Form Mc 20 - Affidavit And Order Suspension Of Fees/costs Page 2
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2CERTIFICATION OF ATTORNEY
1. I have reviewed the affidavit of indigency, and I certify that its contents are true to the best of my information, knowledge, and
belief.
2. I will bring to the court's attention the matter of suspended costs and fees and the availability of funds to pay them before
any disposition is entered. I will report at that time any changes in the information contained in the affidavit of indigency or
any other information regarding the affiant's financial status or alterations of the fee arrangement.
Date
Attorney signature
Bar no.
Attorney name (type or print)
CERTIFICATION BY PERSON OTHER THAN PARTY
1. I have personal knowledge of the facts appearing in the affidavit.
2. The person in whose behalf the petition is filed is unable to sign it because of
minority:
other disability:
Date of birth
Nature of disability
Relationship:
Date
Affiant signature
Affiant name (type or print)
Address
City, state, zip
Telephone no.
ORDER
IT IS ORDERED:
1. Fees and costs in this action required by law or court rule are waived/suspended until further order of the court. Before
any final disposition or discontinuance is entered, the moving party shall bring the fee and costs suspension to the
attention of the judge for final disposition.
2. The applicant's spouse shall pay the fees and costs required by law or court rule.
3. This application is denied.
Date
Judge/Magistrate
Bar no.
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