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Civil Rule 3.2 Actions in Forma Pauperis a. Affidavit. All actions sought to be filed in forma pauperis, pursuant to 28 U.S.C. § 1915, must be accompanied by an affidavit that includes a statement of all assets which shows inability to pay initial fees or give security. This affidavit must consist of a declaration in support of request to proceed in forma pauperis. This declaration must contain the following: 1. A statement as to current employment including the amount of wages or salary per month and the name and address of the current employer. 2. A statement, if not currently employed, as to the date of last employment and the amount of wages or salary per month which was received. 3. A statement as to any money received within the past twelve months from any of the following sources: a) Business, profession, or self-employment; b) Rent payments, interest, or dividends; c) Pensions, annuities, or life insurance payments; d) Gifts or inheritances; e) Any other source. The statement must include a description of each source of money and the amount of money received from each source during the past twelve months. 4. A statement as to any cash in possession and as to any money in a financial institution, including checking, savings, and any other accounts. The statement must include any money available to the declarant. 5. A statement as to any real estate, stocks, bonds, notes, automobiles, investments, or other valuable property (excluding ordinary household furnishings and clothing). The statement must describe the property and state its approximate value. 6. A statement as to all persons who depend upon the declarant for support. The statement must include the relationship of the dependents and the amount contributed toward their support. 7. A statement that, because of poverty, there is an inability to pay the initial costs of the proceeding or give security therefore, and the declarant's belief that the declarant is entitled to relief. This declaration must be executed under penalty of perjury. b. Prison Account Certification. In actions by incarcerated persons who seek to bring a civil action or appeal a judgment in forma pauperis, the affidavit requesting leave to proceed in forma pauperis must contain a certified copy of the trust fund account statement (or institutional equivalent) for the prisoner for the 6-month period immediately preceding the filing of the suit or notice of appeal, obtained from the appropriate official of each prison at which the prisoner is or was confined. c. Partial Fee Assessment for Prisoners. In considering a prisoner's requests to proceed in forma pauperis, the Court must assess and, when funds exist, collect, as a partial payment of any court fees required by law, an initial partial filing fee of 20 percent of the greater of (1) the average monthly deposits to the prisoner's account; or (2) the average monthly balance in the prisoner's account for the 6-month period immediately preceding the filing of the complaint or notice of appeal. Thereafter, the prisoner is required to make monthly payments of 20 percent of the preceding month's income credited to the prisoner's account. The agency having custody of the prisoner must forward payments from the prisoner's account to the Clerk of the Court each time the amount in the account exceeds $10 until the filing fees are paid. d. Partial Fee Assessment for Non-Prisoners. In considering a non-prisoner's request to proceed in forma pauperis, the Court may, in its discretion, impose a partial filing fee which is less than the full filing fee that is required by law, but which is commensurate with the applicant's ability to pay. e. Partial Fee Waiver. In all actions sought to be filed in forma pauperis pursuant to 28 U.S.C. § 1915(a), and in which the person has insufficient assets or means by which to pay the full or assessed partial filing fee, the person may submit an application for waiver of the initial partial filing fee. In order to qualify for a waiver, the person must justify depletions of the previously adequate account or income history to show that the depletion was not a deliberate attempt to avoid payment of initial filing fees. f. In Forma Pauperis Procedure. All persons must submit the request to proceed in forma pauperis, accompanied by the affidavit required by 28 U.S.C. § 1915(a)(1) and Civil Local Rule 3.2.a, at the time the suit or notice of appeal is submitted for filing. Incarcerated persons must also attach the 6-month prison account certification required by 28 U.S.C. § 1915(a)(2) and Civil Local Rule 3.2.b. Applications for partial fee waivers (if any) pursuant to 28 U.S.C. § 1915(b)(4) and Civil Local Rule 3.2.e may also be submitted at the time the suit or notice of appeal is submitted for filing. NO PARTIAL FEE CHECKS WILL BE ACCEPTED UNTIL THE COURT REVIEWS THE AFFIDAVIT AND ACCOUNT INFORMATION SUBMITTED IN SUPPORT OF A PRISONER'S REQUEST TO PROCEED IN FORMA PAUPERIS AND ISSUES AN ORDER ASSESSING THE AMOUNT OF INITIAL FEE WHICH IS DUE. The Clerk of the Court is authorized to return any partial fee check submitted prior to the Court's partial fee assessment order. g. Fee Collection Cap. In no event will the fee collected exceed the amount of fees permitted by statute for the commencement of a civil action or an appeal of a civil action or criminal judgment.