Ohio R. Prac. S. Ct. app A
IN THE SUPREME COURT OF OHIO
Affdavit of Indigency
I, ________________________________________ , do hereby state that I am without the necessary funds to pay the costs of this action for the following reason(s):
[Note: S.Ct.Prac.R. 3.06 requires your affidavit of indigence to state the reason(s) you are unable to pay the docket fees and/or security deposit. Failure to state specific reasons that you are unable to pay will result in your affi davit being rejected for filing by the Clerk.]
Pursuant to Rule 3.06, of the Rules of Practice of the Supreme Court of Ohio, I am requesting that the filing fee and security deposit, if applicable, be waived.
____________________________________
Affant
Sworn to, or affrmed, and subscribed in my presence this _________ day of _______________________ , 20____.
____________________________________
Notary Public
My Commission Expires: _______________ .
[Note: This affi davit must be executed not more than six months prior to being filed in the Supreme Court in order to comply with S.Ct.Prac.R. 3.06. Affi davits not in compliance with that section will be rejected for filing by the Clerk.]
Ohio. R. Prac. S. Ct. app A