Form CIV-GP-16 "Affidavit in Support of an Application to Proceed as a Poor Person and Authorizing the State to Pay the Costs for the Production of a Stenographic Transcript" - New York City

What Is Form CIV-GP-16?

This is a legal form that was released by the New York City Civil Court - a government authority operating within New York City. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2004;
  • The latest edition provided by the New York City Civil Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CIV-GP-16 by clicking the link below or browse more documents and templates provided by the New York City Civil Court.

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Download Form CIV-GP-16 "Affidavit in Support of an Application to Proceed as a Poor Person and Authorizing the State to Pay the Costs for the Production of a Stenographic Transcript" - New York City

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CIVIL COURT OF THE CITY OF NEW YORK
County of
Index No.:
Part
in the matter of the Application of
AFFIDAVIT IN SUPPORT OF
AN APPLICATION TO PROCEED
AS A POOR PERSON
to prosecute as a poor person against
AND AUTHORIZING THE STATE
TO PAY THE COSTS
FOR THE PRODUCTION OF
A STENOGRAPHIC TRANSCRIPT
State of New York, County of
ss:
, being duly sworn, deposes and says:
1. I am the party named as
in the above titled action.
2. The case was tried before Judge
.
3. 1 request that an Order be granted:
AUTHORIZING THE STATE TO PAY THE COSTS FOR THE STENOGRAPHIC TRANSCRIPT.
The estimate* of the costs for the production of the transcript is $
[*Attach estimate(s) and total them if more than one.]
pay
If no Notice of' Appeal is to be filed, but a request for the State to
the costs for the production of a transcript is being submitted,
please state why the transcript is needed
.
4. 1 make this application based on CPLR §1101. I do not have, nor am I able to obtain, the funds needed to file a
Notice of Appeal and/or to pay for the stenographic transcript. I will be unable to proceed unless the Order is granted.
5. 1 am/am not a recipient of Public Assistance from the Department of Social Services of the City of New York.
(strike one).
6. 1 have no income other than the sum of $
per
from
.
7. 1 own no property of any kind except necessary personal wearing apparel and
.
8. No other person is beneficially interested in the recovery sought.
9.
a) I have not made a previous application for this or similar relief
b) I have made previous application(s) for this or similar relief, but I am making this further application
because
Sworn to before me this
day of
Sign your name
20
Print your address
Signature of Court Employee and Title
Telephone Number
CIV-GP-16-i (Revised 1/04)
FREE CIVIL COURT FORM
No fee may be charged to fill in this form.
Form can be found at: http://www.nycourts.gov/courts/nyc/civil/forms.shtml.
CIVIL COURT OF THE CITY OF NEW YORK
County of
Index No.:
Part
in the matter of the Application of
AFFIDAVIT IN SUPPORT OF
AN APPLICATION TO PROCEED
AS A POOR PERSON
to prosecute as a poor person against
AND AUTHORIZING THE STATE
TO PAY THE COSTS
FOR THE PRODUCTION OF
A STENOGRAPHIC TRANSCRIPT
State of New York, County of
ss:
, being duly sworn, deposes and says:
1. I am the party named as
in the above titled action.
2. The case was tried before Judge
.
3. 1 request that an Order be granted:
AUTHORIZING THE STATE TO PAY THE COSTS FOR THE STENOGRAPHIC TRANSCRIPT.
The estimate* of the costs for the production of the transcript is $
[*Attach estimate(s) and total them if more than one.]
pay
If no Notice of' Appeal is to be filed, but a request for the State to
the costs for the production of a transcript is being submitted,
please state why the transcript is needed
.
4. 1 make this application based on CPLR §1101. I do not have, nor am I able to obtain, the funds needed to file a
Notice of Appeal and/or to pay for the stenographic transcript. I will be unable to proceed unless the Order is granted.
5. 1 am/am not a recipient of Public Assistance from the Department of Social Services of the City of New York.
(strike one).
6. 1 have no income other than the sum of $
per
from
.
7. 1 own no property of any kind except necessary personal wearing apparel and
.
8. No other person is beneficially interested in the recovery sought.
9.
a) I have not made a previous application for this or similar relief
b) I have made previous application(s) for this or similar relief, but I am making this further application
because
Sworn to before me this
day of
Sign your name
20
Print your address
Signature of Court Employee and Title
Telephone Number
CIV-GP-16-i (Revised 1/04)
FREE CIVIL COURT FORM
No fee may be charged to fill in this form.
Form can be found at: http://www.nycourts.gov/courts/nyc/civil/forms.shtml.