Order Regarding Waiver Of Filing Fees And Surcharges - Harassment {UH-02.0120}

Court of Washington For No. ____________________________ Petitioner, vs. Respondent. Order Re Waiver of Filing Fees and Surcharges - Harassment [ ] Granted (ORPRFP) [ ] Denied (ORDYMT) [X] Clerk's Action Required 3.1 I. Basis The court received the motion to waive filing fees and surcharges filed by or on behalf of the petitioner. II. Findings The Court reviewed the motion and supporting declaration(s). Based on the declaration(s) and any relevant records and files, the Court finds: 2.1 [] The petitioner is indigent based on the following: He or she: [] [] [] [] is represented by a qualified legal aid provider that screened and found the applicant eligible for free civil legal aid services; and/or receives benefits from one or more needs-based, means-tested assistance programs; and/or has household income at or below 125% of the federal poverty guideline; and/or has household income above 125% of the federal poverty guideline but cannot meet basic household living expenses and pay the fees and/or surcharges; and/or other: . [] Order re Civil Fee Waiver _Harassment (ORPRFP, ORDYMT) - Page 1 of 2 UH 02.0120 (07/2011) ­ GR 34, RCW 10.14.055, .060 American LegalNet, Inc. www.FormsWorkFlow.com 2.2 [] The petitioner is seeking protection from a person who: [ ] has stalked them as that term is defined in RCW 9A.46.110; [ ] engaged in conduct that would constitute a sex offense as defined in RCW 9A.44.130; or [ ] is a family or household member as defined in RCW 26.50.010(2) who has engaged in conduct that would constitute domestic violence as defined in RCW 26.50.010(1). 2.3 [] Other: . III. Order Based on the findings the court orders: 3.1 [] The motion is granted, and [] all filing fees and surcharges the payment of which is a condition precedent to the petitioner's ability to secure access to judicial relief are waived. Law Enforcement shall serve all papers in this action without charging a fee for service to the petitioner. other: . 3.2 3.3 [] The motion is denied. [] [] If there is a material change in financial circumstances, the ruling can be revisited by the court or the petitioner. If the motion was granted and the court, upon review, later finds that either the petitioner or another responsible party to this proceeding has sufficient resources to pay the waived filing fees or surcharges, the Court may modify this order and require the petitioner or another party to pay the filing fees and/or surcharges that have been waived by this order. Dated: Judge/Commissioner Presented by: Signature of Petitioner or Lawyer/WSBA No. Print or Type Name Date Order re Civil Fee Waiver _Harassment (ORPRFP, ORDYMT) - Page 2 of 2 UH 02.0120 (07/2011) ­ GR 34, RCW 10.14.055, .060 American LegalNet, Inc. www.FormsWorkFlow.com