Form 4B-201. Affidavit of poverty and indigency.

[For use with Rules 1B-303 and 1B-305 NMRA] STATE OF NEW MEXICO IN THE PROBATE COURT _______________ COUNTY IN THE MATTER OF THE ESTATE OF No. __________ ______________________, DECEASED. AFFIDAVIT OF POVERTY AND INDIGENCY I, the applicant, state that A. I wish to start an action in the probate court of ____________ County, New Mexico; B. The estate of the decedent does not have enough funds to pay the costs of the action because the estate only has the following assets (list assets): ________________________________________________________________ ________________________________________________________________ WHEREFORE, I ask that I not have to pay the costs of this action, including the filing fee. I affirm under penalty of perjury under the laws of the State of New Mexico that all of the above statements are true and correct. ________________________________ Signature of applicant ________________________________ Printed name ________________________________ Date ________________________________ Street address ________________________________ City, state, and ZIP code ________________________________ Telephone number (optional) ________________________________ Email address (optional)