USCA Form 32 "Motion for Waiver of Fees" - Washington, D.C.

What Is USCA Form 32?

This is a legal form that was released by the United States Court of Appeals for the District of Columbia - a government authority operating within Washington, D.C.. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2009;
  • The latest edition provided by the United States Court of Appeals for the District of Columbia;
  • 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 USCA Form 32 by clicking the link below or browse more documents and templates provided by the United States Court of Appeals for the District of Columbia.

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Download USCA Form 32 "Motion for Waiver of Fees" - Washington, D.C.

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U
S
C
A
NITED
TATES
OURT OF
PPEALS
D
C
C
ISTRICT OF
OLUMBIA
IRCUIT
333 Constitution Avenue, NW
Washington, DC 20001-2866
Phone: 202-216-7000 | Facsimile: 202-219-8530
USCA No.
MOTION FOR WAIVER OF FEES
I,
, declare that because of my
poverty I am unable to prepay the costs of retrieval and photocopying the requested documents in the above
case. My affidavit is attached.
I believe I am entitled to these documents because:
(Provide a statement of the reasons you wish to present to the Court.)
Signature
Name of Requester
Address
Submit original to:
Clerk
U.S. Court of Appeals for the D.C. Circuit
U.S. Courthouse, Room 5523
Washington, D.C. 20001
USCA Form 32
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August 2009 (REVISED)
U
S
C
A
NITED
TATES
OURT OF
PPEALS
D
C
C
ISTRICT OF
OLUMBIA
IRCUIT
333 Constitution Avenue, NW
Washington, DC 20001-2866
Phone: 202-216-7000 | Facsimile: 202-219-8530
USCA No.
MOTION FOR WAIVER OF FEES
I,
, declare that because of my
poverty I am unable to prepay the costs of retrieval and photocopying the requested documents in the above
case. My affidavit is attached.
I believe I am entitled to these documents because:
(Provide a statement of the reasons you wish to present to the Court.)
Signature
Name of Requester
Address
Submit original to:
Clerk
U.S. Court of Appeals for the D.C. Circuit
U.S. Courthouse, Room 5523
Washington, D.C. 20001
USCA Form 32
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August 2009 (REVISED)
UNITED STATES COURT OF APPEALS
FOR THE DISTRICT OF COLUMBIA CIRCUIT
AFFIDAVIT IN SUPPORT OF MOTION TO WAIVE FEES
I swear (affirm) that the responses which I make below to the questions concerning my ability
to pay the costs as stated in the motion are true.
1.
Are you presently employed?
Yes
No
a.
If the answer is "yes", state the amount of your salary or wages per month and
give the name and address of your employer. (List both gross and net salary.)
Gross salary and wages per month: $
Net salary and wages per month: $
Employer Name:
Address:
b.
If the answer is "no", state the date of your last employment and the amount of
the salary and wages per month which you received.
Date of last employment:
Salary and wages per month: $
Have your received within the past twelve months any income or property from any
2.
of the following sources?
a. Business, profession or other form of self-employment?
Yes
No
b. Rent payments, interest, or dividends?
Yes
No
c. Pensions, annuities or life insurance policies?
Yes
No
d. Gifts or inheritances?
Yes
No
e. Any other sources?
Yes
No
If the answer to any of the above is "yes", describe each source of money and state
the amount received from each during the past 12 months.
Source:
Amount: $
Amount: $
Source:
Source:
Amount: $
Source:
Amount: $
Source:
Amount: $
USCA Form 32
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August 2009 (REVISED)
3.
Do you own any cash or checking or savings accounts (including joint accounts)?
Yes
No
a. If the answer is "yes," state the total value of the items owned: $
4.
Do you own any real estate, stocks, bonds, notes, automobiles, or other valuable
property (excluding ordinary household furnishings and clothing)?
Yes
No
a. If the answer is "yes," describe the property and state its approximate value.
Approximate value: $
5.
List any persons who are dependent upon you for support, state your relationship to
those persons, and indicate how much you contribute toward their support.
Dependent:
Relationship:
Amount: $
Dependent:
Relationship:
Amount: $
Dependent:
Relationship:
Amount: $
Dependent:
Relationship:
Amount: $
Dependent:
Relationship:
Amount: $
I declare under penalty of perjury that the forgoing is true and correct.
Signature of applicant
Name of Requester
Address
Executed on:
USCA Form 53b
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August 2009 (REVISED)
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