AND NOW, this ___ day of ___, 20___, upon presentation and consideration of the attached, verified, Application to Waive Fees and Costs, IT IS HEREBY ORDERED THAT:
___ Petitioner's request for a waiver of fees and costs is granted.
___ Petitioner's request for a waiver of fees and costs is denied.
_____ Petitioner is ordered to remit the required filing fees to the Prothonotary within thirty days of the date of this Order.
Parties permitted to proceed with a waiver of fees and costs must inform the Court of improvement in their financial circumstances which will enable them to pay any waived fees and costs.
BY THE COURT:
Judge
Application to Waive Fees and Costs Page 1 of 1