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Declaration Re Waived Court Fees And Costs LACIV 222 - California
| Declaration Re Waived Court Fees And Costs Form. This is a California form and can be used in Civil Los Angeles Local County . |
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NAME, ADDRESS, AND TELEPHONE NUMBER OF ATTORNEY OR PARTY WITHOUT ATTORNEY: STATE BAR NUMBER Reserved for Clerk's File Stamp ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES COURTHOUSE ADDRESS: PLAINTIFF: DEFENDANT: CASE NUMBER: DECLARATION RE: WAIVED COURT FEES AND COSTS DEPARTMENT NUMBER: 1. The court waived fees and costs in this action for (name): ______________________ ____________________________________________________________________ 2. _____________________________has been ordered to pay the waived fees & costs. (Name) 3. The order requiring payment of waived fees and costs has been satisfied. [Gov. Code, § 68637 (b)(1) & (2)] (check one): Yes No If yes, attach proof of payment. I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. Date: ________________________________ _____________________________________ _____________________________ (TYPE OR PRINT NAME ATTORNEY PARTY MAKING DECLARATION) (SIGNATURE) LACIV 222 (New) LASC Approved 08-09 DECLARATION RE: WAIVED COURT FEES AND COSTS Gov. Code, § 68630 et seq. American LegalNet, Inc. www.FormsWorkFlow.com
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