FORM 10.   Cost Bill

                        (Rule 14.4)

                                   No. (appellate court)

     (SUPREME COURT or COURT OF APPEALS, DIVISION  ___)
                 OF THE STATE OF WASHINGTON

(Title of trial court proceeding )
with parties designated as in    )          COST BILL
rule 3.4)                        )

    (Name of party asking for costs), (appellant, petitioner, or
respondent), asks that the following costs be awarded:

    1.  Statutory attorney's fees                             $
    2.  Preparation of original and one copy of report
        of proceedings                                        $
    3.  Copies of clerk's papers                              $
    4.  Transmittal of record on review                       $
    5.  Expenses incurred in superseding the decision of
        the trial court (Identify)                            $
    6.  Charges of appellate court clerk for reproduction
        of briefs, petitions, and motions (Identify and
        separately state the charge for each.)                $
    7.  Preparing 50 pages of original documents              $
    8.  Filing fee                                            $___
                                                    Total     $

    The above items are expenses allowed as costs by rule 14.3, reasonable
expenses actually incurred, and reasonably necessary for review. (Name of
party) should pay the costs.
    (Date)
                                 _____________________________________
                                             Signature
                                 Attorney for (Appellant, Respondent,
                                           or Petitioner)
                                 (Name, address, telephone number, and
                                 Washington State Bar Association
                                 membership number of attorney)