© 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.
© Clark County Self-Help Center Fee Waiver Order
Rev. Nov. 2015 ALL RIGHTS RESERVED
2
IT IS FURTHER ORDERED that the above-named party shall be permitted to
commence or defend the action without costs. The Clerk of Court shall file or issue any
necessary writ, process, pleading, or paper without charge.
IT IS FURTHER ORDERED that the Sheriff or other appropriate officer within this
State shall make personal service of any necessary writ, pleading, or paper without charge.
IT IS FURTHER ORDERED that this Order shall not apply to costs for transcripts
or recordings of court proceedings. A separate application and order shall be required to waive
any such fees.
IT IS FURTHER ORDERED that this Order shall expire one year from the date the
Order is filed. The party shall be required to reapply for any further waiver after this Order
expires.
DATED this _______ day of _____________________, 20__.
___________________________________
DISTRICT COURT JUDGE
Respectfully Submitted:
(Signature) __________________________________
(Printed Name) _______________________________
In Proper Person
/s/