How to Complete a Statement of Inability to Pay Costs

Courts in Texas have a new form to use when you want to file a lawsuit or appeal, and you can’t afford to pay the court costs. This form is the Statement of Inability to Afford Payment of Court Costs or an Appeal Bond.

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Statement of Inability to Pay Costs

We’ve made a video explaining how to fill out this thirteen-page document:

Introduction: The statement of inability to afford payment of court costs is a form you file with the court, so you may not have to pay court fees. This video shows you how to fill out this form.

Remember, this form is a legal document. You are swearing an oath that everything you say in this form is true. The information you put on this form must be complete and correct.

Let us get started filling out the form. You can pause the video after each section as you fill out the form, then return to the video.

Fill In The Caption Information

• The Caption Information will be on the first page. The Caption Information includes the cause number, the party’s names, the court and the county. If the cause number is not already entered, the clerk will enter it for you when you turn in the document. Enter the Plaintiff’s name and the Defendant’s name as it appears on your court document. Next, fill in the court number and the county. Then, check the box next to the type of court you are in.

Section 1—Your Information

• Section 1, page 2, where you can fill in your contact information.

Section 2 — Enter Dependent Information

• Section 2, page 3 is where you will enter your dependents. There is a space in this section to list any of your dependents. A dependent is anyone who relies on you for financial support. Typical examples are your children, your parents, or your spouse if they don’t work and pay for their living expenses.
• If you do not have any dependents, simply write “N/A” on the first line of this space.

Section 3—Are you represented by Legal Aid?

• Section 3, page 4 is where you will check the box telling the court whether you are represented by legal aid.
• If you applied for legal aid representation and qualified for their services, this is a good sign that you are unable to afford court costs.
• You must attach a letter from the legal aid showing that you qualified for their services.

Section 4—Do you receive public benefits?

• Section 4, page 5, is where you will check the box telling the court whether you receive public benefits.
• Select each box that describes a public benefit you receive.” If you select “other”, you must describe the benefit you receive in the space next to that choice. You must also attach some proof of the benefit, such as an award letter.

Section 5—What are your monthly income and income sources?

• Section 5, on pages 6 & 7, is where you will list all the ways you receive an income. Do not leave any space blank on this section. If you do not receive any income from a listed source, write “$0” in the amount space and “N/A” in the description space.
• If you need more space to describe “other sources of income”, attach another page to the form with the description, and write “See attached Exhibit” in the space provided.

Section 6—What is the value of your property?

• Section 6, page 8, is where you will list all your investments and property. Do not list the value of your household furnishings, clothing, tools of a trade, or personal effects.
• The “value” of property means the amount it would sell for, after subtracting the amount you still owe for it. The value is not the amount you paid for the property, unless it would still sell for the same amount, and you don’t owe any money on it.

Sometimes it is hard to decide how much property would sell for. This is usually not a set amount, so you must estimate the amount based on how much a similar piece of property in your area would sell for. Here are some online resources you can use to decide the sale value of a piece of property:

• For an automobile, you can enter your car’s information on Kelley Blue Book.com Slide (www.kbb.com).
• For real estate, you can look at the market value listed on your county’s appraisal district website.
• For other properties, you can look at how much similar items are selling for on an auction site like ebay.com.

Section 7—What are your monthly expenses?

• Section 7, page 9, is where you will list all your expenses. The court wants to know if you have any leftover income you can use to pay court fees after your other expenses are met. It is important not to leave spaces blank on this section. If you do not have an expense for a listed category, write “$0” in the amount space.
• It is unlikely that you will have zero dollars for monthly expenses for many of these. Don’t leave an expense out just because you are having a tough time estimating the monthly amount.

Here are some tips if you are stuck:

• If it is a yearly expense, instead of a monthly expense, divide the yearly amount by 12 to find the monthly amount.
• If it is a one-time expense that you are still making credit payments on it, you can put your monthly payment as the monthly amount.
• If it is an irregular expense, you can also add up the approximate yearly amount and divide by 12. For instance, let’s say you spend money on clothes, but you don’t buy clothes every month. Just add up the total amount you spent on clothes for the year, and divide by 12.

Section 8—Are there debts or other facts explaining your financial situation?

• Section 8, page 10, is where you tell the court about other debts or financial difficulties that you were unable to explain in any of the sections above. You do not have to write anything in this section.

Section 9 — Ability To Pay Court Costs

• Sections 9, on page 10, is where you will tell the court that you are not able to pay court costs or the appeal bond. Put an “X” in the box that applies. Only select the second box if you are filing an appeal of a justice court decision.
  Declaration & Signature Options
• Section 10, on Pages 11 through 13, is your declaration to the court. It also shows the two ways you can sign this document. You can sign this document by self-certifying that everything you put on this document is correct, or you can sign this document in front of a notary public.
• Remember, you are swearing an oath that everything you say in this form is true.

We hope this information has been helpful. Remember, if you have not already applied for legal aid services, you can apply at Lone Star legal aid, online or over the phone.