Fee Waiver Request

Fee Waiver Request Form

Please note that no exceptions can be made to the Fee Waiver requirements.

Due to legal requirements, Fee Waivers are only granted when the requirements are met. Any Fee waiver requests require you to complete the following questions. Additional documentation about HOUSEHOLD income will be required to determine if fees can be waived.

• Please do not contact our office to check on the status of a fee wavier.
• Additional phone calls, to check the status, will delay processing time.
• We will contact you when we have processed your request.

Upon receipt of all documents, allow 1-2 business days for processing. If you do not provide the necessary documentation for a fee waiver, the fee waiver request will not be considered or approved.

Name*

First

Last

Email

How many people are in your household?*

What is your gross HOUSEHOLD annual income?*

What State do you live in?*

Select valueAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorthCarolinaNorth DakotaOhioOklahomaoregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Multiple Choice*

I certify that the information submitted in this application is true and correct to the best of my knowledge.

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