IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF _____________________ ______________________________________,
Petitioner/Plaintiff,
v. ______________________________________,
Respondent/Defendant.
) ) ) ) ) ) )
Case No. _________________ FEE WAIVER OR DEFERRAL RECOMMENDATION AND ORDER
CLERK'S RECOMMENDATION OR ORDER (to be completed by court clerk) I have reviewed (applicant name) _______________________________________'s application for waiver or deferral of fees and RECOMMEND ORDER the following:
DENIAL of the applicant's request for waiver or deferral of fees because: the applicant is financially able to pay the fees (see part __________ of the Declaration); the application is not complete or contains insufficient information (see part _________ of the Declaration); the applicant has not shown proof of current eligibility for public benefits; or _________________________________________________________________________.
WAIVER of the applicant's fees in whole or in part. Total Fees $ _______________ The applicant is RECOMMENDED Amount to be Waived $ ______________ ORDERED to pay:
$ ____________
in full by (date) ________________. pursuant to a schedule to be established by court staff. by a payment schedule of $ __________ today and $ __________ on the same day of each month until paid.
DEFERRAL of the applicant's fees. The applicant is RECOMMENDED ORDERED to pay:
$ ____________
in full by (date) ________________. pursuant to a schedule to be established by court staff. by a payment schedule of $ __________ today and $ __________ on the same day of each month until paid.
________________
Date
______________________________________ _____________________________________
Signature of Clerk Name of Clerk (printed or typed)
Fee Waiver or Deferral Recommendation and Order OJIN Code: ORFW (Order Fee Waiver), ORFD (Order Fee Deferral), or ORDN (Order of Denial)
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JUDGE'S ORDER (to be completed by judge)
The clerk's recommendation is AFFIRMED. The clerk's recommendation is MODIFIED or I ORDER as follows: The applicant's request for waiver or deferral of fees is DENIED because: the applicant is financially able to pay the fees (see part _______ of the Declaration); the application is not complete or contains insufficient information (see part ____, of the Declaration); or __________________________________________________________________.
The applicant's fees are WAIVED in whole or in part. Total Fees $ _______________ The applicant is ORDERED to pay: $ ____________ in full by (date) ________________. pursuant to a schedule to be established by court staff. by a payment schedule of $ __________ today and $ __________ on the same day of each month until paid. Amount Waived $ ______________
The applicant's fees are DEFERRED. The applicant is ORDERED to pay: $ ____________ in full by (date) ________________. pursuant to a schedule to be established by court staff. by a payment schedule of $ __________ today and $ __________ on the same day of each month until paid.
Other findings __________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________
___________________________
Date
_____________________________________
Signature of Judge
_____________________________________
Name of Judge (printed or typed)
Fee Waiver or Deferral Recommendation and Order OJIN Code: ORFW (Order Fee Waiver), ORFD (Order Fee Deferral), or ORDN (Order of Denial)
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