What is the Statement of Inability to Afford Payment of Court Costs?

It is a bilingual court form for describing your financial situation and stating that you cannot afford court costs or, in some appeals, an appeal bond or cash deposit.

Who fills out this form?

A person in a court case who cannot afford court costs or an appeal bond can fill it out with information about income, property, expenses, debts, and other financial circumstances.

Ellis County, TX · Ellis County

No notary required

Statement of Inability to Afford Payment of Court Costs or an Appeal Bond

This bilingual form lets a person in a court case explain their finances and ask the court to waive court costs or an appeal bond.

At a glance

Issued by: City of Ellis County · Ellis County, Ellis County, Texas
Notarization: Not required: file this form without a notary.
Official source: tx-elliscounty3.civicplus.com
Blank form: Download the PDF
Catalogued: Oct 5, 2026
Machine-readable: JSON record · about the forms index

What this form is

A person files this form in a court case to state that they cannot afford court costs or, when appealing a justice court decision, an appeal bond or cash deposit. It asks about dependents, legal aid, benefits, income, property, expenses, debts, and other financial circumstances. The signer chooses either a declaration under penalty of perjury or an affidavit option.

Who needs it

A person in a court case who cannot afford court costs or an appeal bond can use this form to provide financial information to the court.

How to submit it

File the form with the court clerk; the clerk fills in the cause number when you file it.

About notarization

Option 1 is signed and dated without a notary; Option 2 requires completing the affidavit section before a notary if you do not want to list your address.

How to submit this form

1
Download the Form
Download the Statement of Inability to Afford Payment of Court Costs or an Appeal Bond.
2
Complete the Form
Fill in your court and personal information and answer the questions about dependents, benefits, income, property, expenses, and debts.
3
Gather Supporting Documents
Attach proof of public benefits if applicable, and any legal aid certificate or other legal aid document that applies.
4
Choose and Sign a Declaration Option
Complete either Option 1 or Option 2. Option 2 is completed before a notary if you do not want to list your address.
5
File with the Court Clerk
File the form with the court clerk, who fills in the cause number.

Frequently asked questions

What is the Statement of Inability to Afford Payment of Court Costs?: It is a bilingual court form for describing your financial situation and stating that you cannot afford court costs or, in some appeals, an appeal bond or cash deposit.
Who fills out this form?: A person in a court case who cannot afford court costs or an appeal bond can fill it out with information about income, property, expenses, debts, and other financial circumstances.
Do I need a notary for the Statement of Inability to Afford Payment of Court Costs?: No, if you choose Option 1, the declaration. Option 2 requires completing the affidavit section before a notary if you do not want to list your address.
How do I submit the Statement of Inability to Afford Payment of Court Costs?: File the completed form with the court clerk. The clerk fills in the cause number when you file it.

Need something notarized?

This Statement of Inability to Afford Payment of Court Costs or an Appeal Bond doesn’t need a notary, but Texas residents can notarize other documents online with a commissioned online notary.