Application to Proceed in District Court Without Prepaying Fees or Costs

1
Your Information
2
Affidavit in Support of the ApplicationI am a plaintiff or petitioner in this case and declare that I am unable to pay the costs of these proceedings and that I am entitled to relief requested. I declare under penalty of perjury that the information below is true and understand that a false statement may result in a dismissal of my claims.
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3
Average monthly income amount during the past 12 months.For both you and your significant other (meaning boyfriend, girlfriend, spouse, or other person you rely on for support), estimate the average amount of money received from each of the following sources during the past 12 months. Adjust any amount that was received weekly, biweekly, quarterly, semiannuanlly, or annually to show the monthly rate. Use gross amounts, that is, amounts before any deductions for taxes or otherwise. PLEASE SCROLL FOR ALL THE FIELDS . IF A QUESTION DOEN NOT APPLY PLEASE TYPE NA
You
Significant other
I don't know
Specify (if required)
Employment
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Self-Employment
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Income from real property (such as rental income)
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
Interest and dividends
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
Alimony
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
Child support
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Row 5, Column 3
Retirement (such as social security, pensions, annuities, insurance)
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Row 6, Column 3
Disability (such as social security, insurance payments)
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Row 7, Column 3
Unemployment payments
Row 8, Column 0
Row 8, Column 1
Row 8, Column 2
Row 8, Column 3
Public-assistance (welfare)
Row 9, Column 0
Row 9, Column 1
Row 9, Column 2
Row 9, Column 3
Public-assistance (food assistance)
Row 10, Column 0
Row 10, Column 1
Row 10, Column 2
Row 10, Column 3
Public-assistance (Section 8 Housing Assistance)
Row 11, Column 0
Row 11, Column 1
Row 11, Column 2
Row 11, Column 3
Other (specify)
Row 12, Column 0
Row 12, Column 1
Row 12, Column 2
Row 12, Column 3
Total Monthly Income
Row 13, Column 0
Row 13, Column 1
Row 13, Column 2
Row 13, Column 3
Employment
Self-Employment
Income from real property (such as rental income)
Interest and dividends
Alimony
Child support
Retirement (such as social security, pensions, annuities, insurance)
Disability (such as social security, insurance payments)
Unemployment payments
Public-assistance (welfare)
Public-assistance (food assistance)
Public-assistance (Section 8 Housing Assistance)
Other (specify)
Total Monthly Income
You
Row 0, Column 0
Significant other
Row 0, Column 1
I don't know
Row 0, Column 2
Specify (if required)
Row 0, Column 3
You
Row 1, Column 0
Significant other
Row 1, Column 1
I don't know
Row 1, Column 2
Specify (if required)
Row 1, Column 3
You
Row 2, Column 0
Significant other
Row 2, Column 1
I don't know
Row 2, Column 2
Specify (if required)
Row 2, Column 3
You
Row 3, Column 0
Significant other
Row 3, Column 1
I don't know
Row 3, Column 2
Specify (if required)
Row 3, Column 3
You
Row 4, Column 0
Significant other
Row 4, Column 1
I don't know
Row 4, Column 2
Specify (if required)
Row 4, Column 3
You
Row 5, Column 0
Significant other
Row 5, Column 1
I don't know
Row 5, Column 2
Specify (if required)
Row 5, Column 3
You
Row 6, Column 0
Significant other
Row 6, Column 1
I don't know
Row 6, Column 2
Specify (if required)
Row 6, Column 3
You
Row 7, Column 0
Significant other
Row 7, Column 1
I don't know
Row 7, Column 2
Specify (if required)
Row 7, Column 3
You
Row 8, Column 0
Significant other
Row 8, Column 1
I don't know
Row 8, Column 2
Specify (if required)
Row 8, Column 3
You
Row 9, Column 0
Significant other
Row 9, Column 1
I don't know
Row 9, Column 2
Specify (if required)
Row 9, Column 3
You
Row 10, Column 0
Significant other
Row 10, Column 1
I don't know
Row 10, Column 2
Specify (if required)
Row 10, Column 3
You
Row 11, Column 0
Significant other
Row 11, Column 1
I don't know
Row 11, Column 2
Specify (if required)
Row 11, Column 3
You
Row 12, Column 0
Significant other
Row 12, Column 1
I don't know
Row 12, Column 2
Specify (if required)
Row 12, Column 3
You
Row 13, Column 0
Significant other
Row 13, Column 1
I don't know
Row 13, Column 2
Specify (if required)
Row 13, Column 3
1 of 14
4
Below, state any gifts received
You
Significant other
Reason for receiving (such as “loans” and/or “assistance from friends/family”)
1.
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
2.
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
3.
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
1.
2.
3.
You
Row 0, Column 0
Significant other
Row 0, Column 1
Reason for receiving (such as “loans” and/or “assistance from friends/family”)
Row 0, Column 2
You
Row 1, Column 0
Significant other
Row 1, Column 1
Reason for receiving (such as “loans” and/or “assistance from friends/family”)
Row 1, Column 2
You
Row 2, Column 0
Significant other
Row 2, Column 1
Reason for receiving (such as “loans” and/or “assistance from friends/family”)
Row 2, Column 2
You
Row 3, Column 0
Significant other
Row 3, Column 1
Reason for receiving (such as “loans” and/or “assistance from friends/family”)
Row 3, Column 2
1 of 4
5
Income amount expected next monthFor both you and your significant other (meaning boyfriend, girlfriend, spouse, or other person you rely on for support), estimate the average amount of money expected from each of the following sources next month. Adjust any amount that is expected to be received weekly, biweekly, quarterly, semiannuanlly, or annually to show the monthly rate. Use gross amounts, that is, amounts before any deductions for taxes or otherwise. PLEASE SCROLL FOR ALL THE FIELDS . IF A QUESTION DOEN NOT APPLY PLEASE TYPE NA
You
Significant other
I don't know
Specify (if required)
Employment
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Self-Employment
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Income from real property (such as rental income)
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
Interest and dividends
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
Alimony
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
Child support
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Row 5, Column 3
Retirement (such as social security, pensions, annuities, insurance)
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Row 6, Column 3
Disability (such as social security, insurance payments)
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Row 7, Column 3
Unemployment payments
Row 8, Column 0
Row 8, Column 1
Row 8, Column 2
Row 8, Column 3
Public-assistance (such as welfare)
Row 9, Column 0
Row 9, Column 1
Row 9, Column 2
Row 9, Column 3
Public-assistance (food assistance)
Row 10, Column 0
Row 10, Column 1
Row 10, Column 2
Row 10, Column 3
Public-assistance (Section 8 Housing Assistance)
Row 11, Column 0
Row 11, Column 1
Row 11, Column 2
Row 11, Column 3
Other (specify)
Row 12, Column 0
Row 12, Column 1
Row 12, Column 2
Row 12, Column 3
Total Expected Monthly Income
Row 13, Column 0
Row 13, Column 1
Row 13, Column 2
Row 13, Column 3
Employment
Self-Employment
Income from real property (such as rental income)
Interest and dividends
Alimony
Child support
Retirement (such as social security, pensions, annuities, insurance)
Disability (such as social security, insurance payments)
Unemployment payments
Public-assistance (such as welfare)
Public-assistance (food assistance)
Public-assistance (Section 8 Housing Assistance)
Other (specify)
Total Expected Monthly Income
You
Row 0, Column 0
Significant other
Row 0, Column 1
I don't know
Row 0, Column 2
Specify (if required)
Row 0, Column 3
You
Row 1, Column 0
Significant other
Row 1, Column 1
I don't know
Row 1, Column 2
Specify (if required)
Row 1, Column 3
You
Row 2, Column 0
Significant other
Row 2, Column 1
I don't know
Row 2, Column 2
Specify (if required)
Row 2, Column 3
You
Row 3, Column 0
Significant other
Row 3, Column 1
I don't know
Row 3, Column 2
Specify (if required)
Row 3, Column 3
You
Row 4, Column 0
Significant other
Row 4, Column 1
I don't know
Row 4, Column 2
Specify (if required)
Row 4, Column 3
You
Row 5, Column 0
Significant other
Row 5, Column 1
I don't know
Row 5, Column 2
Specify (if required)
Row 5, Column 3
You
Row 6, Column 0
Significant other
Row 6, Column 1
I don't know
Row 6, Column 2
Specify (if required)
Row 6, Column 3
You
Row 7, Column 0
Significant other
Row 7, Column 1
I don't know
Row 7, Column 2
Specify (if required)
Row 7, Column 3
You
Row 8, Column 0
Significant other
Row 8, Column 1
I don't know
Row 8, Column 2
Specify (if required)
Row 8, Column 3
You
Row 9, Column 0
Significant other
Row 9, Column 1
I don't know
Row 9, Column 2
Specify (if required)
Row 9, Column 3
You
Row 10, Column 0
Significant other
Row 10, Column 1
I don't know
Row 10, Column 2
Specify (if required)
Row 10, Column 3
You
Row 11, Column 0
Significant other
Row 11, Column 1
I don't know
Row 11, Column 2
Specify (if required)
Row 11, Column 3
You
Row 12, Column 0
Significant other
Row 12, Column 1
I don't know
Row 12, Column 2
Specify (if required)
Row 12, Column 3
You
Row 13, Column 0
Significant other
Row 13, Column 1
I don't know
Row 13, Column 2
Specify (if required)
Row 13, Column 3
1 of 14
6
List your employment history for the past two years, most recent employer first.Gross monthly pay is before taxes or other deductions
Employer
Address
Dates of employment
Gross monthly pay
Employer
Address
Dates of employment
Gross monthly pay
7
List your significant others employment history for the past two years, most recent employer first.Gross monthly pay is before taxes or other deductions
Employer
Address
Dates of employment
Gross monthly pay
Employer
Address
Dates of employment
Gross monthly pay
8
How much cash do you and your significant other have?
9
Below, state any money you or your significant other have in bank accounts or any other financial institution**PLEASE SCROLL FOR ALL THE FIELDS .** I
Financial institution
Type of account
Amount you have
Amount your significant other has
1.
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
2.
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
3.
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
4.
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
5.
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
1.
2.
3.
4.
5.
Financial institution
Row 0, Column 0
Type of account
Row 0, Column 1
Amount you have
Row 0, Column 2
Amount your significant other has
Row 0, Column 3
Financial institution
Row 1, Column 0
Type of account
Row 1, Column 1
Amount you have
Row 1, Column 2
Amount your significant other has
Row 1, Column 3
Financial institution
Row 2, Column 0
Type of account
Row 2, Column 1
Amount you have
Row 2, Column 2
Amount your significant other has
Row 2, Column 3
Financial institution
Row 3, Column 0
Type of account
Row 3, Column 1
Amount you have
Row 3, Column 2
Amount your significant other has
Row 3, Column 3
Financial institution
Row 4, Column 0
Type of account
Row 4, Column 1
Amount you have
Row 4, Column 2
Amount your significant other has
Row 4, Column 3
1 of 5
10
Assets ListList the assets, and their values, which you own or your significant other owns. Do not list clothing and ordinary household furnishings.
Value
Home
Row 0, Column 0
Other real estate
Row 1, Column 0
Row 2, Column 0
Home
Other real estate
Value
Row 0, Column 0
Value
Row 1, Column 0
Value
Row 2, Column 0
1 of 3
11
Motor VehiclesPlease list any motor vehicles owned by you or your significant other
Motor vehicle #1: Make and year
Model
Registration #
Value
Motor Vehicle #2: Make and year
Model
Registration #
Value
12
Other AssetsPlease list any other assets and their values that you or your significant other own.
Asset Type
Value
1.
Row 0, Column 0
Row 0, Column 1
2.
Row 1, Column 0
Row 1, Column 1
3.
Row 2, Column 0
Row 2, Column 1
Row 3, Column 0
Row 3, Column 1
1.
2.
3.
Asset Type
Row 0, Column 0
Value
Row 0, Column 1
Asset Type
Row 1, Column 0
Value
Row 1, Column 1
Asset Type
Row 2, Column 0
Value
Row 2, Column 1
Asset Type
Row 3, Column 0
Value
Row 3, Column 1
1 of 4
13
Money owed to you or your significant otherState every person, business, or organization owing you or your significant other money, and the amount owed
Person owing you or your significant other money
Amount owed to you
Amount owed to your significant other
1.
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
2.
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
3.
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
1.
2.
3.
Person owing you or your significant other money
Row 0, Column 0
Amount owed to you
Row 0, Column 1
Amount owed to your significant other
Row 0, Column 2
Person owing you or your significant other money
Row 1, Column 0
Amount owed to you
Row 1, Column 1
Amount owed to your significant other
Row 1, Column 2
Person owing you or your significant other money
Row 2, Column 0
Amount owed to you
Row 2, Column 1
Amount owed to your significant other
Row 2, Column 2
Person owing you or your significant other money
Row 3, Column 0
Amount owed to you
Row 3, Column 1
Amount owed to your significant other
Row 3, Column 2
1 of 4
14
State the persons who rely on you or your significant other for support
Name (or, if under 18, initials only)
Relationship
Age
1.
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
2.
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
3.
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
4.
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
5.
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
1.
2.
3.
4.
5.
Name (or, if under 18, initials only)
Row 0, Column 0
Relationship
Row 0, Column 1
Age
Row 0, Column 2
Name (or, if under 18, initials only)
Row 1, Column 0
Relationship
Row 1, Column 1
Age
Row 1, Column 2
Name (or, if under 18, initials only)
Row 2, Column 0
Relationship
Row 2, Column 1
Age
Row 2, Column 2
Name (or, if under 18, initials only)
Row 3, Column 0
Relationship
Row 3, Column 1
Age
Row 3, Column 2
Name (or, if under 18, initials only)
Row 4, Column 0
Relationship
Row 4, Column 1
Age
Row 4, Column 2
1 of 5
15
Expenses: Rent or home-mortgageRent or home-mortgage payment (including lot rented for mobile home). Adjust ant payment that are made weekly, biweekly, quarterly, semiannually, or annually to show the monthly rate.
Amount paid by you
Amount paid by your significant other
Please Select
Please Select
Yes
No
Are real estate taxes included?
Please Select
Please Select
Yes
No
Is property insurance included?
16
Expenses ContinuedEstimate the average monthly expenses of you and your family, Show separatley the amounts paid by your significant other. Adjust ant payment that are made weekly, biweekly, quarterly, semiannually, or annually to show the monthly rate. **PLEASE SCROLL FOR ALL THE FIELDS .** IF A QUESTION DOEN NOT APPLY PLEASE TYPE NA
You
Significant other
I don't know
Utilities (electricity, heating fuel, water, sewer, and telephone)
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Home maintenance (repairs and upkeep)
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Food
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Clothing
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Laundry and dry-cleaning
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Medical and dental expenses
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Transportation (not including motor vehicle payments)
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Recreation, entertainment, newspapers, magazines, etc.
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Alimony, maintenance, and support paid to others
Row 8, Column 0
Row 8, Column 1
Row 8, Column 2
Utilities (electricity, heating fuel, water, sewer, and telephone)
Home maintenance (repairs and upkeep)
Food
Clothing
Laundry and dry-cleaning
Medical and dental expenses
Transportation (not including motor vehicle payments)
Recreation, entertainment, newspapers, magazines, etc.
Alimony, maintenance, and support paid to others
You
Row 0, Column 0
Significant other
Row 0, Column 1
I don't know
Row 0, Column 2
You
Row 1, Column 0
Significant other
Row 1, Column 1
I don't know
Row 1, Column 2
You
Row 2, Column 0
Significant other
Row 2, Column 1
I don't know
Row 2, Column 2
You
Row 3, Column 0
Significant other
Row 3, Column 1
I don't know
Row 3, Column 2
You
Row 4, Column 0
Significant other
Row 4, Column 1
I don't know
Row 4, Column 2
You
Row 5, Column 0
Significant other
Row 5, Column 1
I don't know
Row 5, Column 2
You
Row 6, Column 0
Significant other
Row 6, Column 1
I don't know
Row 6, Column 2
You
Row 7, Column 0
Significant other
Row 7, Column 1
I don't know
Row 7, Column 2
You
Row 8, Column 0
Significant other
Row 8, Column 1
I don't know
Row 8, Column 2
1 of 9
17
Expenses Continued: InsuranceInsurance not deducted from wages or included in mortgage payments. **PLEASE SCROLL FOR ALL THE FIELDS .** IF A QUESTION DOEN NOT APPLY PLEASE TYPE NA
You
Significant other
I don't know
Homeowner's or renter's
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Life
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Health
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Motor vehicle
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Other
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Homeowner's or renter's
Life
Health
Motor vehicle
Other
You
Row 0, Column 0
Significant other
Row 0, Column 1
I don't know
Row 0, Column 2
You
Row 1, Column 0
Significant other
Row 1, Column 1
I don't know
Row 1, Column 2
You
Row 2, Column 0
Significant other
Row 2, Column 1
I don't know
Row 2, Column 2
You
Row 3, Column 0
Significant other
Row 3, Column 1
I don't know
Row 3, Column 2
You
Row 4, Column 0
Significant other
Row 4, Column 1
I don't know
Row 4, Column 2
1 of 5
18
Expenses Continued: TaxesTaxes not deducted from wages or included in mortgage payments. IF A QUESTION DOES NOT APPLY PLEASE TYPE NA
Specify the type of tax
Amount paid by you
Amount paid by your significant other
Specify the type of tax
Amount paid by you
Amount paid by your significant other
19
Expenses Continued: Installment Payments
You
Your significant other
Name (If required)
Motor vehicle
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Credit Card (Name)
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Department store (Name)
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Other (Name)
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Motor vehicle
Credit Card (Name)
Department store (Name)
Other (Name)
You
Row 0, Column 0
Your significant other
Row 0, Column 1
Name (If required)
Row 0, Column 2
You
Row 1, Column 0
Your significant other
Row 1, Column 1
Name (If required)
Row 1, Column 2
You
Row 2, Column 0
Your significant other
Row 2, Column 1
Name (If required)
Row 2, Column 2
You
Row 3, Column 0
Your significant other
Row 3, Column 1
Name (If required)
Row 3, Column 2
1 of 4
20
Expenses Continued: Regular expenses for operation of business, profession, or farmAttach a detailed statement
Drag and drop files here
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Cancelof
21
Expenses Continued: OtherPlease list any other expenses
Specify expense
You
Your significant other
1.
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
2.
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
3.
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
4.
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
5.
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
1.
2.
3.
4.
5.
Specify expense
Row 0, Column 0
You
Row 0, Column 1
Your significant other
Row 0, Column 2
Specify expense
Row 1, Column 0
You
Row 1, Column 1
Your significant other
Row 1, Column 2
Specify expense
Row 2, Column 0
You
Row 2, Column 1
Your significant other
Row 2, Column 2
Specify expense
Row 3, Column 0
You
Row 3, Column 1
Your significant other
Row 3, Column 2
Specify expense
Row 4, Column 0
You
Row 4, Column 1
Your significant other
Row 4, Column 2
1 of 5
22
Your Total ExpensesCalculated from your previous responses
23
Your Significant Others Total ExpensesCalculated from your previous responses
24
Do you expect any major changes to your monthly income or expenses or in your assets or liabilities during the next 12 months?
Please Select
Please Select
Yes
No
Please select
If yes, please describe
25
Have you spent - or will you be spending - any money for expenses or attorney fees in conjunction with this lawsuit?

Yes, Chad Brown Law, P.L.L.C. – EAJA

25% of past due benefits.
26
Provide any other information that will help you explain why you cannot pay the costs of these proceedings.
0/250
Huge
Large
Normal
Small
Ok
Ok
27
Identify the city and state or your legal residence
City
State
City
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
County
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
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