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Fee Scale Form 2008-2022

Fee Scale Form 2008-2022

Use a fee scale form 2008 template to make your document workflow more streamlined.

Income Name Amount Frequency (Circle one) You $ Weekly Monthly Yearly Spouse $ Weekly Monthly Yearly Children $ Weekly Monthly Yearly Other $ Weekly Monthly Yearly $ Weekly Monthly Yearly $ Weekly Monthly Yearly TOTAL Other Income You Spouse Children Employer: Oth er Subtotal Sliding Fee Scale: A – 80% Discount Social Security Public Assistance B – 60% Discount Retirement Pension Food Stamps Child Alimony NOTE: To comply with federal regulations, in order to give...
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