AFFIDAVIT OF INDIGENCY
DEPENDENTS NAME(S) AGE RELATIONSHIP ARE YOU CURRENTLY A CORRECTIONAL FACILITY? ... $ D. Stocks and Bonds (provide description) 1. $ 2. $ E. Other Property (large equipment, watercrafts, etc.) 1. $ 2. $ F. Bank Accounts. BANK NAME. TYPE OF ACCOUNT. BALANCE $ $ G. Other Assets (identify) $ ASSETS TOTAL VALUE ... ................
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