IN THE CIRCUIT COURT OF THE TENTH JUDICIAL CIRCUIT
IN AND FOR HARDEE, HIGHLANDS AND POLK COUNTIES, FLORIDA
After careful consideration of the Affidavit of Insolvency executed under oath by the Affiant,
I HEREBY ADJUDGE that __________________________________ is/is not (circle one) insolvent within the intent and meaning of Section 57.081 of the Florida Statutes and
THEREFORE is/is not (circle one) entitled to the services of the Court, Sheriff and Clerk of the Court in the County of ______________________________ without initial charge. If, however, costs are recovered, they shall be paid to the Clerk.
DONE AND ORDERED on this ________ day of ___________________________, 2000.
Copy: Above Affiant