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Court of Appeals Twelfth Court of Appeals District at Tyler BILL OF COSTS Court of Appeals No. 12-15-00132-CV Trial Court No. C1430149 Dominique A. Malone Vs. Progressive County Mutual Insurance Company DOCUMENTS FILED AMOUNT FEE PAID BY Indigent $25.00 Dismissed, not paid Required Texas.gov efiling fee $20.00 Dismissed, not paid Filing $100.00 Dismissed, not paid Supreme Court chapter 51 fee $50.00 Dismissed, not paid TOTAL: $195.00 I, Cathy S. Lusk, Clerk of the Court of Appeals, Twelfth Court of Appeals District at Tyler, Texas, certify that the above copy of the Bill of Costs is true and correct. GIVEN UNDER MY HAND AND SEAL OF SAID COURT, at Tyler, this 28th day of August 2015, A.D.

CATHY LUSK, CLERK

By:_____________________________ Katrina McClenny, Chief Deputy Clerk