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Payment Plan Application

  1. Please list the case number(s) you wish to be considered for a payment plan. 

  2. Payment Reminders*

    Would you like to receive text message payment reminders? 

    (Data rates may apply..) 

  3. How would you like to receive a response from the Court? *
  4. Please select which payment plan you are requesting. *
  5. If you have selected the Reduced Payment Plan option, please provide the following information.  

  6. I understand the court may require verification of the information provided above. I agree to immediately report any change in my financial status to the court. I certify under penalty of perjury under Washington State law that the information I have provided on this form is true and correct. (Perjury is a criminal offense RCW 9A.72.)
  7. FOR COURT USE ONLY
  8. Determination of Eligibility for Reduced Payments
  9. Leave This Blank:

  10. This field is not part of the form submission.