Poverty Affidavit Form Assistant

This interview will help you fill out a poverty affidavit that can be used in any common pleas, municipal or county court in Ohio. The court will use the information on your form to decide if you qualify to file in court without paying fees upfront.

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When to Use This Form

Learn when this form or letter might be useful to you.

In Ohio, the law says that anyone whose income before taxes is at or below 187.5% of the federal poverty level and whose monthly expenses equal or exceed their liquid assets qualifies to file in court without paying fees upfront. It also says that the court has discretion to grant a waiver to others depending on the circumstances.

If you believe that you are unable to pay your court costs upfront, you can file the Poverty Affidavit. If the court rejects your application, you will be asked to pay the fees within 30 days or your case will be dismissed.

After You Finish

Learn what to do when you have finished filling out this form.

Once you finish the Form Assistant: 

  • Fill in the last four digits of your social security number on the first page. To protect your privacy, we do not ask for that information in the Form Assistant interview. You can add it to the final PDF before you print it, or write it in by hand after you print it. 
  • Take the form to a notary.  Print out the form, but don’t sign anything yet. You will need to sign it in front of a notary. The notary will check your identification, watch you sign and stamp where needed with an official seal. You can find notaries at banks and some courthouses and libraries, or search for "notaries near me" on Google. You may be able to get the form notarized at the clerk of court’s office or at your court's self-help center, if they have one.
  • Make photocopies. After the notary stamps your documents, make at least one photocopy for your records.
  • File. Take the form to clerk’s office to be filed, along with the rest of the paperwork that you are filing for your legal matter.

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