Form 1b/1c - Petition For Nullity - Payment Agreement - Archdiocese Of Denver - Metropolitan Tribunal & Office Of Canonical Affairs Page 20

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PAYMENT AGREEMENT
Case Names: PET MAIDEN-RESP MAIDEN
Prot. No.: 3015-4015
PET first M. PET Last
123456 Main Street
Anywhere, CO 800011
I, the undersigned, agree to pay the fees noted below to the Metropolitan Tribunal of the Archdiocese of
Denver. I understand that failure to pay these fees, pursuant to this agreement, may cause my case to be
suspended.
At this time, the following fees apply to your case:
1. Filing Fee:
$25.00 (paid)
2. Processing Fee:
$550.00
Please indicate how you intend to pay your current balance, which is $550.00:
____ Payment in full
(Payment enclosed Y/N_____, $______, Ck #_________)
____ Monthly installments of $______
NOTE: If you prefer monthly installments, we would appreciate the balance being paid within twelve months. The Archdiocese of Denver
Management Corporation will send you an invoice on the 27th of each month. (The invoice will be for the entire amount, please make a
payment for the amount specified in this agreement) This payment agreement is required to be returned to our office regardless if you
choose to pay in full or make monthly payments.
It is not our wish to impose financial hardship on anyone, if you need to make different payment arrangements, please contact our office.
This payment agreement takes effect upon the acceptance of your petition. If
your petition is not accpeted this payment agreement is void.
________________
_________________________________________
Date
Petitioner’s Signature
________________
_________________________________________
Place
Signature of Notary Public, Deacon or Advocate
Please do NOT send any payments until you receive an invoice
from the Archdiocese of Denver Management Corporation.
Page 20 of 20
1B

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