Benedict Emesowum v. Anne Baronitis, Seargent B. Rinner, University of Texas Health Science Center at Houston ( 2015 )

IN THE FIRST COURT OF APPEAL FOR THE STATE OF TEXAS CASE NO. 01-15-00524-CV 1STCOURT OFAPPEALS HOUSTON. TEXAS TRIAL COURT CASE NO. 1061504 JUN 17 2015 Benedict Emesowum, Plaintiff vs. christop^ CLERK. Pf« Anne Baronitis Et. Al., Defendant Amended Affidavit of Indigence I, Benedict Emesowum, affirm that I am unable to pay court costs of $296.00 and I verify that the statements made in this affidavit are true and correct: 1. I have filed the case described above. 2. I am entitled to governmental income; the type of governmental entitlement income is Earned Income Tax Credit. I am yet to receive this governmental entitlement income. 3. The nature and amount of my current employment income is: Unemployed 4. The amount of any other current government-entitlement income is: N/A. 5. The nature and amount of my current income, other than that described in my answers to 3 and 4 above, are miscellaneous and amount to about $450.00 6. The income of my spouse is N/A 7. I own the following real property: N/A. 8. I own the following personal property: N/A 9. I have the following amount of cash: N/A. 10. I have the following amounts of funds on deposit: $55.00 11. I have the following assets, other than those described in my answers 3 through 10 above: N/A. 12. I have no dependents. 13. The nature and amount of my debts are N/A. Page 1 of 2 14. The nature and amount of my monthly expenses are: Rent & Bills $300.00; Groceries $100.00, and transportation $50.00, Phone $38.00. 15. An attorney is not providing free legal services to me. 17. An attorney has not agreed to pay or advance court costs. -Affiant Certificate of Oath or Affirmation On this date^admjriistered the-aboveoath or affirmation from the person named above. I am * Jfiggjj^A* ( „ fVlMvlP and am authorized to administer an oath or affirmation pursuant to Texas Government Code section 602.002, 602.003, 602.004, or 602.005. If I have a seal of office that I am required by law to affix to documents when administering _an oath or affirmation, then I have included an original impression of my official seal below. . ^ t W/,^ [Signature of person administering oath or affirmation] [Date] [original impression of official seal, if any, of person administering oath or affirmation] l^ST SHEENAC MOORE * '£<•% Notary Public,State ot Texas *I My Commission Expires " June 14, 2016 Page 2 of 2