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IN THE THIRD JUDICIAL DISTRICT SHAWNEE COUNTY, KANSAS Plainti Defendant POVERTY AFFIDAVIT In the district court of Shawnee County; I do solemnly swear that the claim set forth in the petition herein is just, and I do further swear that, by reason of my poverty, I am unable to pay a docket fee. My income and assets are as follows: Current monthly income: 4 0 e Checking com BaNKe} America Savings account: Cash; Home equity: Ay ONE Estimated automobile value: os VLE Other pertinent financial information: AMNE VERIFICATION Under penalty of perjury, I certify that the above information and statements are true to the best of my knowledge.