Information and Instructions (consists of three pages)

Confidential Document Form ("CDF") (consists of two pages)

Waiver of Fees and Costs Order of Court (consists of one page)

Application to Waive Fees and Costs (consists of two pages)

You are without financial resources. A party shall be deemed without financial resources if:

You receive needs-based public assistance (including, but not limited to, Supplemental Nutrition Assistance Program (SNAP), Medicaid, Supplemental Security Income (SSI), or Temporary Assistance to Needy Families (TANF); or

You meet the following income and gross asset requirement:

gross income (i.e., before taxes and other deductions) that is 200% or less than the federal poverty guidelines for the party's household size; and

assets less than $10,000.00, excluding the party’s home and one vehicle.

You suffer from substantial financial hardship. Substantial financial hardship means that a party is or will be unable to fully meet their basic human needs or obligations including, but not limited to, nutrition, housing, utilities, health, transportation, care of dependents, or other areas of essential need, by paying the fees and costs associated with the legal action based upon:

the party's gross income, assets, and expenses;

the number of minor children or adult children, who are incapable of self-support due to a physical or mental disability that the party is supporting, including a child support obligation;

employment history;

other available financial resources, including resources from individuals who have a duty of support to the party; and

other factors affecting the party's income, assets, or expenses.

You are represented by counsel practicing in a legal aid organization or providing you with free legal services (public defender or court-appointed counsel), and your counsel reasonably believes that you are unable to pay the fees and costs associated with the legal action.