Application & Declaration Form For Deferral Or Waiver Of Fees (Page 5 of 5) in pdf

INSTRUCTIONS FOR FEE DEFERRAL

OR WAIVER APPLICATION & DECLARATION

Fees and costs are required in any civil case, including dissolutions (divorce), small claims,

evictions (FED – Forcible Entry and Detainer), and arbitration. A list of fees is available at

or from the court clerk. The court accepts cash, credit and debit cards,

and money orders or checks made out to the State of Oregon. If you cannot afford to pay the

amount required, you may ask the court to defer or waive those fees and costs. If the court

defers the fees and costs you do not need to pay them at the time of filing. You still have to pay

according to the schedule set up by the court.

If you want to apply for a deferral or waiver of fees, complete the following forms:

The case heading must be the same as on the papers you filed or received

APPLICATION & DECLARATION FOR DEFERRAL OR WAIVER OF FEES.

Fill in the case heading and mark whether you are the Plaintiff/Petitioner or

Defendant/Respondent. You must completely fill out the Declaration. Do not leave any

sections blank. Date, sign, and print your name. This document is kept confidential (only

court staff will see it, not the other party).

ORDER REGARDING DEFERRAL OR WAIVER OF FEES.

Fill in the case heading and mark whether you are the Plaintiff/Petitioner or

Defendant/Respondent. The judge or designated court staff will complete the rest of the

form.

You must show proof of income and monthly bills (including rent and utilities) for the past two

months. If you claim to be eligible for public assistance, you must show proof of the amount

you receive from all programs. Once the forms are complete, bring them to court. You will

appear before a judge or other court staff.

At the end of your case, fee deferrals may be addressed again if any amount is still unpaid. The

judge will review the situation and decide whether the fees should be waived. At that time, you

will have to update your information.

Note: Court-specific instructions may be attached.

Tips for completing the Declaration:

 Complete EVERY entry – enter “N/A” for “Not Applicable” if it does not apply to you.

 ONLY enter payments that you are legally required to make for yourself or your

dependents. If you are paying any expenses for a child who is not your legal

dependent, a parent, or anyone else, do NOT include those payments in your

Declaration.

 “DL/ID” is your Driver’s License or identification number.

 “Transportation” includes bus passes, parking fees, etc.

 “Vehicle payments” and “Insurance” include all vehicles that you are currently

making payments on (cars, trucks, motorcycles, scooters, bicycles, etc.).

 “Liquidation of assets” – if you sold your valuable possessions, how much would you

get?

 A contingency fee agreement means that your lawyer gets paid part of any judgment

or award that you get in this case.

Fee Deferral or Waiver Application and Declaration (eForm: 11/9/12)

Page 5 of 5

Case No:

Application & Declaration Form For Deferral Or Waiver Of Fees Page 5

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