Request to Waive Court Fees

Cal. Form FW-01

California Superior Local Rules

HO W TO FILE A FE E WAIVE R REQUES T SELF-HELP FORM PACKET SHC-FW-01 (Rev. 03/01/2026) https://www.occourts.org/self-help SUPERIOR COURT OF CALIFORNIA COUNTY OF ORANGE Self-Help Services www.occourts.org/self-help Self-Help Services can review your completed forms before you file them with the Court. To request a document review, visit one of our locations.

Judicial Council of California, courts.ca.gov Rev. March 1, 2026, Mandatory Form Gov. Code, § 68633; Cal. Rules of Court, rules 3.51, 8.26, and 8.818 Request to Waive Court Fees FW-001 Request to Waive Court Fees CONFIDENTIAL Clerk stamps date here when form is filed. Fill in court name and street address: Superior Court of California, County of Fill in case number and name: Case Number: Case Name: If you are getting public benefits, are a low-income person, or do not have enough income to pay for your household’s basic needs and your court fees, you may use this form to ask the court to waive your court fees.

The court may order you to answer questions about your finances. If the court waives the fees, you may still have to pay later if: • You cannot give the court proof of your eligibility, • Your financial situation improves during this case, or • You settle your civil case for $10,000 or more. The trial court that waives your fees will have a lien on any such settlement in the amount of the waived fees and costs.

The court may also charge you any collection costs. 1 Your Information (person asking the court to waive the fees): Name: Street or mailing address: City: State: Zip: Phone: 2 Your Job, if you have one (job title): Name of employer: Employer’s address: 3 Your Lawyer, if you have one (name, firm or affiliation, address, phone number, and State Bar number): a. The lawyer has agreed to advance all or a portion of your fees or costs (check one): Yes No (If yes, your lawyer must sign here) Lawyer’s signature:b.

If your lawyer is not providing legal-aid type services based on your low income, you may have to go to a hearing to explain why you are asking the court to waive the fees. 4 What court’s fees or costs are you asking to be waived? Superior Court (See Information Sheet on Waiver of Superior Court Fees and Costs (form FW-001-INFO).) Supreme Court, Court of Appeal, or Appellate Division of Superior Court (See Information Sheet on Waiver of Appellate Court Fees (form APP-015/FW-015-INFO).) 5 Why are you asking the court to waive your court fees? a. I receive (check all that apply; see form FW-001-INFO for

definitions): Food Stamps Supp. Sec. Inc. SSP Medi-Cal County Relief/Gen. Assist. IHSS CalWORKS or Tribal TANF CAPI WIC Unemployment b. My gross monthly household income (before deductions for taxes) is less than the amount listed below. (If you check 5b, you must fill out 7, 8, and 9 on page 2 of this form.) Family Size Family Income Family Size Family Income Family Size Family Income 1 $2,660.00 3 $4,553.33 5 $6,446.67 2 $3,606.67 4 $5,500.00 6 $7,393.33 If more than 6 people at home, add $946.67 for each extra person. c. I do not have enough income to pay for my household’s basic needs and the court fees.

I ask the court to: (check one and you must fill out page 2): waive all court fees and costs waive some of the court fees let me make payments over time 6 Check here if you asked the court to waive your court fees for this case in the last six months. (If your previous request is reasonably available, please attach it to this form and check here): I declare under penalty of perjury under the laws of the State of California that the information I have provided on this form and all attachments is true and correct. Date: Print your name here Sign here FW-001, Page 1 of 2

Rev. March 1, 2026 Request to Waive Court Fees Your name: Case Number: If you checked 5a on page 1, do not fill out below. If you checked 5b, fill out questions 7, 8, and 9 only. If you checked 5c, you must fill out this entire page. If you need more space, attach form MC-025 or attach a sheet of paper and write Financial Information and your name and case number at the top. 7 Check here if your income changes a lot from month to month. If it does, complete the form based on your average income for the past 12 months. 8 Your Gross Monthly Income a.

List the source and amount of any income you get each month, including: wages or other income from work before deductions, spousal/child support, retirement, social security, disability, unemployment, military basic allowance for quarters (BAQ), veterans payments, dividends, interest, trust income, annuities, net business or rental income, reimbursement for job-related expenses, gambling or lottery winnings, etc. (1) $ (2) $ (3) $ (4) $ b. Your total monthly income: $ 9 Household Income a.

List the income of all other persons living in your home who depend in whole or in part on you for support, or on whom you depend in whole or in part for support. Name Age Relationship Gross Monthly Income (1) $ (2) $ (3) $ (4) $ b. Total monthly income of persons above: $ Total monthly income and household income (8b plus 9b): $ 10 Your Money and Property a. Cash $ b. All financial accounts (List bank name and amount): (1) $ (2) $ (3) $ c. Cars, boats, and other vehicles Make / Year Fair Market Value How Much You Still Owe (1) $ $ (2) $ $ (3) $ $ d.

Real estate Address Fair Market Value How Much You Still Owe (1) $ $ (2) $ $ e. Other personal property (jewelry, furniture, furs, stocks, bonds, etc.): Describe Fair Market Value How Much You Still Owe (1) $ $ (2) $ $ 11 Your Monthly Deductions and Expenses a. List any payroll deductions and the monthly amount below: (1) $ (2) $ (3) $ (4) $ b. Rent or house payment & maintenance $ c. Food and household supplies $ d. Utilities and telephone $ e. Clothing $ f. Laundry and cleaning $ g. Medical and dental expenses $ h. Insurance (life, health, accident, etc.) $ i.

School, child care $ Child, spousal support (another marriage)j. $ Transportation, gas, auto repair and insurance k. $ l. Installment payments (list each below): Paid to: (1) $ (2) $ (3) $ m. Wages/earnings withheld by court order $ n. Any other monthly expenses (list each below). Paid to: How Much? (1) $ (2) $ (3) $ Total monthly expenses (add 11a –11n above): $ To list any other facts you want the court to know, such as unusual medical expenses, etc., attach form MC-025 or attach a sheet of paper and write Financial Information and your name and case number at the top. Check here if you attach another page.

Important! If your financial situation or ability to pay court fees improves, you must notify the court within five days on form FW-010. FW-001, Page 2 of 2

A request to waive court fees was filed on (date): Read this form carefully. All checked boxes are court orders.þ

(1) Fee Waiver. The court grants your request and waives your court fees and costs listed below. (Cal. Rules of Court, rules 3.55 and 8.818.) You do not have to pay the court fees for the following: Additional Fee Waiver. The court grants your request and waives your additional superior court fees and costs that are checked below. (Cal.

Rules of Court, rule 3.56.) You do not have to pay for the checked items. • Court fee for phone hearing • Giving notice and certificates • Sending papers to another court department • Reporter’s fee for attendance at hearing or trial, if the court is not electronically recording the proceeding and you request that the court provide an official reporter • Assessment for court investigations under Probate Code

section 1513, 1826, or 1851 • Preparing, certifying, copying, and sending the clerk’s transcript on appeal • Holding in trust the deposit for a reporter's transcript on appeal under rule 8.130 or 8.834 • Making a transcript or copy of an official electronic recording under rule 8.835

(2) Jury fees and expenses Fees for a peace officer to testify in court Court-appointed interpreter fees for a witness Fees for court-appointed experts Order on Court Fee Waiver (Superior Court) FW-003, Page 1 of 3Judicial Council of California, www.courts.ca.gov Revised September 1, 2019, Mandatory Form Government Code, § 68634(

e) Cal. Rules of Court, rule 3.52 • Filing papers in superior court • Making copies and certifying copies • Sheriff’s fee to give notice Person who asked the court to waive court fees: Notice: The court may order you to answer questions about your finances and later order you to pay back the waived fees. If this happens and you do not pay, the court can make you pay the fees and also charge you collection fees.

If there is a change in your financial circumstances during this case that increases your ability to pay fees and costs, you must notify the trial court within five days. (Use form FW-010.) If you win your case, the trial court may order the other side to pay the fees. If you settle your civil case for $10,000 or more, the trial court will have a lien on the settlement in the amount of the waived fees. The trial court may not dismiss the case until the lien is paid. a.

The court grants your request, as follows: Name: Street or mailing address: City: State: Zip: The court made a previous fee waiver order in this case on (date): FW-003 Order on Court Fee Waiver (Superior Court) Clerk stamps date here when form is filed.

Fill in court name and street address: Superior Court of California, County of Orange Fill in case number and name: Case Number: Case Name: Request to Waive Court Fees Request to Waive Additional Court FeesAfter reviewing your: the court makes the following orders: Lawyer, if person in has one (name, firm name, address, phone number, e-mail, and State Bar number): 1 2 3 4 1 (specify): Other 6

(1) Pay your fees and costs, or

(2) Pay your fees and costs in full or the amount listed in c below, or Ask for a hearing in order to show the court more information. (Use form FW-006 to request hearing.) Order on Court Fee Waiver (Superior Court) FW-003, Page 2 of 3Rev. September 1, 2019 • • • b. The court denies your fee waiver request because: • Warning! If you miss the deadline below, the court cannot process your request for hearing or the court papers you filed with your original request. If the papers were a notice of appeal, the appeal may be dismissed.

File a new revised request that includes the incomplete items listed: Below On Attachment 4b(1) Your request is incomplete. You have 10 days after the clerk gives notice of this Order (see date of service on next page) to: The information you provided on the request shows that you are not eligible for the fee waiver you requested for the reasons stated: Your name: Case Number: This is a Court Order.

The court has enclosed a blank Request for Hearing About Court Fee Waiver Order (Superior Court) (form FW-006).You have 10 days after the clerk gives notice of this order (see date of service below) to: The court needs more information to decide whether to grant your request. You must go to court on the date on page 3. The hearing will be about the questions regarding your eligibility that are stated: c. Bring the items of proof to support your request, if reasonably available, that are listed: Below On Attachment 4b(2)

(1) Below On Attachment 4c(1)

(2) Below On Attachment 4c(2)

Warning! If item c(1) is checked, and you do not go to court on your hearing date, the judge will deny your request to waive court fees, and you will have 10 days to pay your fees. If you miss that deadline, the court cannot process the court papers you filed with your request. If the papers were a notice of appeal, the appeal may be dismissed.

Date: Signature of (check one): Judicial Officer Clerk, Deputy Date: Time: Room:Dept.: Hearing Date g Name and address of court if different from above: I certify that I am not involved in this case and (check one): Clerk's Certificate of Service I handed a copy of this Order to the party and attorney, if any, listed in and , at the court, on the date below. This order was mailed first class, postage paid, to the party and attorney, if any, at the addresses listed in and , from Date: , California, on the date below.

A certificate of mailing is attached. 1 2 (city): 1 2 Your name: Case Number: Order on Court Fee Waiver (Superior Court) FW-003, Page 3 of 3Rev. September 1, 2019 This is a Court Order. Request for Accommodations Assistive listening systems, computer-assisted real-time captioning, or sign language interpreter services are available if you ask at least five days before the hearing. Contact the clerk’s office for Request for Accommodations by Persons With Disabilities and Response (form MC-410). (Civ. Code, § 54.8.) , DeputyClerk, by ________________________________ Name:

Document details

Collection	California Superior Local Rules
Citation	Cal. Form FW-01
Type	court_rule
Language	en
Format	pdf
Source	CA_LOCAL
Identifier	48357fe42ebbf49d30d70cfa8e7589834aa7f1e6

Source file is stored in the law ingest library (pdf).