Application To Waive Fees And Costs
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Code No.
____________________________
Your Name: ____________________________
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Address:
____________________________
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____________________________
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Telephone:
____________________________
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In Proper Person
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IN THE________ JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA
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IN AND FOR THE COUNTY OF _________________
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)
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, )
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Plaintiff(s),
)
)
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vs.
)
)
CASE NO.:
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____________________________________, )
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Defendant(s).
)
DEPT NO.:
)
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____________________________________ )
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APPLICATION TO WAIVE FEES AND COSTS
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(Filing Fees/Service Only)
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Pursuant to NRS 12.015, and based on the following Affidavit, I request permission
from this Court to proceed without paying court costs or other costs and fees as provided in NRS
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12.015 because I lack sufficient financial ability.
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AFFIDAVIT
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STATE OF NEVADA
)
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)
ss.
COUNTY OF CLARK
)
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I,
, after being duly sworn, depose and state as follows:
(your name)
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1.
I have read the contents of this Application to Waive Fees and Costs and am
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competent to testify as to the contents of this Application and the contents are true of my own
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