Request For Waiver Of Prepayment Of Court Costs {5F-P-167}

STATE OF HAWAI221I FAMILY COURT FIFTH CIRCUIT REQUEST FOR WAIVER OF PREPAYMENT OF COURT COSTS CASE NUMBER FC- NO. - - PLAINTIFF/PETITIONER,VS. DEFENDANT/RESPONDENT. This document is prepared by: Name: Address: Telephone No. ( ) - - I, the above-named Plaintiff/Petitioner, swear under penalty of perjury that I do not have the resources or income to pay the costs of this matter and request that prepaymentof the costs be waived. DATE PLAINTIFF/PETITIONER222S SIGNATURE Reprographics REQUEST FOR WAIVER OF PREPAYMENT (10/08) OF COURT COSTS 5F-P-167 American LegalNet, Inc. www.FormsWorkFlow.com