STATE OF SOUTH CAROLINA	)	IN THE FAMILY COURT
)	JUDICIAL CIRCUIT
COUNTY OF	)
)
)
)	MOTION AND AFFIDAVIT
Plaintiff,	)	TO PROCEED IN FORMA PAUPERIS
vs.	)
)
)
Defendant.	)	Docket No.

I, , being duly sworn, state that I am the Plaintiff and that I do not have the funds available to pay the costs of filing and service in this case. I request that the complaint be filed and service made without cost to me.

Sworn to before me this

______day of _________________,20_____

___________________________________	_____________________________________

Notary Public of South Carolina	Plaintiff

My Commission expires: _________________

ORDER

Leave is granted to proceed in forma pauperis.

Leave is denied to proceed in forma pauperis. This case will be dismissed without further order of the court if the filing fee and associated costs are not paid on or before _______________________,20____. (Family Court Only)

Date:	_________________, 20____
Family Court Judge
__________________________,S.C.

NOTICE TO PLAINTIFF:	The Court may assess costs against either party at hearing.

Custodial Parent (if applicable):

SCCA 405F (12/2009)

FFOR062 - Motion and Affidavit to Proceed In Forma Pauperis

2010-04-07