Fee Deferral or Waiver Order (eForm: 11/9/12) Page 1 of 1 Case No: IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY 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: 1. Deferral (Temporary): The court DEFERS the following fees on a temporary and/or partial basis: Filing Fees S Service Fee Motion Fee Arbitration Fee Trial Fee Other: (describe) The noted fees are deferred until the court receives notice that Applicant is represented by a lawyer or until a hearing or trial. Fees are due in full upon occurrence of either event unless Applicant files a new Application and Declaration for Deferral or Waiver of Fees and the court grants that application. If neither event occurs, the fees are due as specified in a future judgment in this case. or Payment must be made According to the terms of the attached payment plan (or) $ per month until paid in full 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 Fee Motion Fee Arbitration Fee Trial Fee Other (d escribe) 3. Denial: The court DENIES the because: 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, signature Name, printed American LegalNet, Inc. www.FormsWorkFlow.com