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Affidavit And Order Suspension Of Fees Or Costs MC 20 - Michigan
| Affidavit And Order Suspension Of Fees Or Costs Form. This is a Michigan form and can be used in General Statewide . |
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Original - Court 2nd copy - Opposing party Approved, SCAO 1st copy - Applicant PROBATE OSM CODE: OSF STATE OF MICHIGAN CASE NO. JUDICIAL DISTRICT AFFIDAVIT AND ORDER JUDICIAL CIRCUIT SUSPENSION OF FEES/COSTS COUNTY PROBATE Court address Court telephone no.Plaintiff/Petitioner name, address, and telephone no. Defendant/Respondent name, address, and telephone no. v Plaintiffs/Petitioners attorney, bar no., address, and telephone no. Defendants/Respondents attorney, bar no., address, and telephone no. Probate In the matter of NOTE: Requests for waiver/suspension of transcript AFFIDAVIT costs must be made separately by motion. 1. The attached pleading is to be filed with the court by or on behalf of , Name applicant, who is plaintiff/petitioner. defendant/respondent. 2. The applicant is entitled to and asks the court for suspension of fees a nd costs in the action for the following reason: a. S/he is currently receiving public assistance: $ per Case No.: . b. S/he is unable to pay those fees and costs because of indigency, based o n the following facts: INCOME: Employer name and address per week. month. two weeks. Length of employment Average gross pay Average net pay ASSETS: State value of car, home, bank deposits, bonds, stocks, etc. OBLIGATIONS: Itemize monthly rent, installment payments, mortgage payments, child sup port, etc. 3. (in domestic relations cases only) The applicant is entitled to an or der requiring his/her spouse to pay attorney fees. REIMBURSEMENT: It is understood that the court may order the applicant to pay the fees and costs when the reason for their waiver or suspension no longer exists. Affiant signature Subscribed and sworn to before me on , County, Michigan. Date My commission expires: Signature: Date Deputy clerk/Register/Notary public Notary public, State of Michigan, County of (SEE REVERSE SIDE FOR ORDER) MC 20 (6/04) AFFIDAVIT AND ORDER, SUSPENSION OF FEES/COSTS MCR 2.002 American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 2 CERTIFICATION OF ATTORNEY 1. I have reviewed the affidavit of indigency, and I certify that its conte nts are true to the best of my information, knowledge, and belief. 2. I will bring to the courts attention the matter of suspended costs and fees and the availability of funds to pay them before any disposition is entered. I will report at that time any changes in t he information contained in the affidavit of indigency or any other information regarding the affiants financial status or altera tions of the fee arrangement. Date Attorney signature Attorney name (type or Bar no. print) CERTIFICATION BY PERSON OTHER THAN PARTY 1. I have personal knowledge of the facts appearing in the affidavit. 2. The person in whose behalf the petition is filed is unable to sign it be cause of minority: other disability: Date of birth Nature of disability Relationship: Date Affiant signature Affiant name (type or print) Address City, state, zip Telephone no. ORDER IT IS ORDERED: 1. Fees and costs in this action required by law or court rule are waived/s uspended until further order of the court. Before any final disposition or discontinuance is entered, the moving party sha ll bring the fee and costs suspension to the attention of the judge for final disposition. 2. The applicants spouse shall pay the fees and costs required by law or c ourt rule. 3. This application is denied. Date Judge Bar no. American LegalNet, Inc. www.USCourtForms.com
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