Can I e-sign the application?

Yes. Electronic signatures are legally valid under the ESIGN Act and UETA when the signer shows intent, consents to electronic records, the signature is attributable, and the record can be retained and reproduced.

Some courts or specific declarations may require notarization; Florida commonly requires notarization for certain affidavit-style declarations and some documents may also require two witnesses.

What supporting documents are required?

Typical proof includes recent pay stubs, benefit letters, bank statements, and photo ID. Provide copies sufficient to corroborate income and assets.

What if the court asks for more information?

Promptly submit requested documents or amended forms. Failure to respond can result in denial of fee relief and possible case delays.

Will applying delay my case?

A short administrative delay is possible while the clerk or judge reviews the application; complete submissions reduce the chance of extended postponements.

Can false statements lead to charges?

Yes. Deliberately false statements on sworn forms may expose the applicant to perjury charges and sanctions under state law.

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Florida Application for Determination of Civil Indigent Status

Florida Application for Determination of Civil Indigent Status

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

APPLICATION FOR DETERMINATION OF CIVIL INDIGENT STATUS

IN THE CIRCUIT/COUNTY COURT OF THE JUDICIAL CIRCUIT

IN AND FOR COUNTY, FLORIDA

_____________________________________ CASE NO.

vs.

Notice to Applicant: If you qualify for civil indigence you must enroll in the Clerk’s Office payment plan and pay a one-time administrative fee of $25.00.

1. I have dependents. (Do not include children not living at home and do not include a working spouse or yourself.)

2. I have a take home income of $ paid weekly bi-weekly semi-monthly monthly yearly

(Take home income equals salary, wages, bonuses, commissions, allowances, overtime, tips and similar payments, minus deductions required by law and other court ordered support payments)

3. I have other income paid weekly bi-weekly semi-monthly monthly yearly: (Circle “Yes” and fill in the amount if you have this kind of income, otherwise circle “No”)

Social Security benefits.................... Yes $ No

Unemployment compensation......... Yes $ No

Union Funds...................................... Yes $ No

Workers compensation.................... Yes $ No

Retirement/pensions......................... Yes $ No

Trusts or gifts.................................... Yes $ No

Veterans’ benefits............................ Yes $ No

Child support or other regular support from family members/spouse.... Yes $ No

Rental income.................................. Yes $ No

Dividends or interest....................... Yes $ No

Other kinds of income not on the list... Yes $ No

4. I have other assets: (Circle “yes” and fill in the value of the property, otherwise circle “No”)

Cash................................................... Yes $ No

Bank account(s)................................ Yes $ No

Certificates of deposit or money market accounts.... Yes $ No

*Equity in Motor vehicles/Boats/Other tangible property.... Yes $ No

Savings............................................. Yes $ No

Stocks/bonds..................................... Yes $ No

*Equity in Real estate (excluding homestead).... Yes $ No

*include expectancy of an interest in such property

5. I have a total amount of liabilities and debts in the amount of $ ,

6. I have a private lawyer in this case Yes No

A person who knowingly provides false information to the clerk or the court in seeking a determination of indigent status under s. 57.082, F.S. commits a misdemeanor of the first degree, punishable as provided in s.775.082, F.S. or s. 775.083, F.S. I attest that the information I have provided on this application is true and accurate to the best of my knowledge.

Signed this day of , 20 .

Date of Birth

Drivers License or ID Number

Signature of Applicant for Indigent Status

NOTICE: If the applicant is determined by the clerk to be Not Indigent, you may seek judicial review by filing a petition with the court.

CLERK’S DETERMINATION

Based on the information in this Application, I have determined the applicant to be Indigent Not Indigent, according to s. 57.082, F.S.

Dated this day of , 20 .

Clerk of the Circuit court

This form was completed with the assistance of

Final approval by The Florida Supreme Court on June 30, 2005.

What the Florida Application for Determination of Civil Indigent Status Is

The Florida Application for Determination of Civil Indigent Status is a court-facing form used to evaluate whether a party in a civil case qualifies for fee waivers, reduction of costs, or appointment of counsel based on financial need. Courts use the information to decide eligibility for exemptions from filing fees, service fees, transcript costs, and other expenses tied to civil litigation. The application collects detailed household income, assets, monthly expenses, and other financial facts to determine whether the applicant meets the local court’s indigency standard.

Why this application matters for Florida civil cases

Determining indigency can remove barriers to access to the civil justice system by waiving fees and enabling representation or other court services for eligible applicants.

Who completes and reviews the application

Accurate completion helps the court resolve fee matters quickly and reduces the risk of denial or later sanctions for false statements.

Self-represented litigants preparing the form to request fee waivers or appointed counsel.
Legal aid attorneys or pro bono counsel submitting applications on behalf of clients.
Court clerks and judges who verify information and issue rulings on fee relief.

Core parts of a professional, court-ready application

A complete Florida Application for Determination of Civil Indigent Status contains consistent sections and clear supporting documentation so courts can make an eligibility decision without unnecessary follow-up.

Applicant details

Full legal name, date of birth, contact information and relationship to the case; establishes identity and role in litigation.

Household composition

Names and relationships of household members and dependents; used to calculate household size for means testing.

Income statement

Monthly and annual income sources (wages, benefits, child support, pensions); shows gross and net amounts relevant to eligibility.

Asset inventory

List of bank accounts, vehicles, real property, and other assets with estimated values; courts may consider liquid assets separately.

Monthly expenses

Housing, utilities, medical, transportation, and debt payments; supports claims about inability to pay court fees.

Declaration and signature

Signed statement under penalty of perjury attesting to truthfulness, date, and signature of applicant (notarization if required).

Step-by-step: completing the application

Follow this sequence to gather documents, populate the form, and submit to the clerk’s office.

01

Gather documents: Collect pay stubs, benefit letters, bank statements, and ID.
02

Complete form: Fill every required field using instructed formats.
03

Attach support: Include copies of documents that substantiate income and assets.
04

File with court: Submit in person, by mail, or electronically per local clerk rules.

What happens after you submit the application

Understanding the clerk and judicial review steps helps set expectations and plan next actions.

Clerk intake: Clerk reviews for completeness and logs the filing.
Judicial review: Judge or magistrate evaluates eligibility and supporting documents.
Order issued: Court issues an order granting, denying, or partially granting relief.
Appeal or motion: If denied, file a motion for reconsideration or follow local appellate procedures.

Configuring an online submission workflow

Set up digital routing that mirrors the court’s paper process to keep records consistent.

Field	Configuration
Document type	Form PDF with fillable fields
Required fields	Lock critical fields to prevent accidental edits
Attachments	Allow PDF/JPEG uploads for proofs
Routing	Send to clerk then to judicial reviewer

Digital submission and signature considerations

Align the eSubmission setup with court clerk requirements and state law on e-records to avoid rejection or evidence issues.

Authentication: Email plus SMS or multi-factor gives stronger signer attribution.
Audit trail: Capture IP, timestamp, and action log for each signer event.
File formats: Accept PDF/A and PDF with embedded fields to preserve form fidelity.

Common mistakes that delay review

Incomplete income details or missing dates causing requests for more information
Omitting required supporting documents such as recent pay stubs or benefit letters
Using inconsistent names or addresses between form and attachments
Failing to sign or date the declaration under penalty of perjury

Consequences of incorrect, misleading, or false information

Denial of relief: Court may refuse fee waivers or appointment of counsel

Case delays: Additional filings or hearings may be ordered

Sanctions: Noncompliance can trigger court sanctions or fines

Perjury exposure: False statements may lead to criminal charges

Loss of credibility: Court may weigh credibility in later proceedings

Record rejection: Court clerk may reject incomplete or unsigned submissions

Real-world uses of the Florida indigency application

These scenarios illustrate how the application is used across typical civil matters.

Housing Eviction Defense

A tenant files the application with pay stubs and benefits letters to request a waiver of filing fees

The court reviews income and household size
The judge grants a partial waiver and schedules a hearing, reducing the tenant’s immediate out-of-pocket costs while preserving the case.

Family Law Filing

A parent seeking custody files for fee relief and attaches a bank statement and unemployment documentation

The clerk forwards the application to the judge for review
The court grants relief and refers the matter to family services for mediation given the applicant’s limited resources.

Representative people involved

Applicant — Self-Represented

An individual with limited income who completes the form, attaches proof of benefits and pay, and signs the declaration under penalty of perjury; they often request fee waivers or appointed counsel.

Clerk / Judge

Court personnel who verify form completeness, confirm required attachments, and issue an order granting or denying indigency status; they apply local rules and judicial discretion in evaluations.

eSignature vendors to consider for secure submission (signNow listed first)

Vendors differ by pricing model, feature set, and compliance posture. Below is a concise comparison focused on starting price and select capabilities relevant to submitting court forms electronically.

	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, no credit card	Varies by vendor	Varies by vendor	Varies by vendor	Varies by vendor
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Frequently asked questions about the Florida indigency application

Answers below cover typical points of confusion about form completion, submission, and electronic signing.

Need help? Contact support

Can I e-sign the application?
Yes. Electronic signatures are legally valid under the ESIGN Act and UETA when the signer shows intent, consents to electronic records, the signature is attributable, and the record can be retained and reproduced.
Do I need a notary?
Some courts or specific declarations may require notarization; Florida commonly requires notarization for certain affidavit-style declarations and some documents may also require two witnesses.
What supporting documents are required?
Typical proof includes recent pay stubs, benefit letters, bank statements, and photo ID. Provide copies sufficient to corroborate income and assets.
What if the court asks for more information?
Promptly submit requested documents or amended forms. Failure to respond can result in denial of fee relief and possible case delays.
Will applying delay my case?
A short administrative delay is possible while the clerk or judge reviews the application; complete submissions reduce the chance of extended postponements.
Can false statements lead to charges?
Yes. Deliberately false statements on sworn forms may expose the applicant to perjury charges and sanctions under state law.

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