in the Interest of A. L. D. L., a Child

COURT OF APPEALS FOR THE
FIRST DISTRICT OF TEXAS AT HOUSTON

CORRECTED
NOTICE TO TRIAL-COURT CLERK
REGARDING AFFIDAVIT OF INDIGENCE
FILED IN COURT OF APPEALS

Appellate case name: In the Interest of A. L. D. L., a child

Appellate case number: 01-15-00826-CV

Trial court: County Court at Law No 1 of Galveston County

Trial court case number: 14-FD-2183

On November 17, 2015, appellant, P.D., filed in this Court an affidavit of indigence. See
TEX. R. APP. P. 20.1(c)(1). Appellant mistakenly filed the affidavit in this Court instead of in the
trial court. See TEX. R. APP. P. 20.1(c)(1). On November 18, 2015, the Clerk of this Court sent
the affidavit to the trial-court clerk. The trial-court clerk is instructed to note the date the
affidavit was received in the trial court, but file the affidavit effective as of the date the affidavit
was filed in this Court, November 17, 2015. See TEX. R. APP. P. 25.1(a). A copy of the affidavit
also is on file with this Court.

The trial-court clerk must promptly send a copy of the affidavit to the appropriate court
reporter. See TEX. R. APP. P. 20.1(d)(1). Any contest to the affidavit, including a claim that the
affidavit was not timely filed, is due to be filed in the trial court ten days after the affidavit is
received by the trial-court clerk. See TEX. R. APP. P. 20.1(e) (time for contest); see also Higgins
v. Randall Cnty. Sheriff’s Office, 193 S.W.3d 898, 899–900 (Tex. 2006) (holding untimely filed
affidavit was nonetheless valid unless trial court sustains contest to affidavit); see also TEX. R.
APP. P. 20.1(c)(1) (time for filing affidavit in appeal).

If no contest to the affidavit is filed, the trial-court clerk must promptly notify this Court.
If a contest is filed, then the trial-court must promptly prepare, certify, and file in this Court a
clerk’s record containing the affidavit of indigence, contest(s) to the affidavit of indigence, the
trial court’s signed order extending the time for conducting a hearing on the contest (if any), the
trial court’s signed order sustaining the contest(s) to the affidavit of indigence, and any other
documents directly related to the affidavit of indigence. See TEX. R. APP. P. 34.5(c)(1). If any
party requests that a hearing related to the contest be transcribed, then the court reporter must
promptly prepare, certify, and file in this Court a reporter’s record containing all relevant
documents relating to the contest. The trial-court clerk and/or reporter must file the required
notice, record, or status report no later than December 18, 2015.

A copy of the affidavit of indigence filed in this Court on November 17, 2015, and sent to
the trial-court clerk on November 18, 2015, is attached to this notice.

Clerk’s signature:
Christopher A. Prine, Clerk of the Court

Date: December 3, 2015
 ( FILEO IN
9ST COURT OF APPEALS
HOUSTON, TEXAS

NOV 17 201^
CHRISTOHHEBv'
AFFIDAVIT OF INDIGENCE
CLERK.
CAUSE NO. GH£zD£%LLe£^/

B^ IN THE DISTRICT COURT #0-

C-^Vye-^,^ ^r* nf\fl??\
D JUDICIAL DISTRICT

w
C-toV/P^,ac>_ COUNTY,
TEXAS

THE STATE OF TEXAS:

COUNTY OF j^g^ao
The undersigned makes this affidavit in connection with the filing of the above-numbered and
entitled cause without the posting of a security deposit and for the purpose of having citation
issued in accordance with Texas Rule of Civil Procedure 145 and Texas Rule ofAppellate
Procedure 20.1. (The items applicable tothe undersignedandcheckedandthe information calledfor is
furnished widerpenalties ofperjury.)

1. Basis for indigence: I am unable to pay a court cost because:
[ ] I am presently receiving a governmententitlementbased on indigence as follows (describe
nature and amount of government entitlement): . . ..

and

I have no ability to pay court costs based on facts set out below.

2. Employment information:

n Iam not now employed; the last time I was employed was fctp»-: \. "2 c\*=r
at Tv\o yn7r, i-sw^ P. V VKptW\U ^r>ovr-A VJr\ \W^

[ ] I am employed: I work for.

The nature of the job is_ .. The income I receive from this job is $
per

3. Income from sources other than employment:

[ ] I have no income with is derived from sources other than employment, such as interest,

FORM 3
dividends, annuities, etc.

[ ] I have income derived from sources other than employment as follows:

Type of income Amount per period

4. Spouse's Income

[ ] My spouse has no income.

[ ] My spouse has income as follows:

Type of income Amount per period

_Ml&

j^W J^k
5. Property:

f^I own no property and no interest in any property.

[ ] I own the following interests in property:

RealEstate: kj \jy

Motor Vehicles: m\Pt

Stock and/or bonds: .LA A*.

Cash mU
Other: ^ \K

6. Bank Accounts:

Bank Type of Account Amount

-W W

FORM 3
 r4k m1* _ki£t

7. Dependents:

[ ] I have no dependents.

[$'.I have the following dependents:

Name Age Relationship

151

J£_ AfraVrWr
•3
k\_r^< Ao.Cmf -©- cW x^Lr
8.Deb,s:^WC^ u 6cxu<
"5
[ ] I have ho debts.

[<}T have the following debts:

Creditor Amount

3tuQ i IXuq Ci^QQp&u^
f
(V)nW Dc^^-r- Evu.n ft?>a>nr>
A \f^x i^n

9.1 have the following monthly expenses:

Type ofExpense: Amount per month

W^ .- . - ——
db.vhu t . Jfcffra.t^
'TW-stm /fl^c?D

10. Loans:

I have attempted to obtain a loan for these costs from the following financial and/or
lending institutions, but have been unableto secure such a loan.

FORM 3
 Financial Institution/Lender: Address:

Li JB
i4k

M-l*
wJa.
11. Attorneys

MII was not represented by an attorney in this court.
[ ] I was represented by an attorney in this court, but my attorney did not charge me a legal fee
for this representation.

[ ] I was represented by an attorney in this court under a contingent fee arrangement.

12. Costs:

[ ] No attorney has agreed to pay or advance my court costs.

[ ] An attorney has agreed to pay or advance my court costs under the following circumstances
(explain here): s

I am unable to pay the costs of court. I verify that the statements made in this affidavit
are true and correct..

Signed this the Y3jfe day of bk^Zgit^butf 20j\5"

Affiant

Sworn and Subscribed to before me this the \A~rx' day of_jJ^£ccW±: . 20\f?~.
. . ; Name Printed: \f- P/UW
Notary Public, (aMlMQQ County, Tex. My commission expires: jO'/M" 10H

FORM 3
ATTORNEY FOR THE AFFIANT SHALL CERTIFY THE CONDITIONS UNDER WHICH HE
REPRESENTS THE AFFIANT.

Date: . , 20
Signature of Attorney

© TACSRS 2001

FORM 3
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