Order Regarding Deferral Or Waiver Of Fees
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1I
C
C
S
O
N THE
IRCUIT
OURT OF THE
TATE OF
REGON
C
Marion
FOR THE
OUNTY OF
Case No. ___________________
Plaintiff/Petitioner
v.
Order Regarding Deferral or
Waiver of Fees for:
Plaintiff/Petitioner
Defendant/Respondent
Defendant/Respondent
The court finds that the applicant is currently unable to pay all or part of the noted fees. THE
COURT HEREBY ORDERS THAT:
The court DEFERS the following fees on a temporary and/or
1. Deferral (Temporary):
partial basis:
Filing Fees
Sheriff’s Service Fee
Motion Fee
Arbitration Fee
Trial Fee
Other: (describe)
Payment must be made
According to the terms of the attached payment plan (or) $
per
month until paid in full beginning _____________
As ordered by a judgment in this case (or)
Other:
If fees are not paid as ordered, judgment will be entered against you without further
notice.
2. Waiver:
The court WAIVES the following fees (no payment):
Filing Fees
Sheriff’s Service Fee
Motion Fee
Arbitration Fee
Trial Fee
Other (d
escribe)
The court DENIES the applicant’s request for deferral or waiver of fees because:
3. Denial:
Applicant is financially able to pay the fees (see part _____ of the Declaration);
Application contains insufficient information (see part _____ of the Declaration);
Other findings _______________________________________________
Date
Circuit Court Judge or designee
Fee Deferral or Waiver Order (eForm: 11/9/12)
Page 1 of 1
Case No:
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