After review of the above criteria, if you believe that you may be eligible to seek a waiver of fees and costs associated with a legal action, you must complete and file an "Application to Waive Fees and Costs" with the Court. A copy of the Application is included in this packet, and it is available online as a fillable PDF on the Administrative Office of Pennsylvania Courts website, located at https://www.pacourts.us/forms/for-the-public.
This packet may also be used by a party who is declaring an economic hardship and seeking to obtain a transcript of a Court proceeding, as permitted by Pennsylvania Rule of Judicial Administration 4008(b).
You should complete, sign, and date the Application to Waive Fees and Costs and Verification. Complete the caption exactly as it appears on all the pleadings in your case. Make sure that you complete all the requested information. If some of the questions don’t apply to you, then write ‘None’ or ‘N/A.’ If you do not answer all the questions, your Application may be denied.
Complete the caption on the Order of Court but leave the rest of the Order of Court blank. The Judge will fill in the rest of the Order of Court. File the blank Order of Court, the completed Application, and one copy of each. You must also submit a self-addressed stamped envelope along with your documents. You should keep an additional copy of each of these documents for your records. The filing office will then forward the documents to the Judge for consideration. Once the Judge acts on the Application, the filing office will send a copy of the signed Order of Court to you in the stamped envelope you provided.
A requestor will need to file these forms with the appropriate filing office:
For a request related to criminal, delinquency, dependency or summary appeal matters at the Common Pleas level, the request will be filed at the Adams County Clerk of Courts Office
For a request related to Orphans' Court matters, the request will be filed at the Adams Couty Clerk of the Orphans' Court Office
For a request related to civil matters at the Common Pleas level, the request will be filed at the Adams County Office of the Prothonotary
For a request related to domestic relations matters, the request will be filed at the Adams County Domestic Relations Section
If you have been granted a protective order pursuant to the Protection from Abuse Act or the Protection for Victims of Sexual Violence or Intimidation Act, you are not required to list your address, your current employer's name, or your current work schedule. Instead, you should list that information on a separate form, called the “confidential Information Form” and submit it to the correct filing office with your Petition. The Confidential Information Form is a separate form that can be found outside of the Law Library on the third floor of the Adams County Courthouse.