Application to Appeal in Forma Pauperism (O.44, R.1.)

(Title)

I………, the above-named, present the accompanying memorandum of appeal from the decree in the above suit and apply to be allowed to appeal as a pauper.

Annexed is a full and true schedule of all the movable and immovable property belonging to me with the estimated value thereof.

Dated the ………day of ……..19………..

(Signed.)

Note– Where the application is by the plaintiff he should state whether he applied and was allowed to sue in the Court of first instance as a pauper.