IN THE ____________ COURT OF ____________ COUNTY, WEST VIRGINIA
_________________________ Plaintiff or Petitioner v. Case No. ____________
_________________________ Defendant or Respondent
ORDER: TO FILE NEW FINANCIAL AFFIDAVIT AND APPLICATION FOR WAIVER OF FEES, COSTS, OR SECURITY
This court hereby ORDERS ________________________________________ (name of party) to file a new financial affidavit and application for determination by this court as to eligibility for waiver of fees, costs, or security attendant to proceedings and services in this case. __________________________________________ shall not be eligible for such (name of party) waiver until a further order of this court grants his or her new application.
ENTER, this __________ day of ______________________________.
________________________________ Circuit Judge/Family Court Judge/Magistrate
SCA-C&M204.03