Form MC 20 at a glance
What it is: MC 20 is the State of Michigan Fee Waiver Request, on which you request a waiver of your filing fees.
Where and when to file: Complete this form and file it with the court.
A filled-in Form MC 20 example: a fee waiver request based on public assistance
How to fill out Form MC 20, box by box
Court, Plaintiff/Petitioner, Defendant/Respondent and your name
Enter the JUDICIAL DISTRICT, JUDICIAL CIRCUIT and COUNTY, the Court address, the Court telephone no., the CASE NO. and JUDGE, and the matter in In the matter of.
Enter the Plaintiff/Petitioner's name, address, and telephone no. and the Defendant/Respondent's name, address, and telephone no.
Enter the Plaintiff/Petitioner's attorney, bar no., address, and telephone no. and the Defendant/Respondent's attorney, bar no., address, and telephone no.
Print or type your name after I.
I receive public assistance because of indigence
Request a waiver of your filing fees for the following reason: (Check 1, 2, or 3)
Check 1 if you receive the following type(s) of public assistance because of indigence:
Food Assistance Program through the State of Michigan (also known as FAP or SNAP), Medicaid (including Healthy Michigan, CHIP, and ESO), Family Independence Program through the State of Michigan (also known as FIP or TANF), Women, Infants, and Children benefits (WIC), Supplemental Security Income through the federal government (SSI), or Other means-tested public assistance.
Enter your public assistance case number(s) (if any). Write "none" if no case number. Do not write your Social Security Number.
I am represented by a legal services program
Check 2 if you are represented by a legal services program or you receive assistance from a law school clinic because of indigence, and enter the name of the legal services program or law school clinic.
I am unable to pay the fees
Check 3 if you are unable to pay the fees and you did not check item 1 or 2.
Enter your gross household income in $ every Week, Two weeks, Month or Year, the number of people in your household and your source of income.
List assets and their worth, such as bank accounts, and obligations and how much you pay, such as rent or other debts. If you need more space, attach a separate sheet.
Declaring under the penalties of perjury and signing
By signing you declare under the penalties of perjury that this request has been examined by you and that its contents are true to the best of your information, knowledge, and belief.
Enter the Date and your Signature.
More rules for Form MC 20
After you receive a decision on your request, you must serve your request and the decision on the other party(ies).
A decision on your request, and a prisoner's request
Your request was denied
IF YOUR REQUEST WAS DENIED: To continue your case and preserve your filing date, you have 14 days from the issue date (completed by clerk) to pay the filing fees or request a review.
To request a review, fill out a Request for Review of Denied Fee Waiver (form MC 114) and file it with the court.
The fee waiver request is denied because your gross household income is over 125% of the federal poverty guidelines and payment of the fees would not constitute a financial hardship for you, or Other.
Payment of filing fees is waived
Payment of filing fees is waived because your gross household income is under 125% of the federal poverty guidelines, or over 125% of the federal poverty guidelines but payment of the fees would constitute a financial hardship for you, or Other.
If payment of filing fees is waived and you become able to pay the fees before this case is resolved, you must notify the court.
The request is filed by a prisoner
If this request is filed by a prisoner, a certified statement of the prisoner's trust account showing a current balance and a 12-month history of deposits and withdrawals must accompany this form.
Common questions about Form MC 20
Where do I file it?
Complete this form and file it with the court.
Sources
[1] Form MC 20 (Rev. 1/26), Fee Waiver Request, State of Michigan Judicial (the Official source link on this page).