Free Application for Waiving Fee - New Hampshire

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THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH
http://www.courts.state.nh.us

Court Name: Case Name: Case Number:
(if known)

APPLICATION FOR WAIVING FEE
Check one: Filing fee Default fee Citation fee

1. 2. 3. 4.

Person requesting that fee be waived Document being filed Amount of fee to be waived $

Reasons for request to waive fee:

For the above-stated reasons, I request that the fee specified above be waived.

Date

Signature of person making request

ORDER Fee is waived. Fee is not waived.
Date Judge

NHJB-2314-P (10/01/2006) (formerly AOC-202D-003)

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