Free ##cc-Dc8.vp - Maryland


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Date: November 16, 2004
File Format: PDF
State: Maryland
Category: Court Forms - State
Author: warnkenr
Word Count: 281 Words, 5,111 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.courts.state.md.us/courtforms/joint/ccdc008.pdf

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¨ CIRCUIT COURT ¨ DISTRICT COURT OF MARYLAND FOR................................................
City/County

Located at ......................................................................... Case No. ...............................................
Court Address

In the matter of .....................................................

vs.

................................................................
Defendant

PETITION FOR WAIVER OF COSTS
The Petitioner hereby applies for a Waiver of Costs and represents that the answers to the following questions are true. (a) (b) (c) (e) Do you have any money?..................................... How much? ..................................... Where? ............................. Are you employed?................................ Where? ..................................................................................................... Position.................................................................................................................................................................... Are you self-employed? ......................... Doing what? ............................................................................................. Do you own an automobile?.................................. Make.............................................................. Year ................... Is it paid for?............................ How much do you owe? ................................. To whom? ....................................... Where is the car?....................................................................................................................................................... (f) Do you owe any money to others? ..................... How much?......................................... To whom?......................... (g) Do you own any real estate? ................... Value................................. Where............................................................ (h) Do you own any other property of any kind? ...................................... What?............................................................ (i) (j) Does anyone owe you money? ............... If so, state name, address, and amount ....................................................... ................................................................................................................................................................................. Do you receive money from any other source, including disability benefits, investments?........................................ If so, how much......................................................................................................................................................... (k) If married, give the name and address of your wife/husband...................................................................................... ................................................................................................................................................................................. Does your wife/husband work? .............. Where? ..................................................................................................... ........................................................................................................................ Rate of Pay? .................................... (l) Do you have any children?.................................... Names, ages, and addresses:....................................................... ................................................................................................................................................................................. ................................................................................................................................................................................. Could they contribute to your assistance now?.......................................................................................................... (m) What is your home address? ...........................................................................................Telephone ......................... The Petitioner further represents being without funds and unable to obtain any funds whatsoever from anyone, including family and associates, to pay for: o Counsel o Payment of the fine o Appeal expenses o Civil filing fee or other court costs. I solemnly affirm under the penalties of perjury that the contents of the foregoing document are true and correct. ..................................................................................... (d) What is your rate of pay? ...........................................................................................................................................

o Approved o Denied
Judge/Clerk of Circuit Court

ORDER

Petitioner

Reset Form
................................................................
Date

...........................................................................................
CC-DC 8 (Rev. 5/2003)