Affidavit In Support Of Motion For Waiver Or Deferral Of Fees And Costs
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Affidavit In Support Of Motion For Waiver Or Deferral Of Fees And Costs Form. This is a Oregon form and can be use in Lincoln Local County.
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Tags: Affidavit In Support Of Motion For Waiver Or Deferral Of Fees And Costs, 7, Oregon Local County, Lincoln
F OR M 7
IN THE CIRCUIT COURT OF THE STATE OF OREGON
FOR LINCOLN COUNTY
In the Matter of the Marriage of
9 Co-Pe titioner
9
and
9 Co-Petitioner
STATE OF OREGON
County of Lin coln
9
)
)
)
)
, )
Petitioner
)
)
)
, )
Respondent )
Ca se N o.
AFFIDAVIT IN SUPPORT OF MOTION
FOR WAIVER OR DEFERRAL OF
FEES AND COSTS
ss.
I,
being first duly sworn, depose and say:
I am a party in this case. I have insufficient income and resources to pay the filing fees, service fees and
cou rt cos ts neces sary to proc eed in this su it.
My m onthly household income which supports _______ persons is as follows:
W ages
$
Child Support / Alimony $
W elfare Grant
$
Veteran s Be nefits
$
Unem ployment
$
Other
$
Social Se curity
$
Other
$
TO TAL
$____________
My monthly expenses are as follows:
Rent/Mortgage
$
Transportation
$
Utilities
$
Clothing
$
Food
$
De bt Pa ym ents
$
Other
$
Other
$
TO TAL
$
My asse ts, other than househo ld goods and furnishings consist of:
My present debts are as follows:
$
$
$
$
$
$
$
TOTAL DEBTS
$
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Oth er facts re levan t to this affidavit: ________________________________________________________
____________________________________________________________________________________
I understand that the cou rt rules allow a sum m ons and certa in othe r doc um ents to be served (d elivered to
the other party) b y any com petent person, other than m yself, who is 18 years of age or older and who is
also a res ident of the state where service is m ade. I understa nd that an Oregon sheriff will norm ally
charge a fee for doing this for me. I am requesting that the court waive the normal service fee of any
Oregon sheriff. The reason I need the Sheriff to serve the docum ents inste ad of h aving them serve d by a
friend, acquaintance or other third person is:
I understan d that th e fe es and costs w hich have not been waived which rem ain unpaid at the tim e
jud gm ent is ente red shall becom e a jud gm ent in favor of the Sta te of O regon, and that failure or d efault in
paym ent of said judgm ent by a date certa in given by the court o r on the ha ppe ning of on e or m ore e vents
sub jects m e to being cha rged with be ing in conte m pt of c ourt.
Dated
Signature
SUBSCR IBED AND SW ORN to before me this
day of
, 20
.
Signature
Page 2 - AFFID AVIT
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