Petition for Waiver of Fees/Costs - Affidavit of Indigency (Allegation of Imminent Danger)

This form is a petition used to ask the court for a waiver of fees and costs because the person filing it claims they are poor. It also includes a section for making an allegation of imminent danger.

Common questions

Who should fill out this form?

The form is titled as a 'Prisoner's Petition,' suggesting it is for a prisoner to complete. The instructions say the petitioner should print or type their name in the designated spot.

What information does this form ask for?

It asks for detailed financial information, including current income, assets like savings and real estate, and any legal obligations. It also requires a statement about the alleged danger.

Is there a filing fee mentioned?

The form is specifically for requesting a waiver of fees and costs, meaning the filer is stating they cannot prepay those costs.

Revision history

No changes recorded since we started tracking this form on October 10, 2026. The current version took effect September 1, 2004.

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