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IMPORTANT: The Clerk of the Circuit Court has given the authorization for Internet users to print this form and fill it out at home. However, IT MAY NOT BE SIGNED AT HOME. A person wanting to fill out a form at home may do so but may not sign it until arriving at the courthouse and doing so in the presence of a court clerk.
Insolvency Affidavit
The following is an electronic reproduction of what the court document looks like.
IN THE CIRCUIT COURT, TWENTIETH JUDICIAL CIRCUIT
IN THE STATE OF FLORIDA, IN AND FOR CHARLOTTE COUNTY
_________
CIVIL ACTION
Petitioner CASE NO:
VS
__________
Respondent
INSOLVENCY AFFIDAVIT
STATE OF FLORIDA )
) SS.
CHARLOTTE COUNTY )
BEFORE ME, the undersigned authority personally appeared
________________________________, who being by me first duly sworn,
deposes and says:
THAT she does not have property or other means of payment, either in her possession or under her
control nor has she divested herself of her property for the purpose of receiving benefit from this
oath, and that she is unable to secure payment of the costs to prosecute this action.
FURTHER AFFIANT SAITH NOT.
_______________ Affiant
Subscribed and sworn to on this____________day of_________________19______.
______________
Deputy Clerk
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