Annex hereto a copy of the referral letter from the legal services or legal aid society referring this pro bono client to you.

Set forth the reasons the pro bono client is seeking financial assistance to pay their filing fee. Please include either an Order denying an application for a fee waiver or the calculation as to why the client does not qualify for a fee waiver as per 28 U.S.C. Section 1930 and why the client will not be able to make installment payments. Attach copies of Schedules I and J to supplement the application.