Common use of PLEASE COMPLETE THE FOLLOWING Clause in Contracts

PLEASE COMPLETE THE FOLLOWING. I prepared all of the pleadings and papers to be filed in this case myself, and no one has been, or will be, paid on my behalf. I have not paid anyone or any organization for the preparation and processing of these documents or for the forms to be used in this case. day of , 20 . Notary Public for State of Montana Residing at My Commission Expires: Hon. Fourth Judicial District Missoula County Courthouse ▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇▇▇ Missoula, Montana 59802 (▇▇▇) ▇▇▇-▇▇▇▇ Fax (▇▇▇) ▇▇▇-▇▇▇▇ In re the Marriage of: , Co-Petitioner, and , Co-Petitioner. Dept. No. Cause No.: DR- ORDER ON INABILITY TO PAY FILING FEES AND OTHER COSTS Having considered the information contained in [ ] Wife [ ] Husband Co-Petitioner’s Affidavit of Inability to Pay Filing Fees and Other Costs, IT IS ▇▇▇▇▇▇ ORDERED that, pursuant to §▇▇-▇▇-▇▇▇, MCA et seq., all officers of the Court shall perform all services associated with this action, including filing, issuance and service of all pleadings and Court orders, without demanding or receiving fees in advance. Leave to file the Petition expires thirty (30) days from the date of this Order. Dated this day of , 20 . DISTRICT COURT JUDGE FORM #216 Name Address City State Zip Code Phone Number Email Address WIFE, CO-PETITIONER PRO SE Name Address City State Zip Code Phone Number Email Address HUSBAND, CO-PETITIONER PRO SE

PLEASE COMPLETE THE FOLLOWING. I prepared all of the pleadings and papers to be filed in this case myself, and no one has been, or will be, paid on my behalf. I have not paid anyone or any organization for the preparation and processing of these documents or for the forms to be used in this case. day of , 20 . Notary Public for State of Montana Residing at My Commission Expires: Hon. Fourth Judicial District Missoula County Courthouse ▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇▇▇ Missoula, Montana 59802 (▇▇▇) ▇▇▇-▇▇▇▇ Fax (▇▇▇) ▇▇▇-▇▇▇▇ In re the Marriage of: , Co-Petitioner, and , Co-Petitioner. Dept. No. Cause No.: DR- ORDER ON INABILITY TO PAY FILING FEES AND OTHER COSTS Having considered the information contained in [ ] Wife [ ] Husband Co-Petitioner’s Affidavit of Inability to Pay Filing Fees and Other Costs, IT IS ▇▇▇▇▇▇ ORDERED that, pursuant to §▇▇-▇▇-▇▇▇, MCA et seq., all officers of the Court shall perform all services associated with this action, including filing, issuance and service of all pleadings and Court orders, without demanding or receiving fees in advance. Leave to file the Petition expires thirty (30) days from the date of this Order. Dated this day of , 20 . DISTRICT COURT JUDGE FORM #216 215b Name Address City State Zip Code Phone Number Email Address WIFE, [ ] WIFE [ ] HUSBAND CO-PETITIONER PRO SE Name Address City State Zip Code Phone Number Email Address HUSBANDIn re the Marriage of: , COCo-PETITIONER PRO SEPetitioner, and , Co-Petitioner. Dept. Cause No. AFFIDAVIT OF INABILITY TO PAY FILING FEES AND OTHER COSTS STATE OF MONTANA ) COUNTY OF ) I, , 1. I have a good cause of action or defense and am unable to pay the costs. 2. I request that the Court issue an order waiving prepayment of my fees. 3. I understand the court may order me to answer questions about my finances. 4. I understand if the court waives my fees, I may still have to pay later if I cannot give the court proof of my financial eligibility or if my financial situation improves before this case is over. I am: Single Married Divorced Separated 5. I am asking the court to waive my fees because I receive (check all that apply): □ The gross monthly income for all household members (before deduction for taxes) that I support or who help support me is less than listed in the table below. I am including all sources of income (such as child support, benefits, unemployment, dividends, interest, business rental income, etc.) [Mark the box below that describes your household size and monthly income before taxes.] I am the only person living in my household and I make less than $1,128.00 a month. There are (2) people living in the household and together we make less than $1,517.00/month. There are (3) people living in the household and together we make less than $1,907.00/month. □ There are (4) people living in the household and together we make less than $2,296.00/month. There are (5) people living in the household and together we make less than $2,686.00/month. There are (6) people living in the household and together we make less than $3,076.00/month. There are (7) people living in the household and together we make less than $3,465.00/month. There are (8) people living in the household and together we make less than $3,855.00/month. Are persons dependent on you for support? Yes No If yes, list each person and that person's age and relationship to you: I have unusual medical or care expenses or am experiencing an emergency (describe): Hourly wage $ Hours you work per week Type of employment Length of current Employment Employer's name and address Is there any reason, such as disability, family responsibilities, or pursuit of an education that prevents you from being able to work full-time? Yes, please explain: . No.