Affidavit For Proceeding In Forma Pauperis Under Minn. Stat. § 563.01
Exhibit 1: Debt and Expenses
(Pov. Law Form IFP Exh. 1)

Debt (Affidavit ¶ 15) 	Debt	
(Excluding Car Loans And Real Estate Mortgage/Loans)		
		
Credit Card		
Student Loan		
Other:		
Other:		
		
Total Debt (Affidavit ¶ 15)		
		
Expenses (Affidavit ¶¶  11-13)	Cost	
		
Child Support (Affidavit ¶ 11)		
Spousal Maintenance (Affidavit ¶ 12)		
Rent / Affidavit Mortgage Payment (¶ 13)		
		
Total Expenses (Affidavit ¶¶  11-13)		
		
Other Expenses (Affidavit ¶ 16)	Cost	
		
Contract For Deed / 2nd Mortgage		
Homeowner’s / Rental Insurance		
Property Taxes (If Not Included In Mortgage Payment)		
Heat		
Electricity		
Water And Sewer		
Telephone		
Cell Phone		
Cable / Dish TV		
Internet		
Food		
Clothing		
Household Supplies		
Bus / Taxi		
Car Loan Payment		
Gas		
Car Insurance 		
Medical And Dental Expenses  (Not Covered By Insurance)		
Child Care		
Credit Card Payment		
Student Loan Payment		
Other: 		
Other:		
Other: 		
		
Other Expenses (Affidavit ¶ 16)		
		
Total Monthly Expenses (Affidavit ¶¶  11-13, 16)