Fill and Sign the Motion and Declaration for Waiver of Filing Fees and Form

Mt and Decl for Civil Fee Waiver - Harassment (MT WVF ) - Page 1 of 2 UH 02.0100 (07 /201 9) – GR 3 4, RCW 10.14.055, .060 Court of Washington For Petitioner , vs. Respondent . No . ________________________ Motion and Declaration For Waiver of Filing Fee s and Surcharges - Harassment (M TWVF ) (RCW 10.14.060 ; RCW 10.14.055 ) I. Motion 1.1 I am the petitioner in this action. 1.2 I am asking for a waiver of all filing fees and sur charges . II. Basis for Motion 2.1 [ ] GR 34 allows the court to waive “ filing fees or surcharges the payment of which is a condition precedent to a litigant's ability to secure access to judicial relief ” for a person who is indigent. RCW 10.14.060 provides that if the petitioner’s request for fee waiver is granted, “then no fees for service may be charged to the pet itioner. ” As outlined below, I am indigent. 2.2 [ ] RCW 10.14.055 allows the court to waive “ filing fees or surcharges the payment of which is a condition precedent to a litigant's ability to secure access to judicial relief” for a person who is seeking relief from a person : [ ] who has stalked them as that term is defined in RCW 9A.46.110 ; or [ ] who has engaged in conduct that would constitute a sex offe nse as defined in RCW 9A.44.130; or [ ] from a person who is a family or household member as defin ed in RCW 26.50.010 who has engaged in conduct that would constitute domestic violence as defined in RCW 26.50.010 . Mt and Decl for Civil Fee Waiver - Harassment (MT WVF ) - Page 2 of 2 UH 02.0100 (07 /201 9) – GR 3 4, RCW 10.14.055, .060 RCW 10.14.060 provides that if the petitioner’s request for fee waiver is granted, “then no fees for service may be charged to the petitio ner. ” Dated: Signature of Requesting Party Print or Type Name III. Declaration I declare that, 3.1 [ ] I cannot afford to meet my necessary household living expenses and pay the filing fees and surcharges imposed by the court. Please see t he attached Financial Statement, which I incorporate as part of this declaration. [ ] In addition to the information in the financial statement I would like the court to consider the following: . 3.2 [ ] I am seeking protection from the respo ndent who : [ ] has stalked me, or the minor child(ren) listed in the petition ; [ ] has engaged in conduct that would constitute a sex offense as defined in RCW 9A.44.130 ; or [ ] is a family or household member as defined in RCW 26.50.010 who has eng aged in conduct that would constitute domestic violence as defined in RCW 26.50.010 ; as described in the Statement in the Petition for Order for Protection – Harassment . [ ] (C heck if applies .) I filed this motion by mail. I enclosed a self -addressed stamped envelope with the motion so that I can receive a copy of the order once it is signed. I declare under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct. Signed at (city) ____________ __________, (sta te) ________ on (date) __________________ . Signature Print or Type Name