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The form collects applicant identification details, ability to read/write, education, marital status, incarceration and competency status, and addresses. It also gathers employment, occupation, employer information, wages, unpaid leave, spouse/partner employment, and comprehensive monthly income and other sources for the past year. Instructions require complete answers, disclosure under penalty of perjury, and attaching supporting evidence such as pay stubs and tax documents.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/application-for-determination-of-indigency-application-for-fee-waiver/292748/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/application-for-determination-of-indigency-application-for-fee-waiver/292748.png","ImageObject",300,407,{"name":92,"@type":93},"Adam","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-28","2026-09-17",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Who should complete this indigency determination application?","Question",{"text":112,"@type":113},"The applicant submits the form to the court. If the applicant is underage or incapacitated, it is represented by a parent, legal guardian, or person with custody, and may proceed pro se.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What information is required about the applicant?",{"text":117,"@type":113},"The form requests name, date of birth, age, sex, marital status, ability to read/write, highest degree completed, physical and mailing addresses, and contact details. It also asks whether the person is incarcerated or admitted to psychiatric facilities and whether a court has declared incompetence.",{"name":119,"@type":110,"acceptedAnswer":120},"What financial details must be disclosed for the fee waiver request?",{"text":121,"@type":113},"The application requires employment status, occupation, employer name/address/telephone, wages, unpaid leave terms, and for the spouse/partner similar employment and unpaid leave information. It also requires gross monthly income, other monthly income sources (tips, commissions, interest, dividends, rental income, etc.), total income, and whether money was received in the past 12 months from specified categories.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},292748,1789654836,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":129,"read_time":46,"preview_page_count":4},1374404737137,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Commonwealth of Puerto Rico  \nGENERAL COURT OF JUSTICE  \n Supreme Court  Court of Appeals  \nCourt of First Instance ,  Superior  Municipal Court of    \n Plaintiff  Petitioner  \n Appellant  Other:  \nv.  \n Defendant  Respondent  Other:    \nCase No.    \nRE:    \nAPPLICATION FOR DETERMINATION OF INDIGENCY  \nTo the Honorable Court: Comes Now  \n,  \n First and Last Names   the applicant ,  \n the applicant’s representative,  \n the underage or incapacitated applicant , represented by a parent, legal guardian, or person with custody,  \npro se, and respectfully states, alleges, and prays:  \n1. The applicant is unable to assume the cost of:  Filling fees  \n Financial report (the potential guardian and the allegedly incapacitated person are both indigent)  \n Other:   as required by law.  \n2. I am convinced that the claim has merit.  \n3. In support of this application, I declare under penalty of perjury that the answers to the following questions are true.  \nINSTRUCTIONS: Complete all the questions in this form and sign it. Do not leave any questions unanswered. If the answer is “0,”“none,” or “not applicable,”write that as your response. If you need more space to answer a question attach a separate sheet ofpaper identified with your name, the parties to the action, the case number, and the question number.  \n\n| A. INFORMATION OF THE PERSON FOR WHOM THE FEE WAIVER IS REQUESTED: |\n| --- |\n| Name Initial First Last Name Second Last Name\u003Cbr>Date of Birth (day/month/year):   Age:   Sex:  Male  Female  Intersex  Identifies as:\u003Cbr>\u003Cbr>\u003Cbr> I rather not answer\u003Cbr>Marital Status:  Married  Single  Domestic Partnership Can you read?  Yes  No Can you write?  Yes  No\u003Cbr>Highest Degree Completed:    Elementary School  Middle School  High School  Technical Degree\u003Cbr> Associate Degree  Bachelor’s Degree  Master´s Degree  Doctorate\u003Cbr>Professional or Vocational Training:   Physical Address:  \u003Cbr>\u003Cbr>Is the physical address the same as the mailing address?  Yes  No ( Please provide  the mailing address) : \u003Cbr>Email:   Mobile Phone: (  )   Home Phone: (  )   |\n\n\n| .\u003Cbr>|\n| --- |\n| Is the person incarcerated?  Yes  No\u003Cbr>If so , provide the name of the institution:   Is the person admitted to a psychiatric hospital or prison psychiatric facility, ward, or unit?\u003Cbr> Yes  No\u003Cbr>If so, provide the name of the institution:   Has the person been declared incompetent by a court?  Yes  No\u003Cbr>If so, provide the date of the declaration of incapacity, the court that issued the decree, and the case number:  \u003Cbr>|\n| B. EMPLOYMENT AND FINANCIAL INFORMATION OF THE PERSON FOR WHOM THE FEE WAIVER IS REQUESTED, THEIR SPOUSE OR PARTNER, OR PARENTS , GUARDIANS , OR PERSON WITH CUSTODY , IN THE CASE OFA MINOR: (Specify each source of income and attach evidence of what is reported, such as pay stubs, employment verification, cheques, bank statements, income tax returns, certifications issued by the Municipal Revenue Collection Center (CRIM), certifications issued by the Child Support Administration (ASUME), contracts, among others). |\n| Are you employed?  Yes  No If so , provide the following information:\u003Cbr>Occupation:   Name of Employer:   Address:  \u003Cbr>\u003Cbr>Telephone: (  )   Ext.   Wages: $    weekly  biweekly  every fifteen days  monthly Are you on unpaid leave?  Yes  No\u003Cbr>If so , provide the term and type of leave: \u003Cbr>If unemployed, provide the date when you became unemployed (day/month/year):   Provide you employment experience during the past three (3) years ( include the name and address of your employer, date of employment , position and monthly wages earned ):\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>\u003Cbr>Is your spouse or partner employed?  Yes  No If so, provide the following information:\u003Cbr>Occupation:   Name of Employer:   Address:  \u003Cbr>\u003Cbr>Telephone: (  )   Ext.   Wages: $    weekly  biweekly  every fifteen days  monthly Is your spouse or partner on unpaid leave?  Yes  No\u003Cbr>If so, provide the term of the leave:  \u003Cbr>If your spouse or partner unemployed, provide the date when th","cbCaif780WtlnzMT","https://ap.wps.com/l/cbCaif780WtlnzMT","pdf",539195,"English","# Application overview\n## Applicant identification and eligibility\n## Incarceration and competency details\n## Employment and financial information\n## Additional income and last 12 months disclosures","[{\"question\":\"Who should complete this indigency determination application?\",\"answer\":\"The applicant submits the form to the court. If the applicant is underage or incapacitated, it is represented by a parent, legal guardian, or person with custody, and may proceed pro se.\"},{\"question\":\"What information is required about the applicant?\",\"answer\":\"The form requests name, date of birth, age, sex, marital status, ability to read/write, highest degree completed, physical and mailing addresses, and contact details. It also asks whether the person is incarcerated or admitted to psychiatric facilities and whether a court has declared incompetence.\"},{\"question\":\"What financial details must be disclosed for the fee waiver request?\",\"answer\":\"The application requires employment status, occupation, employer name/address/telephone, wages, unpaid leave terms, and for the spouse/partner similar employment and unpaid leave information. It also requires gross monthly income, other monthly income sources (tips, commissions, interest, dividends, rental income, etc.), total income, and whether money was received in the past 12 months from specified categories.\"}]","APPLICATION FOR DETERMINATION OF INDIGENCY - Application for Fee Waiver | PDF"]