Form Fw-001 - Request To Waive Court Fees Page 6
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6Case Number:
Your name:
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.
(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 your fees and costs, or
•
•
File a new revised request that includes the items listed below (specify incomplete items):
(2)
The court denies your request because the information you provided on the request shows that you are
not eligible for the fee waiver you requested (specify reasons):
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:
•
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.)
c.
The court needs more information to decide whether to grant your request. You must go to court on the date
below. The hearing will be about (specify questions regarding eligibility):
Bring the following proof to support your request if reasonably available:
Name and address of court if different from above:
J
Date:
Time:
Hearing
Date
Dept.:
Room:
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 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
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
I certify that I am not involved in this case and (check one):
A certificate of mailing is attached.
I handed a copy of this order to the party and attorney, if any, listed in
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and
2
, 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
,
1
2
(city):
from
, California on the date below.
Date:
Clerk, by
, Deputy
This is a Court Order.
Order on Court Fee Waiver (Superior Court)
FW-003,
Revised July 1, 2015
Page 2 of 2
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