……. The court
PLAINTIFF :
ADDRESS :
DEFENDANT :
Subject: request for Legal Aid due to poverty.

INSTRUCTIONS :
In brief, the case will be summarized.
Financial to pay the fees and expenses necessary for me to sue and hire a lawyer
my situation is not favorable.
And from the headman’s office that I can’t afford the costs of the trial.
I have a certificate of poverty.
Legal reasons: article 465 of Law No. 1086 and related legislation.
Legal evidence : poor certificate obtained from Mukhtar, witness statements and
other evidence.
Conclusion and request: for the reasons explained above, from legal aid
I respectfully request your Supreme Court to do what it takes to get me injured.
…/…/…
Plaintiff
signature