WSR 17-01-022
RULES OF COURT
STATE SUPREME COURT
[December 7, 2016]
IN THE MATTER OF THE ADOPTION OF THE PROPOSED AMENDMENTS TO RAP FORM 12A—FINDINGS OF INDIGENCY
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ORDER
NO. 25700-A-1163
The Supreme Court Clerk's Office, having recommended the expeditious adoption of the proposed rule amendments to RAP Form 12A—Findings of Indigency, and the Court having considered the amendments and comments submitted thereto, and having determined that the proposed amendments will aid in the prompt and orderly administration of justice;
Now, therefore, it is hereby
ORDERED:
(a) That the amendments as shown below are adopted.
(b) That the amendments will be published expeditiously in the Washington Reports and will become effective upon publication.
DATED at Olympia, Washington this 7th day of December, 2016.
 
 
Madsen, C.J.
Johnson, J.
 
Wiggins, J.
Owens, J.
 
Gonzalez, J.
Fairhurst, J.
 
Gordon McCloud, J.
Stephens, J.
 
Yu, J.
FORM 12A. FINDINGS OF INDIGENCY
(Rule 15.2(c))
SUPERIOR COURT OF WASHINGTON
FOR ____________ COUNTY
[Name of plaintiff]
Plaintiff,
v.
[Name of defendant]
Defendant.
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No. [trial court]
FINDINGS OF INDIGENCY AND ORDER TO TRANSMIT FINDINGS OF INDIGENCY
The court finds that ______________________________________, the appellant/petitioner in this action is unable by reason of poverty to pay for all or some of the expenses of appellate review. The court finds, however, that the moving party is able to contribute $ _______. The following portions of the record are reasonably necessary for review:
(1) Those portions of the verbatim report of proceedings as follows: [Designate parts of report.]
(2) A copy of the clerk's papers as follows: [Designate papers by name and trial court clerk's subnumber.]
(3) Preparation of original documents to be reproduced by the clerk as provided in rule 14.3(b).
(4) Reproduction of briefs and other papers on review that are reproduced by the clerk of the appellate court.
(5) The cost of transmitting cumbersome exhibits: [Designate cumbersome exhibits needed for review. See rule 9.8(b).]
(6) Other items: [Designate items]
Now, therefore, it is ORDERED that the clerk of the superior court shall promptly transmit to the Supreme Court the Motion for Order of Indigency, any affidavit or declaration in support of the motion, and the Findings of Indigency.
[Date]
 
 
Signature [Name]
Judge of the Superior Court
Presented by:
[Name of party and attorney
for party presenting order;
Washington State Bar Association
membership number]
Presented by:
[signature]
 
Print Name:
 
Address of Party:
 
 
 
[If presented by an attorney, name of
Attorney, name of party, and Washington
State Bar Association membership number.]
Reviser's note: The brackets and enclosed material in the text of the above section occurred in the copy filed by the agency and appear in the Register pursuant to the requirements of RCW 34.08.040.