Arizona Supreme Court Page 1 of 1 AOC DFGF8F-050119 (COURT222S JURISDICTIONAL NAME AND ADDRESS HERE) Name of Petitioner/Plaintiff Name of Respondent/Defendant Case Number: CONSENT JUDGMENT FOR COURT FEES AND COSTS An application for deferral of court fees and costs has been granted in this case. Pursuant to A.R.S. 247 12-302(F), the applicant signed a consent to entry of judgment for court fees and costs not taxed to another party that remain unpaid thirty (30) calendar days following entry of final judgment. MORE THAN thirty (30) days have elapsed since the entry of final judgment and unpaid fees and costs exist, which the applicant is responsible to pay. [ ] The applicant has not filed a supplemental application for waiver or further deferral; OR [ ] The applicant has filed a supplemental application for waiver or further deferral, which has been denied by the court, AND EITHER: [ ] More than twenty (20) days have elapsed since the denial and the applicant has neither requested a hearing nor paid the unpaid fees and costs; OR [ ] Within twenty (20) days, the applicant has requested a hearing and, after the hearing, the court has affirmed the denial and the applicant has failed to pay the fees and costs within the time prescribed by the court; OR [ ] The applicant has filed a supplemental application. Further deferral has been granted and the applicant failed to pay the amount due as ordered. JUDGMENT IS GRANTED in favor of this court and against (print applicant222s name here) in the amount of $ , representing the total amount of deferred court fees and costs remaining unpaid that the applicant is responsible to pay. DATED: Judicial Officer I CERTIFY that I mailed/delivered a copy of this document to: [ ] Applicant [ ] at the above address [ ] in court [ ] Applicant222s attorney [ ] at the above address [ ] in court Date: By Clerk American LegalNet, Inc. www.FormsWorkFlow.com