Affidavit Accompanying Motion — No. 0:22-cr-00124 (Dkt. 963, D. Minn.)

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An affidavit accompanying a motion for permission to appeal in forma pauperis by defendant Hayat Nur in United States v. Hayat Nur, Case No. 0:22-Cr-00124-NEB-DTS, in the U.S. District Court for the District of Minnesota, filed March 25, 2026 as Doc. 963. On the standard form, the defendant swears to income, assets, expenses and dependents for the past 12 months. The form runs 6 pages.

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CASE 0:22-cr-00124-NEB-DTS Doc. 963 _ Filed 03/25/26 Page 1of6

UNITED STATES DISTRICT COURT
for the
DISTRICT OF MINNESOTA

, )
— )
UNITED STATES Plaintiff(s) )
)
Vs Text )
HAYAT NUR Case No. 0:22-Cr-00124-NEB-DTS
)
Defendant(s) )
)

AFFIDAVIT ACCOMPANYING MOTION
FOR PERMISSION TO APPEAL IN FORMA PAUPERIS

Affidavit in Support of Motion Instructions

I swear or affirm under penalty of perjury Complete all questions in this application and
that, because of my poverty, I cannot prepay then sign it. Do not leave any blanks: if the
the docket fees of my appeal or post a bond for answer to a question is "0," "none," or "not
_| them. I believe I am entitled to redress. I swear applicable (N/A)," write in that response. If
or affirm under penalty of perjury under United you need more space to answer a question or to
States laws that my answers on this form are explain your answer, attach a separate sheet of
true and correct, (28 U.S.C, § 1746; 18 U.S.C. _ paper identified with your name, your case's
§ 1621.) docket number, and the question number.

Signed: Ale Date: 02/10/2026

My issues on appeal ATC! During the trial, |was represented by inattective counsel who failed to provide adequate legal assistance.

My attorney did not file any pre-trial motions that could have challenged the evidence or charges against me, nor did they discuss or

explain the potential sentencing guidelines or consequences | could face if convicted at trial as well as restitution agreement after trial.
Attach is more detailed explanation.

to ensure a just outcome regarding both my conviction and the restitution imposed.

L, For both you and your spouse estimate the average amount of money received from each
of the following sources during the past 12 months, Adjust any amount that was received
weekly, biweekly, quarterly, semiannually, or annually to show the monthly rate. Use
gross amounts, that is, amounts before any deductions for taxes or otherwise.

CASE 0:22-cr-00124-NEB-DTS Doc. 963

Filed 03/25/26

Page 2 of 6

Income source Average monthly Amount expected next
amount during the past | month
12 months
You Spouse You Spouse
Employment $ 0 $ 28,800 |$ 0O $ 4,800
Self-employment $ $ 15,400 |$ $ 1,600
Income from real property (suchas | $ 0 $ $ $ 9
rental income)
Interest and dividends $ 0 $ 600 $ OO $ 0
Gifts $ 0 $ Oo |s 0 $ 0
Alimony $ 0 g 0 g¢ 0 $ 60
Child support $ 0 $ 60 $ 600 $ 60
Retirement (such as social security, | $ 0 $ 9 $ 0 a)
pensions, annuities, insurance)
Disability (such as social security, $ $ $ 0 $
insurance payments) 0 0 0
Unemployment payments $ $ QO $ $ 60
Public-assistance (such as welfare) | $ $ $ $ 0
Other (specify): $ 0 $ 0 $ g $ 9
Total monthly income: $ 0 $ 55.500 $ 0 $ 6,400
2. List your employment history for the past two years, most recent employer first. (Gross
monthly pay is before taxes or other deductions.)
Employer Address Dates of employment Gross
monthly pay
JtC AUSM 1517 Hwy 13 E, Burnsville, MN 55337 May 2023-April 2024 | ¢ 4,500
$
$


CASE 0:22-cr-00124-NEB-DTS Doc. 963 Filed 03/25/26 Page 3 of 6

3. List your spouse's employment history for the past two years, most recent employer first.
(Gross monthly pay is before taxes or other deductions.)

Employer Address Dates of employment Gross
monthly pay
Optum 1 Optum on aT Pree MN 6/20/2016-Present |$ 6,723.98
$
$
4, How much cash do you and your spouse have? $__0

Below, state any money you or your spouse have in bank accounts or in any other
financial institution.

Financial Institution Type of Account Amount you have | Amount your
spouse has
Wells Fargo Saving $ 0 $ 22,674
Fidelity 401k Retirement | $ 0 $ 70,000
Coinbase/Robinhood Investment $ 0 $ 1,833

If you are a prisoner seeking to appeal a judgment in a civil action or proceeding, you must
attach a statement certified by the appropriate institutional officer showing all receipts,
expenditures, and balances during the last six months in your institutional accounts. If you
have multiple accounts, perhaps because you have been in multiple institutions, attach one
certified statement of each account.

5, List the assets, and their values, which you own or your spouse owns. Do not list clothing
and ordinary household furnishings.

Home Other real estate Motor vehicle #1

(Value) $ $480,000 (Value) $ 0 (Value) $ $7,500
Make and year: [onda 2016
Model: Accord
Registration #;  ZBF-469


CASE 0:22-cr-00124-NEB-DTS Doc. 963 Filed 03/25/26 Page 4of6
Motor vehicle #2 Other assets Other assets
(Value) $ 13,600 (Value) $ 0 (Value) $ 0
Make and year: Toyota 2018
Model: Rav4
Registration #: BNW-246
6. State every person, business, or organization owing you or your spouse money, and the

amount owed.

Person owing you or your spouse | Amount owed to you Amount owed to your
money spouse
None * 0) $ 0
None $ 0) $ )
None $ 0 $ 0
None $ 0 $ 0)
Ts State the persons who rely on you or your spouse for support.
Name [or, if under 18, initials only] Relationship Age
None N/A N/A
None N/A AiR
Rone N/A N/A
8. Estimate the average monthly expenses of you and your family. Show separately the

amounts paid by your spouse. Adjust any payments that are made weekly, biweekly,
quarterly, semiannually, or annually to show the monthly rate.

You Your Spouse
Rent or home-mortgage payment (include lot rented for mobile | $ $
home)
Are real estate taxes included? [] Yes {No 0 $3,640.66
Is property insurance included? [] Yes kj No
Utilities (electricity, heating fuel, water, sewer, and telephone) | $ 0 $ $359


CASE 0:22-cr-00124-NEB-DTS Doc. 963 Filed 03/25/26 Page 5 of 6

Home maintenance (repairs and upkeep) $ 0 $ 500
Food $ 0 $ 500
Clothing $ 0 $ 500
Laundry and dry-cleaning $ 0 $ 250
Medical and dental expenses $ 0 $ 90
Transportation (not including motor vehicle payments) $ 0 $ 0
Recreation, entertainment, newspapers, magazines, etc. $ 0 $ %
Insurance (not deducted from wages or included in mortgage payments)
Homeowner's or renter's: $ 0 $ 0
Life: $ 0 $ 0
Health: $ 0 $ 80
Motor vehicle: $ 0 $ 50
Other: $ e $ 0
Taxes (not deducted from wages or included in mortgage $ , $ 6
payments) (specify):
Installment payments
Motor Vehicle: $ Q $ 150
Credit card (name): Chase, Wells Fargo $ 0 $ 800
Department store (name): $ 0 $ 0
Other: $ 0 $ 0
Alimony, maintenance, and support paid to others $ 0 $ 0
Regular expenses for operation of business, profession, or farm | $ 0 $ 0
(attach detailed statement)
Other (specify): Real Estate License Fees $ 0 $ 100
Total monthly expenses: $ . $ 3,020
9, Do you expect any major changes to your monthly income or expenses or in your assets

or liabilities during the next 12 months?

[ ] Yes K] No If yes, describe on an attached sheet.


10.

jee

12

CASE 0:22-cr-00124-NEB-DTS Doc. 963 _ Filed 03/25/26 Page 6 of 6

Have you spent — or will you be spending — any money for expenses or attorney fees in
connection with this lawsuit? |, ] Yes { No

If yes, how much? $

Provide any other information that will help explain why you cannot pay the docket fees
for your appeal.

State the city and state of your legal residence.
Lakeville, Minnesota

Your daytime phone number: (507 ) 304-2803

Your age: _29 Your years of schooling: Masters

Last four digits of your social-security number: __ 4258

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