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DC-276

Petition and Order For Approval of Jail Fees Payment Agreement

Virginia · Supreme Court of Virginia

This form is used when a person asks the court to approve a plan to pay back jail fees over time. The petitioner asks the court to approve this payment plan because the respondent cannot pay the full amount of jail fees owed.

Open the official PDFfrom Supreme Court of Virginia

Where this fits in a case

Start a case

Stage: Start a case

This form is used in a General District Court case, specifically when a petitioner is asking the court to approve a payment agreement for jail fees that the respondent cannot pay all at once.

Usually filed by the person starting the case.

Official instructions

How-to guides published by the court for this form.

Common questions

Who fills out this form?
The petitioner respectfully requests that this court approve the payment agreement using this form.
What does the court do with this form?
The court can grant the petition, approve the payment agreement, or deny or dismiss the petition.

Revision history

No changes recorded since we started tracking this form on October 10, 2026.

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