court record, plus current mailing address.
Court name, case number, party role (plaintiff, defendant), and a brief case description to ensure the court associates the application with the correct file.
All income sources with gross amounts: wages, benefits (Social Security, VA, unemployment), pensions, child support, and any regular transfers received.
Monthly household expenses including rent/mortgage, utilities, transportation, medical costs, insurance, and childcare to demonstrate financial burden.
Bank balances, vehicles, real property, stocks, retirement accounts, and other assets with approximate values and commentary on liquidity.
A signed, dated declaration under penalty of perjury certifying that the information is true and that inability to pay is genuine.
| Field | Configuration |
|---|---|
| Upload Documents | Accept PDF, DOCX; limit file sizes per court portal rules. |
| Signer Order | Applicant signs first, then attorney or representative if applicable. |
| Authentication | Use email link or SMS code for identity confirmation. |
| Save Copies | Auto-save signed PDF and certificate to case folder. |
Courts vary in whether they accept electronic signatures and which eFiling providers integrate with their systems.
Confirm court local rules before eSubmission and retain complete signed copies plus any platform-generated audit trail for court review and appeals.
File before required payment deadlines to avoid dismissal.
Processing often takes days to weeks depending on caseload.
Some courts schedule a hearing within 14–30 days.
A granted deferral may temporarily postpone payment obligations.
Check local rules for timelines to contest a denial.
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