Blank New York Poor Person PDF Form

Blank New York Poor Person PDF Form

The New York Poor Person form is a legal document that allows individuals with limited financial resources to request permission to appeal a court decision without the burden of court fees. This form is essential for those seeking legal representation in family court appeals, ensuring that financial constraints do not hinder their access to justice. If you find yourself in need of this form, click the button below to get started on filling it out.

The New York Poor Person form is a crucial document for individuals seeking to appeal a family court decision without the financial means to hire an attorney. This form allows those who qualify to request permission to proceed as a poor person and to have counsel assigned to them. The process begins with a Notice of Motion, where the title of the case must be correctly stated, and specific dates need to be filled in. The motion papers must be served on all relevant parties, including any attorneys involved and the County Attorney. Proper service is essential, as it dictates the return date for the motion, which varies depending on whether the papers are delivered in person or by mail. After serving the motion, the original papers, along with proof of service and any necessary supporting documents, must be submitted to the court. It is important to note that there will be no oral argument on the return date of the motion. The form also includes an affidavit in support of the motion, where the applicant provides personal details, the nature of the proceeding, and financial information to demonstrate their need for assistance. Completing this form accurately and thoroughly is vital for those who wish to ensure their right to appeal is protected.

Document Sample

STATE OF NEW YORK

SUPREME COURT, APPELLATE DIVISION

THIRD JUDICIAL DEPARTMENT

P.O. BOX 7288, CAPITOL STATION

ALBANY, NY 12224

INSTRUCTIONS FOR MOVING FOR PERMISSION TO PROCEED

AS A POOR PERSON AND FOR ASSIGNMENT OF COUNSEL ON A FAMILY COURT APPEAL

1)At the top of the attached form is a Notice of Motion. The title of the case should be placed on the left hand side of the form and it should be written as the title appeared on the order or judgment appealed from. This is the caption. Below the caption is a sentence which begins "Please take notice...". The first date to be filled in is the date the attached affidavit in support of the motion was notarized. The second date to be filled in is the return date of the motion, which should be a Monday after service of the motion papers upon all parties as described in paragraph 2 below.

2)The motion papers should be served on all parties (if a party is represented by an attorney, service of a copy should be made upon the attorney and if a party is represented by the Office of the Attorney General, service of a copy should be made upon that office), and on the County Attorney of the County in which the papers from the lower court were filed and any Attorney for the Child. If service of the motion papers is done by personal delivery, the motion should be made returnable on a Monday at least eight (8) days after such service. If service of the motion papers is done by mail, the motion should be made returnable on a Monday at least thirteen (13) days after the motion papers are mailed.

3)As soon as possible after service of copies of the motion papers, the original motion papers, as well as proof that you have served the motion papers on the other parties, the County Attorney and the Attorney for the Child, should be forwarded to this office. If the motion is being made in connection with an appeal to this Court, you should also attach to the motion papers a copy of the order or judgment being appealed from, the decision, if any, upon which the order or judgment was based, and a copy of the notice of appeal.

4)THERE WILL NOT BE ORAL ARGUMENT ON THE RETURN DATE OF THE MOTION.

Revised:

February 19, 2014

1

Please fill in the underlined spaces in the follow ing form. Return the original to this Court, forward one copy to each of your adversaries, forward one copy to the County Attorney, one copy to the Attorney for the Child and keep one for your records.

STATE OF NEW YORK

 

SUPREME COURT

APPELLATE DIVISION

 

THIRD DEPARTMENT

IN THE MATTER OF

 

 

 

 

 

,

 

Petitioner(s) ,

v

 

 

 

 

,

 

 

 

 

Respondent(s) .

 

 

 

 

NOTICE OF

MOTION FOR PERMISSION TO PROCEED AS A POOR PERSON/ ASSIGNMENT OF COUNSEL ON APPEAL OF AN ORDER OF FAMILY COURT

Family Court

Docket No./ Index No.:

Appellate Division

Case No.

PLEASE TAKE NOTICE that, upon the annexed affidavit sworn to on the

 

day of

, 20

 

, a motion will be made to this court, on the

 

day of

 

 

 

 

 

 

 

 

,20 , in the City of Albany New York, for an order

granting the appellant permission to appeal as a poor person.

Dated:

(Signature)

(Print Name)

(Address)

(Your name, address and telephone number)

DIN # (if applicable)

(Telephone)

PLEASE TAKE NOTICE that, pursuant to section 800.2 (a) of the Rules of this Court, this motion will be submitted on the papers, and the personal appearance of counsel or the parties is neither required nor permitted.

Revised:

February 19, 2014

2

AFFIDAVIT IN SUPPORT OF MOTION

STATE OF NEW YORK

COUNTY OF

 

ss.:

 

 

 

, being duly sworn, deposes and says

that I make this affidavit in support of my application for poor person status and assignment of counsel.

1.My full name and date of birth is:

2.What is the nature of the above entitled proceeding?

3.

I am appealing from a judgment/order of

 

Court,

 

County,

 

 

 

 

 

 

which provides as follows:

(Please attach hereto a copy of the order or judgment appealed from, the decision, if any, upon which the order or judgment is based, and a copy of your notice of appeal.)

4.

a.

An order or judgment has been entered in the

 

 

 

Court Clerk’s

 

 

 

 

 

 

 

 

 

 

 

 

 

Office on

, 20

.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b.

A copy of that

order or judgment was served on me on

, 20

.

 

 

 

 

 

 

 

 

 

 

 

 

 

c.Have you filed an original and two copies of any notice of appeal with the Clerk of the

appropriate court?

 

Yes

 

No

If yes, when?

 

 

 

 

 

 

 

 

 

 

 

 

 

d.If yes, have you served a copy of the notice of appeal on your adversaries and the

attorney for the child?

Yes

No

 

 

 

 

If yes, when?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

e.

Were you represented by counsel?

 

Yes

No

 

Counsel's name and address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(if applicable)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Revised:

February 19, 2014

3

f.

Was counsel assigned or retained?

Assigned

 

Retained

 

 

 

 

 

5.If you were represented by retained counsel in the court below, state the name and address of the person who paid his/her fee and the amount.

6.What relief are you seeking by this motion?

7.What facts are present to support your contention that there is merit to your appeal? (Attach additional documentation, if necessary.)

8.Are you able to pay the costs, fees and expenses necessary to maintain the appeal?

YesNo

9. Are youSingleMarriedSeparatedDivorced

If married, what is the name of your spouse?

What are the first names and ages of your children?

Revised:

February 19, 2014

4

10.What is your occupation? If you are a student, indicate the school which you attend and the name and address of the person who is paying your tuition, room and board.

11. Are you are employed?

Yes

 

No

 

If yes, please state your weekly salary and

 

 

 

 

 

 

provide the name and address of your employer. Please provide a copy of your most recent pay

stub.

12.If married and your spouse is employed, what is his/her weekly gross salary and the name and address of his/her employer?

13. Do you receive support from anyone? Yes

 

No

 

If yes please provide the name,

 

 

 

 

 

relationship, address and the amount of support provided to you.

Revised:

February 19, 2014

5

14. Do you support anyone? Yes

 

No

If yes, please provide the name, relationship,

 

 

 

 

 

 

 

 

address and the amount of support you provide.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15. Do you own real estate either by yourself or with someone else? Yes

 

No

If yes please provide the following information:

 

 

 

 

a.Other owner(s) (if any):

b.Location (street address, mailing address; Town, County, State):

c.Current value, including improvements:

d.Existing mortgages and/or liens (Attach additional sheet if required):

1.Name of bank, mortgagee or lien holder:

2.Balance due:

16.List the location and amount of any savings or checking accounts held in your name or jointly with others (Attach additional sheet if required):

Location (Bank)

 

Type

 

Owners

 

Balance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Revised:

February 19, 2014

6

17.List any stocks, bonds, trusts or cash on hand owned by you in which you have any benefit and give the type, location and value of each (Attach additional sheet if required):

18.Please state the year, make model and value of any motor vehicle(s) owned by you and the amount of any existing loan(s):

19. Do you own any other assets not listed above? Yes

 

No

 

 

 

20.If yes please describe the assets(s) and state the value (Attach additional sheet if required):

21.My monthly income and expenses are as follows:

INCOME: My salary

My spouse's earnings Other income

TOTAL

EXPENSES:

Rent or mortgage payment

Food

Utilities (heat, telephone, water, electric, cable)

Automobile expenses

Premiums on life or medical insurance policies

Repayment of loans

Name of creditor and amount

Other obligations, including alimony /support

TOTAL

Revised:

February 19, 2014

7

22. Is any other person beneficially interested in any recovery sought herein?

Yes

 

No

 

 

 

 

 

 

If so, is such person able to pay the costs, fees and expenses of maintaining the appeal?

Yes

 

No

 

 

 

 

 

 

 

 

 

 

 

23.Do you authorize the Court to make any inquiries or investigation concerning the answers given

to you in this affidavit?

Yes

 

No

 

 

 

 

24.Did someone else complete this form on your behalf?

Yes No

25.If "yes" to question 24, were the questions and answers read to you and are your

answers true?

Yes

 

No

 

 

 

 

(Signature) (Print Name)

Sworn to before me this

 

 

 

 

 

 

 

 

day of

,

.

 

 

 

 

 

 

 

 

 

 

 

Notary Public

 

 

 

Revised:

February 19, 2014

8

 

 

AFFIDAVIT OF SERVICE OF MAILING

STATE OF NEW YORK

)

COUNTY OF

 

) ss.:

 

 

 

 

, being duly sworn, deposes and says:

On the

 

day of

, 20

 

, I served a true copy of the

 

 

 

 

 

 

 

annexed notice of motion and supporting affidavit by mailing the same in a sealed envelope, with

postage prepaid thereon, in a post office or official depository of the U.S. Postal Service within the

State of New York, addressed to the last known addressee(s) as indicated below:

(Insert here the name[s] and address[es] of the person[s] to w hom you are mailing the papers being filed with this Court. If necessary, attach extra pages for additional nam es and addresses.)

Name & Address

Name & Address

(Signature)

(Print Name)

Sworn to before me this

day of

,

.

 

 

 

Notary Public

Revised: February 19, 2014

9

File Specifics

Fact Name Description
Purpose of the Form The New York Poor Person form allows individuals to request permission to appeal a family court decision without the financial burden of court fees and to seek legal counsel.
Governing Law This form is governed by Section 800.2 (a) of the Rules of the New York State Supreme Court, Appellate Division.
Filing Requirements Applicants must serve motion papers to all parties involved, including attorneys and the County Attorney, and submit original papers to the court.
Return Date The motion return date must be set for a Monday, either eight days after personal service or thirteen days after mailing the motion papers.
No Oral Argument There will be no oral argument on the return date of the motion, as decisions are made based on submitted papers only.

How to Use New York Poor Person

Filling out the New York Poor Person form is a straightforward process. It requires careful attention to detail to ensure all information is accurately provided. After completing the form, it will need to be submitted to the appropriate court along with any necessary supporting documents.

  1. At the top of the form, locate the section labeled "Notice of Motion." Write the title of your case on the left side, exactly as it appears on the order or judgment you are appealing.
  2. Fill in the date when the attached affidavit was notarized. This is the first date required on the form.
  3. Next, indicate the return date for the motion. This should be a Monday, scheduled after you have served the motion papers to all parties involved.
  4. Serve the motion papers to all parties. If a party has an attorney, send the documents to the attorney. If a party is represented by the Office of the Attorney General, serve that office. Also, send copies to the County Attorney and the Attorney for the Child.
  5. If you deliver the motion papers personally, set the return date for at least eight (8) days after service. If you mail the documents, the return date should be at least thirteen (13) days after mailing.
  6. After serving the motion papers, promptly send the original motion papers and proof of service to the court. Include a copy of the order or judgment being appealed, any related decision, and a copy of the notice of appeal.
  7. Note that there will not be any oral argument on the return date of the motion.
  8. Complete the underlined spaces in the form and return the original to the court. Keep one copy for your records and send one copy to each adversary, the County Attorney, and the Attorney for the Child.

Your Questions, Answered

  1. What is the New York Poor Person form?

    The New York Poor Person form is a legal document that allows individuals to request permission to appeal a court decision without the financial burden of court fees. It is specifically designed for those who cannot afford to pay for legal representation or court costs.

  2. Who can use the Poor Person form?

    Any individual who is facing financial hardship and wishes to appeal a Family Court decision can use the Poor Person form. This includes those who are unemployed, underemployed, or otherwise unable to afford the costs associated with legal proceedings.

  3. How do I fill out the Poor Person form?

    To fill out the form, start with the Notice of Motion at the top. Write the title of your case on the left side, exactly as it appears on the order or judgment you are appealing. Follow the instructions to complete the affidavit and provide necessary details such as your name, the nature of the proceeding, and financial information.

  4. What information do I need to provide in the affidavit?

    Your affidavit should include:

    • Your full name and date of birth.
    • The nature of the proceeding.
    • Details about the judgment or order you are appealing.
    • Your financial situation, including employment status and income.
    • Information about any legal representation you had in the lower court.
  5. How do I serve the motion papers?

    You must serve the motion papers to all parties involved in your case. If a party has an attorney, serve the attorney. If the Office of the Attorney General is involved, serve them as well. You can deliver the papers in person or by mail, but the return date of the motion will vary depending on the method of service.

  6. What is the return date for the motion?

    The return date is the day you will submit your motion to the court. If you served the motion papers in person, this date should be at least eight days after service. If served by mail, the return date should be at least thirteen days after mailing.

  7. What documents should I include with my motion?

    Along with your motion, you should attach:

    • A copy of the order or judgment you are appealing.
    • The decision that led to that order or judgment.
    • A copy of your notice of appeal.
  8. Will there be an oral argument on the return date?

    No, there will not be an oral argument on the return date of the motion. The motion will be submitted based on the written papers only.

  9. What happens after I submit the Poor Person form?

    After submitting the form, the court will review your application. If approved, you will be granted permission to proceed as a poor person, which may include the assignment of counsel for your appeal.

  10. Where do I send the completed Poor Person form?

    The original form should be sent to the Supreme Court, Appellate Division, Third Judicial Department, in Albany, New York. Additionally, you must forward copies to each of your adversaries, the County Attorney, and the Attorney for the Child.

Common mistakes

  1. Not accurately filling in the caption at the top of the form. The title of the case must match exactly how it appears on the order or judgment being appealed.

  2. Failing to provide the correct notarization date for the affidavit. This date is crucial and should be the date the affidavit was signed and notarized.

  3. Overlooking the requirement to serve motion papers on all relevant parties. This includes attorneys and the County Attorney, which is essential for the motion to be valid.

  4. Incorrectly calculating the return date of the motion. If served by personal delivery, it should be at least eight days later; if by mail, at least thirteen days later.

  5. Not forwarding the original motion papers and proof of service to the court promptly. This step should be completed as soon as possible after serving the papers.

  6. Neglecting to attach necessary documents, such as a copy of the order or judgment being appealed, which is required to support the motion.

  7. Forgetting to indicate whether oral argument will be needed. The instructions state that there will not be any oral argument on the return date of the motion.

  8. Failing to keep a copy of all documents for personal records. It is important to maintain your own copy for future reference.

Documents used along the form

When seeking to proceed as a poor person in New York, several forms and documents may accompany the New York Poor Person form. Each of these documents plays a crucial role in the process, ensuring that the court has all necessary information to make an informed decision regarding the request for financial assistance and legal representation. Below is a list of commonly used forms and documents that may be required.

  • Notice of Appeal: This document formally indicates the intention to appeal a decision made by a lower court. It must be filed with the court and served on all parties involved in the case.
  • Affidavit of Service: This document provides proof that the motion papers and other relevant documents have been properly served to all parties, including the County Attorney and the Attorney for the Child.
  • Order or Judgment Being Appealed: A copy of the specific order or judgment from the lower court that is being contested must be attached to the motion papers. This helps the appellate court understand the context of the appeal.
  • Financial Disclosure Form: This form outlines the applicant's financial situation, including income, expenses, and assets. It helps the court determine eligibility for poor person status.
  • Certificate of Good Faith: This document certifies that the applicant has made a genuine effort to resolve the issues before seeking court intervention. It can demonstrate the seriousness of the appeal.
  • Request for Assignment of Counsel: A separate request may be necessary to formally ask for legal representation. This document outlines the reasons why counsel is needed for the appeal.
  • Supporting Documentation: Any additional documents that support the applicant's claims, such as pay stubs, tax returns, or other financial records, may be included to provide a clearer picture of the applicant's financial status.

Gathering these documents can seem daunting, but each serves a specific purpose in facilitating the appeal process. It is essential to ensure that all forms are completed accurately and submitted in a timely manner. This diligence can significantly impact the outcome of the request for poor person status and the assignment of counsel.

Similar forms

The New York Poor Person form is similar to the Affidavit of Support used in immigration cases. Both documents require the individual to provide detailed personal information and financial circumstances. In the Affidavit of Support, the sponsor must demonstrate their ability to support the immigrant financially, similar to how the Poor Person form requires the applicant to disclose their financial status to qualify for legal aid. Both forms aim to ensure that individuals who cannot afford legal representation receive the necessary support to pursue their cases.

Another comparable document is the Application for Waiver of Fees in civil court cases. This application allows individuals to request a waiver for court fees based on their financial situation. Like the Poor Person form, it requires the applicant to provide evidence of their inability to pay. Both documents serve to remove financial barriers, ensuring that justice is accessible to those in need.

The Motion for Assignment of Counsel in criminal cases also shares similarities with the New York Poor Person form. This motion allows defendants to request a public defender if they cannot afford private counsel. Both documents require the individual to demonstrate their financial hardship. They also focus on the right to legal representation, ensuring that financial constraints do not impede access to justice.

The Fee Waiver Request for family court proceedings is another document akin to the Poor Person form. This request allows individuals to waive fees associated with family court filings due to financial hardship. Both forms require detailed financial disclosures and serve the same purpose: to facilitate access to the legal system for those who may be unable to afford it.

Lastly, the Financial Disclosure Statement used in bankruptcy proceedings is similar in its requirement for a comprehensive overview of an individual's financial situation. Both documents aim to provide the court with necessary information regarding the applicant's finances. They ensure that the court can make informed decisions based on the applicant's ability to pay legal fees or other costs associated with their case.

Dos and Don'ts

When filling out the New York Poor Person form, it’s essential to follow certain guidelines to ensure your application is processed smoothly. Here are six important dos and don’ts to keep in mind:

  • Do ensure that you accurately write the title of your case as it appears on the original order or judgment.
  • Do provide the correct dates for the notarization of your affidavit and the return date of your motion.
  • Do serve all necessary parties with the motion papers, including attorneys and the County Attorney.
  • Do attach copies of all relevant documents, including the order or judgment you are appealing.
  • Don’t forget to keep a copy of the motion papers for your records.
  • Don’t expect oral arguments on the return date; the motion will be submitted on the papers alone.

Misconceptions

Misconceptions about the New York Poor Person form can lead to confusion for those seeking assistance. Here are four common misunderstandings:

  • Misconception 1: The form guarantees free legal representation.
  • While the Poor Person form allows individuals to request permission to appeal without the burden of court fees, it does not automatically provide legal counsel. The court will review the application and determine if counsel will be assigned based on the merits of the case.

  • Misconception 2: You can submit the form without serving other parties.
  • Service of motion papers on all relevant parties is a critical step. Failing to serve the necessary parties can result in delays or dismissal of the motion.

  • Misconception 3: Oral arguments are allowed on the return date of the motion.
  • It is important to note that there will not be oral arguments on the return date. The motion will be submitted based solely on the written papers provided.

  • Misconception 4: The form can be submitted without supporting documents.
  • Applicants must attach relevant documents, including a copy of the order being appealed and proof of service. Incomplete submissions may lead to rejection of the application.

Key takeaways

Filling out and using the New York Poor Person form is a crucial step for individuals seeking to appeal a family court decision without the financial means to do so. Here are key takeaways to consider:

  • Understand the Purpose: The form allows individuals to request permission to appeal as a poor person and to seek assignment of counsel.
  • Accurate Case Title: Ensure the title of the case is written exactly as it appears on the original order or judgment.
  • Notarization Dates: Fill in the date when the affidavit was notarized and the return date for the motion. The return date should be a Monday after service of the motion papers.
  • Service of Motion Papers: Serve the motion papers to all parties involved, including attorneys and the County Attorney, either by personal delivery or mail.
  • Proof of Service: After serving the motion papers, promptly forward the original documents and proof of service to the appropriate court office.
  • Attach Necessary Documents: Include copies of the order or judgment being appealed, the decision it’s based on, and the notice of appeal with your motion papers.
  • No Oral Argument: Be aware that there will not be an oral argument on the return date of the motion.
  • Keep Records: Retain a copy of all documents for your personal records after forwarding the required copies to other parties.

Following these guidelines can help ensure that your application for poor person status is processed smoothly and efficiently. Take action promptly to avoid any delays in your appeal process.