IN THE CIRCUIT COURT OF THE STATE OF OREGON THIRD JUDICIAL DISTRICT Probate Department In the Matter of the Guardianship of: __________________________________ Respondent. ) ) ) ) ) ) ) Case No. ORDER GRANTING/DENYING MARION COUNTY INDIGENT GUARDIANSHIP FUND APPLICATION AND/OR WAIVING FEES AND COSTS This matter came before the Court upon the Application and Motion of the Petitioner for an Order granting approval to have all or part of the expenses of this case paid for by the Marion County Indigent Guardianship Fund and/or to waive court fees and costs. The Court having reviewed the Application and/or Motion, and the Affidavit of the applicant in support of this request, and being fully advised, now IT IS HEREBY ORDERED that Petitioner’s Motion/Application is: “ “ Denied. Allowed for the following (Judge to initial those items that are approved): Court fees and costs are waived. Visitor fee to be paid from Marion County Indigent Guardianship Fund Attorney fee to be paid from Marion County Indigent Guardianship Fund Guardian fee to be paid from Marion County Indigent Guardianship Fund All approved amounts to be paid from the Marion County Indigent Guardianship Fund will be based upon the fee guidelines of the Fund. Dated: _________________________ Submitted by: _____________________________________ Name Bar No. (if any) _____________________________________ Address _____________________________________ City, State, Zip ___________________________________ Circuit Court Judge __________________________________ Print, Type or Stamp Name of Judge ___________________________________ Telephone ___________________________________ E-mail Fax ORDER GRANTING/DENYING MARION COUNTY INDIGENT GUARDIANSHIP FUND APPLICATION AND OR/WAIVING FEES AND COSTS - Page 1 of 1 FC (10/20/04) American LegalNet, Inc. www.USCourtForms.com