Form 14-0075 - Application To Defer Payment Of Filing Fees, Financial Affidavit And Order Page 6
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6ORDER
Claimant’s request for deferral of filing fee(s) is approved. Claimant’s Petition and Original
Notice may be filed without prepayment of filing fee(s). Payment of the filing fee(s) shall be
deferred until final disposition of this proceeding.
Signed and filed this ________day of _______________________, __ ___.
______________________________________
DEPUTY WORKERS’ COMPENSATION
COMMISSIONER
Claimant’s request for deferral of filing fee(s) is denied. Claimant shall forward the
appropriate filing fee(s) within 14 days of this Order, or claimant’s Petition will be dismissed
without prejudice and without entry of further order.
Signed and filed this ________day of _______________________, __ ___.
_____________________________________
DEPUTY WORKERS’ COMPENSATION
COMMISSIONER
The information provided will be open for public inspection under Iowa Code § 22.11.
14-0075 (7/99)
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