2nd copy - Prisoner 3rd copy - Prisoner (if filing fees are ordered) Original - Court 1st copy - Department of Corrections Approved, SCAO STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY Court CASE NO. ORDER REGARDING SUSPENSION OF PRISONER FEES/COSTS address Court telephone no. Plaintiff's/Juvenile's name, address, and telephone no. Defendant's/Respondent's name, address, and telephone no. v Plaintiff's/Juvenile's attorney, bar no., address, and telephone no. Defendant's/Respondent's attorney, bar no., address, and telephone no. THE COURT FINDS: 1. A pleading/claim of appeal was filed with the court by the prisoner who is the plaintiff. defendant. 2. The prisoner requested suspension of fees and costs in the action because of indigency. A certified copy of his/her institutional account was provided showing the current balance and a 12-month history of deposits and withdrawals. 3. Based on the certified copy of the institutional account, it appears a. there are sufficient funds in the prisoner's account to pay the filing fee, and payment for the full filing fee should be ordered. b. there are insufficient funds in the prisoner's account to pay the filing fee, and payment for a partial fee should be ordered. c. the prisoner is indigent, and payment for the filing fee should be suspended/waived until further order of the court. 4. The prisoner's average monthly account deposit for the last 12 months is $ . 5. The prisoner's average monthly account balance for the last 12 months is $ . IT IS ORDERED: 6. The prisoner is ordered to pay a full partial filing fee within 21 days from the date of this order. The prisoner shall resubmit the pleading/claim of appeal for filing along with $ and one copy of this order. If the filing fee is not received within 21 days of the date of this order, the court will not file the action and all documents will be returned to the prisoner. The prisoner is responsible for making arrangements to have the filing fee paid. The Department of Corrections shall withdraw funds to make monthly payments once the initial fee is paid. In addition, the prisoner shall make monthly payments of $ until the full filing fee is paid. The Department of Corrections shall remove funds from the prisoner's institutional account on a monthly basis until the full filing fee is paid. 7. Fees and costs in this action are waived/suspended until further order of the court. If the prisoner becomes able to pay fees and costs before conclusion of the litigation, payment of fees and costs will be ordered as required by law. 8. If costs are assessed, the court will order payments to be made from the prisoner's institutional account as required by law. Date CC 20a (3/08) Judge ORDER REGARDING SUSPENSION OF PRISONER FEES/COSTS Bar no. MCL 600.2963, MCR 2.002 American LegalNet, Inc. www.FormsWorkflow.com