9913EN | October 2017

Filing a Motion to Remit (Remove) Legal Financial Obligations in

District or Municipal Court

Instructions and Forms October 2017

9913EN | October 2017

Table of Contents- Page 1

Contents

Section 1: Questions and Answers........................................................................................................... 1

A. Should I use this packet? .......................................................................................................... 1

B. What forms are in this packet? ................................................................................................. 1

C. How do I label each form? ........................................................................................................ 1

Section 2: How to Fill Out each Form ...................................................................................................... 2

A. Instructions for the Motion to Remit/Waive Fines and Costs .................................................. 2

B. Instructions for the Notice of Issue (Hearing) .......................................................................... 2

C. Instructions for the Financial Statement .................................................................................. 3

D. Instructions for the Declaration of Defendant ......................................................................... 4

E. Instructions for the Order ......................................................................................................... 5

Section 3: Next Steps ............................................................................................................................... 5

A. I filled out the forms. Now what? ............................................................................................. 5

B. I served and filed the motion. Now what? ............................................................................... 6

C. How do I represent myself at the hearing? .............................................................................. 6

9913EN | October 2017

Filing a Motion to Remit LFO’s - Page 1

Filing a Motion to Remit (Remove) Legal Financial Obligations in District or Municipal Court

Section 1: Questions and Answers

A. Should I use this packet?

Yes, but only if one of these is true:

you have a misdemeanor or gross misdemeanor criminal conviction in district or

municipal court

your driver’s license is suspended for failure to pay fines on a misdemeanor or gross

misdemeanor offense

Read Legal Financial Obligations (LFO’s) before using this packet.

If you have a felony criminal conviction in a superior court, use Filing a Motion to

Remit Legal Financial Obligations in Superior Court. You can get it at

www.washingtonlawhelp.org.

If you have traffic infractions holding your license, My Driver’s License was

Suspended. Can I Get it Back has more info.

B. What forms are in this packet?

Motion to Remit/Waive Fines and Costs

Financial statement – General Rule 34 form

Declaration of Defendant

Notice of Issue (Hearing)

Affidavit of Service

C. How do I label each form?

Caption: The caption is located on the upper left box of the first page. If you have a case

filed in municipal court, write City of [whatever city it is] v. [Your Name], DEFENDANT. If

your case was in District Court, write State of Washington v. [Your Name], DEFENDANT.

You must do this on the first page of each form.

9913EN | October 2017

Filing a Motion to Remit LFO’s - Page 2

Case number: This will be on your court paperwork or Department of Licensing records, if

these fines are suspending your license.

Footer: At the bottom-right corner of every page, you must put your name and address.

If you are filing motions for more than one case number, each set must have the

correct case number, county, and caption.

Section 2: How to Fill Out each Form

A. Instructions for the Motion to Remit/Waive Fines and Costs

Fill out the caption.

I. Introduction and Relief Requested. In the blank, put your full legal name.

II. Evidence Relied Upon. Read this section.

III. Legal Authority. Read this section.

IV. Conclusion & Prayer for Relief. This section is very important. You are briefly stating

what you want the judge to do with your case. Check all boxes that apply.

The state Supreme Court in City of Richland v. Wakefield has held that if your

only income is Social Security disability benefits, a court cannot order you to use

any of your benefits to pay your LFO’s. If you get Social Security disability

benefits, you should mention the Wakefield case in your motion.

Signature and Date. Sign and date the motion on the last page. Print or type your address.

If you want the judge to see more paperwork that will help your case, write “See

Attachment #, name of document” at the end of a sentence in the Facts section.

Example 1: I am disabled. My only source of income is SSI. See Attachment 2, Copy

of Social Security Award.

Example 2: I am a full-time student. My only source of income is a PEL grant. See

Attachment 3, PEL Grant award letter.

Example 3: I suffer from multiple illnesses including diabetes and PTSD. See

Attachment 4, Medical Report, Patient history.

B. Instructions for the Notice of Issue (Hearing)

Fill out the caption and footer.

9913EN | October 2017

Filing a Motion to Remit LFO’s - Page 3

Getting a hearing date and time: Call the court clerk. Tell them what type of

motion you are filing and ask for a hearing date. Every county has its own rules

about many days before a hearing to file a motion. Ask the clerk when you must

file the motion. In most counties, it is at least seven days before the hearing.

Put the information they give you in the appropriate spaces.

Sign your name and put the date you signed.

C. Instructions for the Financial Statement

You must put all your income and expenses on this sheet.

Case Name and Case Number: In the blanks, put the caption and case number.

1. Put your name.

2. Check the box if anyone living in your household depends on you for support. Put how many people depend on you. Put their ages.

3. My Monthly Income:

Check to show if you have a job.

If you are working, put your employer’s name.

Gross pay per month: put your pay before taxes.

Take home pay per month: put your pay after taxes.

You may not be able to give exact amounts if your income is not steady or it

changes every month. In that case, you must note that you are giving

approximates or averages.

4. Other Sources of Income per Month in my Household: Put any non-work income here. In Source, put where the income comes from. (Example: veterans’ benefits.) Next to the dollar sign, put how much. Sub-total: If you have income from more than one source, add it all up here. Check the box underneath if you get food stamps. Total Income, lines 3 (take home pay) and 4: Put here the sum of your take-home pay plus any income you listed in 4.

The state Supreme Court in City of Richland v. Wakefield has held that if your

only income is Social Security disability benefits, a court cannot order you to use

any of your benefits to pay your LFO’s.

9913EN | October 2017

Filing a Motion to Remit LFO’s - Page 4

5. My Household Assets: In the blanks, put the amounts that apply to your current situation. After Total Household Assets, add up all your assets.

If a blank does not apply to you, put a zero in it.

6. My Monthly Household Expenses: In the blanks, put the amounts that apply to your current situation. In the blank next to “Sub-Total,” add up all expenses.

7. My Other Monthly Household Expenses: Use this for any monthly household expenses not listed in number 6.

8. My Other Debts with Monthly Payments: List debts such as car payments, credit card payments, and loan payments.

Total Household Expenses and Debts, Lines 6, 7, and 8: Add up your subtotals in 6, 7,

and 8.

Sign and date at the bottom where it says.

D. Instructions for the Declaration of Defendant

Fill out the caption.

On the first line, put your name.

1. Read this.

2. Put the main reasons you cannot afford to pay your LFOs. Put any benefits you get

(TANF, SSI, SFA, and/or food assistance).

The state Supreme Court in City of Richland v. Wakefield has held that if your

only income is Social Security disability benefits, a court cannot order you to use

any of your benefits to pay your LFO’s. If you get Social Security disability

benefits, you should mention the Wakefield case in your motion.

3. Read this.

4. After “My gross income is,” put the amount from box 3 of your Financial Statement. Look

at the chart at this link: http://familiesusa.org/product/federal-poverty-guidelines. Check

the first box in the next sentence if the chart at the link says you are below 125% of the

federal poverty line. Otherwise, check the second box.

Put the date and place you are signing this form. Then sign.

9913EN | October 2017

Filing a Motion to Remit LFO’s - Page 5

E. Instructions for the Order

Fill out the caption.

At the end of the Order, sign on the bottom left signature line. Below that, print your name,

address and phone number.

LEAVE THE REST OF THE ORDER BLANK. This is your proposed Order only. The

judge will fill out and sign this if s/he decides in your favor.

Section 3: Next Steps

A. I filled out the forms. Now what?

You must

1. make copies and sets of copies

2. have a copy of the papers served on the prosecutor

3. file your papers with the court

Copy your papers: Make three copies of every paper, including the proposed order and

financial documents. Then make three full sets of copies of your papers:

One set for you

One for the prosecutor

One for the judge for “working papers”

Working papers are a courtesy set for the judge. Sometimes the originals do not

make it into the court file in time for the judge to read them.

Here is the full list of court papers:

Motion to Remit/Waive Fines and Costs

Financial Statement – GR 34

Any other attachment you are including (any attachments you mentioned in your

Declaration)

Declaration of Defendant

Order (your proposed Order)

Affidavit of Service - Do not make copies of this form until after you have had the

papers served. See below.

9913EN | October 2017

Filing a Motion to Remit LFO’s - Page 6

Serve the papers: You must (or someone else age 18 or over) must deliver a set of copies to

the prosecutor’s office, in-person OR by mail. If you bring the papers to the office, ask the

assistant or prosecutor to sign the Affidavit of Service. This is your proof they have gotten

their copies. After serving the prosecutor, you fill out the Affidavit of Service with both

the date you served the prosecutor

the method in which you served him/her

If you mailed the papers, you must put

the name of the person who mailed it

the date they mailed the motion to the prosecutor

Save all receipts for proof that you served the prosecutor.

After you have filled out the form, have the server sign and date it.

Have the papers served before you go to the clerk’s office to file.

Filing your motion: Go to the Clerk’s office. Explain that you are filing a motion on the

criminal docket AND scheduling a hearing. Give the Clerk the set of originals for filing. Ask

the Clerk to stamp your set of copies with the “Filed” stamp. Ask how to leave a working

copy for the judge.

Keep your copy of your forms for your own records.

B. I served and filed the motion. Now what?

Check your mail. The prosecutor might (does not have to) file and mail you an answer to

your motion. If s/he does, read the response so you know ahead of time what the

prosecutor’s arguments are, if any.

C. How do I represent myself at the hearing?

You must be on time for your hearing day. On your hearing day, sit down in the courtroom.

Wait until the judge calls your case or name.

This publication provides general information concerning your rights and responsibilities. It is not intended as a

substitute for specific legal advice.

This information is current as of October 2017.

© 2017 Northwest Justice Project — 1-888-201-1014

(Permission for copying and distribution granted to the Alliance for Equal Justice and to individuals for non-commercial

purposes only.)

MOTION TO WAIVE FINES AND COSTS AND/OR ESTABLISH A PAYMENT PLAN/COMMUNITY SERVICE - 1

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IN THE _______________ COURT OF THE STATE OF WASHINGTON

IN AND FOR THE COUNTY OF ________________

__________________________,

Plaintiff,

vs.

__________________________,

Defendant.

No.

MOTION TO REMIT/WAIVE FINES

AND COSTS OR IN THE

ALTERNATIVE ESTABLISH A

PAYMENT PLAN/COMMUNITY

SERVICE

I. INTRODUCTION AND RELIEF REQUESTED

Defendant, _______________________, moves the Court for an order remitting

Defendant’s legal financial obligations (LFOs), pursuant to RCW 10.01.160(4) and RCW

10.01.180(4), on the grounds that the imposition of said fines and costs constitutes a manifest

hardship upon Defendant and/or his/her family and the Defendant is not in contumacious

default. In addition, the Defendant moves the Court for an order waiving all other financial

obligations, authorized by statute, due to indigency.

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II. EVIDENCE RELIED UPON

This motion is based on the Defendant’s Declaration attached hereto.

III. LEGAL AUTHORITY

A. RCW 10.01.160(4) requires the court to waive costs cause upon a finding of

manifest hardship.

RCW 10.01.160(4) provides:

A defendant who has been ordered to pay costs and who is not in contumacious

default in the payment thereof may at any time petition the sentencing court for

remission of the payment of costs or of any unpaid portion thereof. If it appears

to the satisfaction of the court that payment of the amount due will impose

manifest hardship on the defendant or the defendant's immediate family, the court

may remit all or part of the amount due in costs, or modify the method of payment

under RCW 10.01.170.1

Under RCW 10.01.160(4), when a Defendant files a motion seeking remission, the

appropriate inquiry is whether the legal financial obligations have resulted in a "manifest

hardship" to Defendant or his/her family. When applying the “manifest hardship test,” courts

must look to Defendant’s current financial circumstances. State v. Blank, 131 Wn.2d 230, 253,

930 P.2d 1213 (1997). Blank held that RCW 10.73.160(4), which is nearly identical to RCW

10.01.160(4), requires the court to apply the manifest hardship test to Defendant’s remission

circumstances at the time s/he makes the motion to remit costs. As detailed in Fuller and its

progeny, “the obligation to repay the State accrues only to those who later acquire the means

to do so without hardship.” Fuller, 417 U.S. at 46, State v. Barklind, 87 Wn.2d 814, 817, 557

P.2d 314 (1977). In other words, "[t]hose who remain indigent or for whom repayment would

1 RCW 10.01.170 gives a court authority to allow payment plans and/or extend time to pay the fines.

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work 'manifest hardship' are forever exempt from any obligation to repay." Fuller, 417 U.S. at

53.

For guidance, courts should look to the comment in court rule GR 34 regarding

indigence. In State v. Blazina, our Supreme Court stated:

This rule allows a person to obtain a waiver of filing fees and surcharges on the

basis of indigent status, and the comment to the rule lists ways that a person may

prove indigent status. GR 34. For example, under the rule, courts must find a

person indigent if the person establishes that he or she receives assistance from a

needs-based, means-tested assistance program, such as Social Security or food

stamps. Id. (comment listing facts that prove indigent status). In addition, courts

must find a person indigent if his or her household income falls below 125

percent of the federal poverty guideline. Id. Although the ways to establish

indigent status remain nonexhaustive, see id., if someone does meet the GR 34

standard for indigency, courts should seriously question that person's ability to

pay LFOs.

State v. Blazina,182 Wn. 2d 827, 838, 839, 344 P.3d 680, 685 (2015) (emphasis added). Under

GR 34, a defendant who is above 125% of the federal poverty level but has recurring basic

living expenses rendering him/her without the financial ability to pay LFOs meets GR 34’s

indigent standard. The court should also take into account other circumstances demonstrating

a defendant’s inability to pay. GR 34. “Basic living costs" means the average monthly amount

Defendant spends for reasonable payments toward living costs, such as shelter, food, utilities,

health care, transportation, clothing, loan payments, support payments, and court-imposed

obligations. RCW 10.101.010.

B. The court must also waive discretionary fines pursuant to RCW 10.01.180(4).

RCW 10.01.180(4) provides:

If it appears to the satisfaction of the court that the default in the payment of a

fine or costs is not contempt, the court may enter an order allowing the defendant

additional time for payment, reducing the amount thereof or of each installment

or revoking the fine or costs or the unpaid portion thereof in whole or in

part.

MOTION TO WAIVE FINES AND COSTS AND/OR ESTABLISH A PAYMENT PLAN/COMMUNITY SERVICE - 4

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(Emphasis added).

The Defendant is not in contempt of court. The inability to pay due to indigency is not

willful contempt. Bearden v. Georgia, 461 U.S. 660, 103 S. Ct. 2064, 76 L.Ed.2d 221 (1983).

Therefore, this Court must waive the discretionary fines imposed on this case or grant other

relief as requested.

IV. CONCLUSION AND PRAYER FOR RELIEF

Defendant respectfully requests the court grant the motion to remit legal financial

obligations by:

WAIVING all or part of the court costs imposed.

WAIVING all or part of the fines imposed.

IF APPLICABLE, REMOVING THE FINES/COSTS FROM COLLECTION

AND LOWERING Defendant’s monthly payments.

SUSPENDING monthly payment of Legal Financial Obligations until Defendant

regains the ability to make said payments

ALLOWING the Defendant to work off the costs/fines on community service.

Other:____________________________________________________________

_________________________________________________________________

_________________________________________________________________

Respectfully submitted this _____day of ____________, 20___.

_______________________________

Defendant’s Signature

Defendant’s Name:

Address:

NOTICE OF ISSUE- PAGE 1 OF 1 NAME:

ADDRESS:

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IN THE _________________ COURT OF THE STATE OF WASHINGTON

IN AND FOR THE COUNTY OF _______________

_________________________,

Plaintiff,

vs.

_________________________,

Defendant.

No.

________________________

NOTICE OF ISSUE

CLERK’S ACTION

REQUIRED

TO: ALL PARTIES, THEIR COUNSEL, AND THE CLERK OF THE COURT

PLEASE NOTE the above cause for hearing at the following time:

DATE:

TIME:

JUDGE:

PLACE:

MATTER: Motion to Remit Fines and Costs.

DATED this _____ day of _____________, 20___.

_____________________________________

Defendant, Pro Se

Financial Statement (Attachment) - Page 1 of 1 WPF GR 34.0300 (2/2011) GR 34

Case Name:_____________________________ Case Number:________________

Financial Statement (Attachment)

1. My name is:

2. [ ] I provide support to people who live with me: How many? Age(s):

3. My Monthly Income: 6. My Monthly Household Expenses:

Employed [ ] Unemployed [ ] Rent/Mortgage: $

Employer’s Name: Food/Household Supplies: $

Gross pay per month (salary or hourly pay):

$ Utilities: $

Take home pay per month: $ Transportation: $

4. Other Sources of Income Per Month in my Household:

Ordered Maintenance actually paid:

$

Source: $ Ordered Child Support actually paid:

$

Source: $ Clothing: $

Source: $ Child Care: $

Source: $ Education Expenses: $

Sub-Total: $ Insurance (car, health): $

[ ] I receive food stamps. Medical Expenses: $

Total Income, lines 3 (take home pay) and 4:

$ Sub-Total: $

5. My Household Assets: 7. My Other Monthly Household Expenses:

Cash on hand: $ $

Checking Account Balance: $ $

Savings Account Balance: $ $

Auto #1 (Value less loan): $ $

Auto #2 (Value less loan): $ Sub-Total: $

Home (Value less mortgage): $ 8. My Other Debts with Monthly Payments:

Other: $ $ /mo

Other: $ $ /mo

Other: $ $ /mo

Other: $ $ /mo

Other: $ Sub-Total: $

Total Household Assets: $ Total Household Expenses and Debts, lines 6, 7, and 8:

$

Date: Signature:

DECLARATION OF DEFENDANT - 1 Name:

Address:

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IN THE _______________ COURT OF THE STATE OF WASHINGTON

IN AND FOR THE _______________ OF _________________________

____________________________,

Plaintiff,

vs.

_____________________________,

Defendant.

No. ________________________

DECLARATION OF DEFENDANT

I, ____________________________ declare:

1. I am the Defendant in this matter.

2. The fines and/or costs imposed on this case impose a manifest hardship on

myself and/or my family for these reasons:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

DECLARATION OF DEFENDANT - 2 Name:

Address:

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

3. I am indigent as defined in court rule GR 34. (See GR 34 Form, attached.)

4. My gross income is $____________ a month. ( ) I am at or below 125%

of the federal poverty level. ( ) My income is above 125% of the

federal poverty line BUT I have recurring basic living expenses that make

me unable to pay my legal financial obligations.

5. I receive assistance from these public benefits programs.

____________________________________________________________

____________________________________________________________

____________________________________________________________

I certify under penalty of perjury under the laws of the state of Washington that the foregoing

statement is true.

Signed in _____________________ (city), Washington on _________________ (date).

_________________________________________

Defendant’s Signature

Defendant’s Name:__________________________

ORDER - 1 Name: Address:

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[PLACE HOLDER FOR ORDER]

IN THE _________________ COURT OF THE STATE OF WASHINGTON

IN AND FOR THE COUNTY OF ________________________

THE STATE OF WASHINGTON,

Plaintiff,

vs.

_____________________________,

Defendant.

No. _______________________

ORDER

[PROPOSED]

(Defendant’s name) _____________________________ has presented a motion to

remit legal financial obligations (LFOs).

I. FINDINGS

1.1. Proper Jurisdiction and Venue

The Court has proper jurisdiction and venue.

1.2. Other

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

ORDER - 2 Name: Address:

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II. ORDER

It is Ordered:

The court grants Defendant’s motion, as follows:

2.1. Legal Financial Obligations

The court waives/ remits Defendant’s legal financial obligations to the following

amounts:

Mandatory LFOs

Restitution $____________

Victim’s Penalty Assessment $____________

Discretionary LFOs

Attorney Costs $____________

Bench Warrant Fee $____________

Extradition Costs $____________

Jury Fee $____________

Witness Costs $____________

Court Costs $____________

Appellate Costs $____________

Drug Offense Costs $____________

Investigative fees $____________

Fines:_________________________________ $____________

2.2. Schedule of Payments: Legal financial obligations are due as follows:

Defendant is not in willful default.

ORDER - 3 Name: Address:

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Defendant’s failure to pay is based on his/her indigency.

The court costs imposed in this case impose a manifest hardship on the

______Defendant

______ Defendant’s family

The court waives the discretionary legal financial obligations imposed

in this case, pursuant to RCW 10.01.160(4) and RCW 10.01.180.

Other:___________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

Dated this _____day of ____________, 20___.

_______________________________

Judge

Presented by:

______________________________________

Defendant’s Signature, Pro-se

Print name: ____________________________

Address: ______________________________

Phone: ______________________________

AFFIDAVIT OF SERVICE - 1 Name: Address:

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IN THE __________________ COURT OF THE STATE OF WASHINGTON

IN AND FOR THE COUNTY OF ____________________________

_____________________________,

Plaintiff,

vs.

_____________________________,

Defendant.

No. ________________________

AFFIDAVIT OF SERVICE

I, ____________________________, declare under penalty of perjury, that I am not a party

to the action, and am over 18 years of age. On the _________ day of

_______________________, ______, I served a true copy of the attached motion to

remit/waive fines and costs and corresponding documents by personal service

to______________________________________, Prosecuting Attorney at

the________________________________________________________________(address).

Dated this _____day of ____________, 20___.

_______________________________

Signature

Name: