Statement of Inability to Afford Payment of Court Costs or an Appeal Bond
Form Approved by the Supreme Court of Texas by order in Misc. Docket No. 16-9122

1. Your Information
2. Are you represented by Legal Aid?
3. Do you receive public benefits?
4. What is your monthly income and income sources?
5. What is the value of your property?
6. What are your monthly expenses?
7. Are there debts or other facts explaining your financial situation?
8. Declaration