© Clark County Self-Help Center Fee Waiver Order
Rev. Nov. 2015 ALL RIGHTS RESERVED
1
OIFP
Name: _________________________
Address: _______________________
City, State, Zip: __________________
Phone: _________________________
Email: _________________________
Self-Represented
DISTRICT COURT
CLARK COUNTY, NEVADA
_____________________________
Plaintiff,
vs.
_____________________________
Defendant.
CASE NO.: ____________________
DEPT: ____________________
Order to Proceed in Forma Pauperis
Upon consideration of the movant’s Application to Proceed in Forma Pauperis, and it
appearing that there is not sufficient income, property, or resources with which to maintain the
action, and good cause appearing therefore:
IT IS HEREBY ORDERED that (name) __________________________________
shall be permitted to proceed In Forma Pauperis with this action pursuant to the terms of this
Order.
IT IS FURTHER ORDERED that if the above-named party prevails in this action,
the Court shall enter an order pursuant to NRS 12.015 requiring the opposing party to pay the
Court, within five (5) days, the costs which would have been incurred by the prevailing party,
and those costs must then be paid as provided by law.