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I am a plaintiff or petitioner in this case and declare that I am unable to pay the costs of these proceedings and that I am entitled to the relief requested. Application to Proceed in District Court Without Prepaying Fees or Costs (Long Form).Download Form (pdf, 556. Download Available Through Site. I, , being duly sworn, state that I am the Plaintiff and that I do not have the funds available to pay the costs of filing and service in this case. Find the affidavit of indigency and related forms and instructions. Do not include these instruction sheets when you file the completed form. In most cases, you must pay a fee to start a case. Which I have completed and attached. I am unable to prepay the prepaid costs in this matter because of poverty.