Instructions
Clear Form
THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH
http://www.courts.state.nh.us
Court Name: Case Name: Case Number:
(if known)
APPLICATION FOR WAIVING FEE
Check one: Filing fee Default fee Citation fee
1. 2. 3. 4.
Person requesting that fee be waived Document being filed Amount of fee to be waived $
Reasons for request to waive fee:
For the above-stated reasons, I request that the fee specified above be waived.
Date
Signature of person making request
ORDER Fee is waived. Fee is not waived.
Date Judge
NHJB-2314-P (10/01/2006) (formerly AOC-202D-003)
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