GUARD IANSH IPS AN D CONSERVATORSH IPS

Cal. Form PB-12

California Superior Local Rules

FE E WAIVE R FO R GUARD IANSH IPS AN D CONSERVATORSH IPS SELF-HELP FORM PACKET 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. SHC-PB-12 (Rev. 03/01/2026) www.occourts.org/self-help SUPERIOR COURT OF CALIFORNIA COUNTY OF ORANGE Self-Help Services www.occourts.org/self-help New Probate Court and In-Person Location: Costa Mesa Justice Complex 3390 Harbor Boulevard Costa Mesa, CA 92626 Attention

Judicial Council of California, courts.ca.gov Rev. March 1, 2026, Mandatory Form Gov. Code, § 68633; Cal. Rules of Court, rules 3.51, 7.5 Request to Waive Court Fees (Ward or Conservatee) FW-001-GC Request to Waive Court Fees (Ward or Conservatee) 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: • The ward’s or conservatee’s financial situation improves during this case, or This form must be used by a guardian or conservator, or by a petitioner for the appointment of a guardian or conservator, to request a waiver of court fees in the guardianship or conservatorship court proceeding or in any other civil action in which the guardian or conservator represents the interests of the ward or conservatee as a plaintiff or defendant.

If the ward or conservatee (including a proposed ward or conservatee if a petition for appointment of a guardian or conservator has been filed but has not yet been decided by the court) directly receives public benefits or is supported by public benefits received by another for their support, is a low-income person, or does not have enough income to pay for their household’s basic needs and the court fees, you may use this form to ask the court to waive the court fees. The court may order you to answer questions about the finances of the ward or conservatee.

If the court waives the fees, the ward or conservatee, their estate, or someone with a duty to support the ward or conservatee, may still have to pay later if: • You cannot give the court proof of the ward’s or conservatee’s eligibility, • You settle the civil case on behalf of the ward or conservatee for $10,000 or more. The trial court that waives fees will have a lien on any such settlement in the amount of the waived fees and costs.

The court may also charge the ward or conservatee, or their estate, any collection costs. 1 Your Information (guardian or conservator, or person asking the court to appoint a guardian or conservator): Name: Phone: Street or mailing address: City: State: Zip: 2 Your Lawyer (if you have one): Name: Firm or Affiliation: State Bar No.: Address: Phone: City: State: Zip: Email: a.

The lawyer has agreed to advance all or a portion of court fees or costs (check one): Yes No b. (If yes, your lawyer must sign here.) Lawyer’s signature: If your lawyer is not providing legal-aid type services based on your or the ward’s or conservatee’s low income, you may have to go to a hearing to explain why you are asking the court to waive the fees. 3 Ward's or Conservatee's Information (file a separate Request for each ward in a multiward case): Name: Age and date of birth (ward only): Street or mailing address: City: State: Zip: Phone: 4 Ward's or Conservatee's Lawyer, if any: Name: Firm or Affiliation: State Bar No.: Address: Phone: City: State: Zip: Email: 5 Ward or Conservatee's Job (job title; if not employed, so state): Name of employer: Employer’s address: State: Zip: FW-001-GC, Page 1 of 4

Rev. March 1, 2026 Request to Waive Court Fees (Ward or Conservatee) Name of (Proposed) Ward or Conservatee: Case Number: 6 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).) 7 Check here if you asked the court to waive 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): 8 Why are you asking the court to waive the ward’s or conservatee’s court fees? a.

The ward or one or both of the ward’s parents, or the conservatee or the conservatee’s spouse or registered domestic partner, receive (check all that apply): Supplemental Security Income (SSI) State Supplemental Payment (SSP) SNAP (Food Stamps) IHSS (In-Home Supportive Services) CalWORKS or Tribal TANF Medi-Cal County Relief/General Assistance CAPI (Cash Assistance Program for Aged, Blind, and Disabled) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC Program) Unemployment Compensation (Names and relationships to ward or conservatee of persons who receive the public benefits listed above): b.

The gross monthly income of the ward’s or conservatee’s household (before deductions for taxes) is less than the amount listed below. (If you check 8b, you must fill out items 14, 15, and 16 on page 4 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. The ward’s or conservatee’s household does not have enough income to pay for its basic needs and the court fees.

I ask the court to (check one, and you must fill out items 14, 15, 16, 17, and 18 on page 4):*

(1) Waive all court fees and costs.

(2) Waive some court fees and costs.

(3) Let the (proposed) guardian or conservator, on behalf of the (proposed) ward or conservatee, make payments over time. * (Do not include income of guardian or conservator living in the household in 8b or 8c or count them in family size in 8b. unless they are a parent of the ward or the spouse or registered domestic partner of the conservatee.) Guardians or petitioners for their appointment must complete items 9 and 10. 9 Ward's Estate: Person only, no estate.

Inventory or petition estimated value: Source (e.g., gift, inheritance, settlement, judgment, insurance): Est. collection date: 10 Ward's Parents' Information: a. Name of ward’s parent: Deceased (date of death): Street or mailing address: City: State: Zip: Phone: b. Name of ward’s parent: Deceased (date of death): Street or mailing address: City: State: Zip: Phone: c. Ward’s parents are (check all that apply): married living together separated divorced Support order for ward?

No Yes Payable to (name): Payor (name): Court: Case Number: Date of order (if multiple, date of latest): Monthly amount: FW-001-GC, Page 2 of 4

Rev. March 1, 2026 Request to Waive Court Fees (Ward or Conservatee) Name of (Proposed) Ward or Conservatee: Case Number: Conservators or petitioners for their appointment must complete items 11–13. 11 Conservatee's Estate: Person only, no estate.

Inventory or petition estimated value: Est. collection date: 12 Conservatee's Spouse’s or Registered Domestic Partner's Information: Name of conservatee’s spouse or registered domestic partner: Spouse Partner Date of marriage or partnership: Deceased (date of death): Street or mailing address: Phone: City: State: Zip: Name of employer (if none, so state): Employer’s address: State: Zip: The conservatee’s spouse or partner managing, or following appointment of a conservator is planning to manage, some or all of the couple’s community property outside the conservatorship estate. is is not If you selected “is” above: The income, money, and property shown on page 4 the income and property managed, or expected to be managed, by the spouse/partner outside the estate. includes does not include Divorced (date of final judgment or decree ): Court: Case Number: Support order for conservatee?

No Yes Date of support order (if multiple, date of latest): Monthly amount: 13 The Conservatee and Trusts: The conservatee: a. is is not a trustor or settlor of a trust. b. is is not a beneficiary of a trust. If you selected “Is” to complete any of the above statements, identify and provide, in an attachment to this Request, the current address and telephone number of the current trustee(

s) of each trust, describe the general terms of and value of each trust and the nature and value of the conservatee’s interest in each trust, and the amount(

s) and frequency of any distributions to or for the benefit of the conservatee prior to your appointment as conservator of which you are aware. (You may use Judicial Council form MC-025 for this purpose.) All applicants who checked item 8b or item 8c on page 2 must continue to and follow the instructions for completion of items 14–16 or items 14–18 on page 4, before signing below. The information I have provided on this form and all attachments about the (proposed) ward or conservatee is true and correct to the best of my information and belief.

The information I have provided on this form and all attachments concerning myself is true and correct. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: Print your name here Sign here FW-001-GC, Page 3 of 4

Rev. March 1, 2026 Request to Waive Court Fees (Ward or Conservatee) Case Number:Name of (Proposed) Ward or Conservatee: If you checked 8a on page 2, do not fill out below. If you checked 8b, you must answer questions 14–16. If you checked 8c, you must answer questions 14–18. If you need more space, attach form MC-025 or attach a sheet of paper, and write "Financial Information" and the ward’s or conservatee’s name and case number at the top. 14 Check here if the ward’s or conservatee’s income changes a lot from month to month.

If it does, complete the form based on their average income for the past 12 months. 15 Ward's or Conservatee's Gross Monthly Income a. List the source and amount of any income the ward or conservatee gets 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) $ (5) $ b.

Total monthly income: $ 16 Ward's or Conservatee's Household's Income a. List the income of all other persons living in the ward’s or conservatee’s home who depend in whole or in part on them for support, or on whom they depend in whole or in part for support. Name Age Relationship Gross Monthly Income (1) $ (2) $ (3) $ (4) $ (5) $ (6) $ (7) $ (8) $ (9) $ (10) $ b.

Total monthly income of persons above: $ Total monthly income and household income (15b plus 16b): $ To list any other facts you want the court to know, such as the (proposed) ward’s or conservatee’s unusual medical expenses, etc, attach form MC-025 or attach a sheet of paper and write “Financial Information” and the (proposed) ward’s or conservatee’s name and case number at the top. Check here if you attach another page. Important! If the ward’s or conservatee’s financial situation or ability to pay court fees improves, you must notify the court within five days on form FW-010-GC.

Do not include income of guardian or conservator living in the household in item 16, their money and property in item 17, or their deductions and expenses in item 18 unless they are a parent of the ward or the spouse or registered domestic partner of the conservatee. Ward's or Conservatee's Household's 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) $ $ 17 18 Ward's or Conservatee's Household's Monthly Deductions and Expenses a. List any payroll deductions and the monthly amount below: (1) $ (2) $ (3) $ (4) $ $b. Rent or house payment and 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 $ j. Child, spousal support (another marriage) $ k.

Transportation, gas, auto repair and insurance $ 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 18a –18n above): $ FW-001-GC, Page 4 of 4

This form must be used by a guardian or conservator, or a petitioner for the appointment of a guardian or conservator, in the guardianship or conservatorship proceeding or in any other civil action in which the guardian or conservator represents the interest of the ward or conservatee as a plaintiff or defendant, to ask the court to waive additional court fees that are not covered in a current order. If you have not already received an order that waived or reduced your court fees, you must complete and file a Request to Waive Court Fees (Ward or Conservatee), form FW-001-GC, along with this form.

Your Information (guardian or conservator, or person asking the court to appoint a guardian or conservator): Name: Street or mailing address: Zip:State: City: Phone number: Request to Waive Additional Court Fees (Superior Court) (Ward or Conservatee) FW-002-GC, Page 1 of 2Judicial Council of California, www.courts.ca.gov New September 1, 2015, Mandatory Form Government Code, §, 68633 California Rules of Court, rules 3.51, 3.56, 7.5 If your lawyer is not providing legal-aid type services based on the ward’s or conservatee’s low income, you may have to go to a hearing to explain why you are asking the court to waive the fees.

The lawyer has agreed to advance all or a portion of your fees or costs (check one): (If yes, your lawyer must sign here.) Lawyer’s signature:_____________________________________________ Yes Noa. b. 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: CONFIDENTIAL FW-002-GC Request to Waive Additional Court Fees (Superior Court) (Ward or Conservatee) Phone number: Zip:State: City: Street or mailing address: Name: Age and date of birth (ward only): Ward’s or Conservatee’s Information (file a separate Request for each ward in a multi-ward case): Date ward’s or conservatee’s last court fee waiver order, if any, was granted: Has the ward’s or conservatee’s financial situation improved since your last Request to Waive Court Fees? (If yes, you must fill out a new Request to Waive Court Fees, form FW-001-GC, and attach it to this form.) No Yes 1 2 3 4 5 6 Name: Your Lawyer (if you have one): State Bar No.: Address: City: E-mail:State: Zip: Firm or Affiliation: Telephone: Name: Ward's or Conservatee's Lawyer, if any: State Bar No.: Address: City: E-mail:State: Zip: Firm or Affiliation: Telephone: 3390 Harbor Boulevard Costa Mesa, CA 92626 Costa Mesa Justice Complex

Name of (Proposed) Ward or Conservatee: Case Number: FW-002-GC, Page 2 of 2New September 1, 2015 Request to Waive Additional Court Fees (Superior Court) (Ward or Conservatee) b. What other fees do you want the court fee waiver order to cover? (Check all that apply): Why does the ward or conservatee need these other services? (Explain): Notice: The court may order you to answer questions about the finances of the ward or conservatee and later order you, as guardian or conservator of his or her estate, to pay back waived fees.

The court may also direct you to make efforts to collect money to pay back waived fees from persons who owe a duty to support the ward or conservatee. If the fees are not paid back, the court may also charge collection fees.

If there is a change in the financial circumstances of the ward or conservatee during this case that increases his or her ability to pay fees and costs, you must notify the trial court within five days. (Use form FW-010-GC for this purpose.) If this case is a civil action against another person on behalf of the ward or conservatee and you win it, the trial court may order the other side to pay the fees. If you settle the case against another person for $10,000 or more payable to the ward’s or conservatee’s estate, 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. The court may also have a lien against the ward’s or conservatee’s estate that must be paid before the estate is distributed, the guardianship or conservatorship proceeding is concluded, and you are discharged as guardian or conservator. I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. a. c. d. e.

Date: Jury fees and expenses Court-appointed interpreter fees for a witness Fees for a peace officer to testify in court Fees for court-appointed experts Other Print your name here 7 8 Sign here (specify): For your protection and privacy, please press the Clear This Form button after you have printed the form.

A request to waive court fees was filed on (date): Read this form carefully. All checked boxes are court orders. Order on Court Fee Waiver (Superior Court) (Ward or Conservatee) FW-003-GC, Page 1 of 3Judicial Council of California, www.courts.ca.gov Revised September 1, 2019, Mandatory Form Government Code, §§ 68631, 68634(

e) Cal. Rules of Court, rules 3.52 and 7.5 (Proposed) guardian or conservator who asked the court to waive court fees for (proposed) ward or conservatee: Name: Street or mailing address: City: State: Zip: The court made a previous fee waiver order in this case on (date): Lawyer for (proposed) ward or conservatee, if any: Telephone: Telephone: FW-003-GC Order on Court Fee Waiver (Superior Court) (Ward or Conservatee) 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: (Proposed) ward or conservatee: Name: Street or mailing address: Zip:State:City: 1 2 5 3 4 6 Request to Waive Additional Court FeesRequest to Waive Court FeesAfter reviewing your: the court makes the following orders: The court grants your request concerning the ward's or conservatee's court fees and costs, as follows:a. Fee Waiver. The court grants your request and waives the 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: (1) • Court fee for phone hearing • Giving notice and certificates • Sending papers to another court department (List continued on next page.) • Filing papers in superior court • Making copies and certifying copies • Sheriff’s fee to give notice X Notice: The court may order you to answer questions about the ward’s or conservatee’s finances after granting a waiver and may later order payment of the waived fees from his or her estate. If this happens and the fees are not paid, the court can also charge collection fees.

The court may also direct you to make efforts to collect money to pay back waived fees from persons who owe a duty to support the ward or conservatee. If there is a change in the ward’s or conservatee’s financial circumstances during this case that increases his or her ability to pay fees and costs, you must notify the trial court within five days. (Use form FW-010-GC.) If this case is an action against another party and you win the case on behalf of the ward or conservatee, the trial court may order the other side to pay some or all of the waived fees.

If you settle the matter 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. The court may also have a lien against the ward’s or conservatee’s estate that must be paid before the estate is distributed, the guardianship or conservatorship proceeding is concluded, and you are discharged as guardian or conservator.

Lawyer, if person in 1 Name: State Bar No: Street or mailing address: Zip:State:City: Firm or Affiliation: Telephone:E-mail: Name: State Bar No: Street or mailing address: State:City: Firm or Affiliation: Telephone:E-mail: Zip: has one: 6 3390 Harbor Boulevard Costa Mesa, CA 92626 Costa Mesa Justice Complex

(1) The court denies your request because it is incomplete. You have 10 days after the clerk gives notice of this order (see date of service on next page) to: Pay the ward’s or conservatee’s fees and costs, or

(2) Pay the 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-GC to request hearing.) Order on Court Fee Waiver (Superior Court) (Ward or Conservatee) FW-003-GC, Page 2 of 3Revised September 1, 2019 • • • b. The court denies your fee waiver request, as follows: • 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.

The court denies your request because the information you provided on the request shows that the ward or conservatee is not eligible for the fee waiver for the reasons specified: Name of (Proposed) Ward or Conservatee: Case Number: The court has enclosed a blank Request for Hearing About Court Fee Waiver Order (Ward or Conservatee)(Superior Court) (form FW-006-GC). You have 10 days after the clerk gives notice of this order (see date of service on next page) to:

(2) Additional Fee Waiver. The court grants your request and waives the 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. 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 (specify): Other • Reporter’s fee for attendance at hearing or trial, if 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 (1)a. Bring the items of proof to support your request, if reasonably available, that are listed: 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 questions regarding your eligibility specified: 6 Below On Attachment 6b(1) Below On Attachment 6b(2) Below On Attachment 6c(1) c. (1)

(2) Below On Attachment 6c(2) File a new revised request that includes the items listed:

Case Number:Name of (Proposed) Ward or Conservatee: Request for Accommodations. Assistive listening systems, computer-assisted real-time captioning, or sign language interpreter services are available if you ask at least 5 days before your hearing. Contact the clerk’s office for Request for Accommodation, Form MC-410. (Civil Code, § 54.8.) Clerk's Certificate of Service Order on Court Fee Waiver (Superior Court) (Ward or Conservatee) FW-003-GC, Page 3 of 3Revised September 1, 2019 This is a Court Order.

Signature of (check one): Date: Date: Time: Room:Dept.: Hearing Date g Name and address of court if different from above: NOTE TO GUARDIAN or CONSERVATOR: If there are unpaid court fees after a denial of a request for a fee waiver, your case—including the guardianship or conservatorship proceeding if the waiver is requested in that matter— might not go forward. After a denial, you may choose to advance the court costs yourself to ensure that the case proceeds.

If you or another person is appointed as guardian or conservator, you would have an opportunity to be reimbursed for such advances from the assets of the guardianship or conservatorship estate, if any, as allowable expenses of administration.

You might also have the right to reimbursement for advanced court costs from persons with an obligation to support the ward or conservatee from assets not part of his or her estate, such as a parent of the ward, the spouse or registered domestic partner of the conservatee who is managing the couple’s community property outside the conservatorship estate, or the trustee of a trust of which the conservatee is a beneficiary. Warning!

If item c 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 the ward’s or conservatee’s 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.

Judicial Officer Clerk, Deputy I certify that I am not involved in this case and (check one): I handed a copy of this Order to the party and attorney, if any, listed in 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 , DeputyClerk, by ________________________________ Name: , at the court, on the date below.and

Document details

Collection	California Superior Local Rules
Citation	Cal. Form PB-12
Type	court_rule
Language	en
Format	pdf
Source	CA_LOCAL
Identifier	c5a10473a9e8803449b6df93455fc93e7e02c864

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