Orange — How to File a Fee Waiver

Source: https://www.occourts.org/system/files/selfhelp/shc-fw-01.pdf

SUPERIOR COURT OF CALIFORNIA Self-Help Services COUNTY OF ORANGE www.occourts.org/self-help

HOW TO FILE A FEE WAIVER REQUEST

SELF-HELP FORM PACKET

SHC-FW-01 (Rev. 03/01/2026)

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.

https://www.occourts.org/self-help

FW-001 Request to Waive Court Fees CONFIDENTIAL

Clerk stamps date here when form is filed.

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, Fill in court name and street address: • Your financial situation improves during this case, or Superior Court of California, County of • 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: Fill in case number and name: City: State: Zip: Case Number: Phone: 2 Your Job, if you have one (job title): Case Name: 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
b. (If yes, your lawyer must sign here) Lawyer’s signature:
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 If more than 6 people 1 $2,660.00 3 $4,553.33 5 $6,446.67 at home, add $946.67 2 $3,606.67 4 $5,500.00 6 $7,393.33 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

Judicial Council of California, courts.ca.gov Rev. March 1, 2026, Mandatory Form Request to Waive Court Fees FW-001, Page 1 of 2 Gov. Code, § 68633; Cal. Rules of Court, rules 3.51, 8.26, and 8.818

Case Number: Your name:

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.

10 Your Money and Property 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 a. Cash $ the past 12 months. b. All financial accounts (List bank name and amount): 8 Your Gross Monthly Income (1) $ a. List the source and amount of any income you get each month, (2) $ including: wages or other income from work before deductions, (3) $ spousal/child support, retirement, social security, disability, c. Cars, boats, and other vehicles unemployment, military basic allowance for quarters (BAQ), Fair Market How Much You veterans payments, dividends, interest, trust income, annuities, Make / Year Value Still Owe net business or rental income, reimbursement for job-related (1) $ $ expenses, gambling or lottery winnings, etc. (2) $ $ (1) $ (3) $ $ (2) $ d. Real estate Fair Market How Much You (3) $ Address Value Still Owe (4) $ (1) $ $ b. Your total monthly income: $ (2) $ $ 9 Household Income e. Other personal property (jewelry, furniture, furs, stocks, bonds, etc.): a. List the income of all other persons living in your home who Fair Market How Much You depend in whole or in part on you for support, or on whom you Describe Value Still Owe depend in whole or in part for support. (1) $ $ Gross Monthly (2) $ $ Name Age Relationship Income (1) $ 11 Your Monthly Deductions and Expenses (2) $ a. List any payroll deductions and the monthly amount below: (3) $ (1) $ (4) $ (2) $ b. Total monthly income of persons above: $ (3) $ (4) $ Total monthly income and household income (8b plus 9b): $ 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 $ j. Child, spousal support (another marriage) $ k. Transportation, gas, auto repair and insurance $

j. Child, spousal support (another marriage) $ k. Transportation, gas, auto repair and insurance $

j. Child, spousal support (another marriage) $
k. Transportation, gas, auto repair and insurance $
l. Installment payments (list each below):
Paid to:
(1) $
(2) $
(3) $

To list any other facts you want the court to know, such as m. Wages/earnings withheld by court order $ unusual medical expenses, etc., attach form MC-025 or n. Any other monthly expenses (list each below). attach a sheet of paper and write Financial Information and your name and case number at the top. Paid to: How Much? (1) $ Check here if you attach another page. (2) $ Important! If your financial situation or ability to pay (3) $ court fees improves, you must notify the court within five Total monthly expenses (add 11a –11n above): $ days on form FW-010.

Rev. March 1, 2026 Request to Waive Court Fees FW-001, Page 2 of 2

Order on Court Fee Waiver Clerk stamps date here when form is filed. FW-003 (Superior Court)

1 Person who asked the court to waive court fees: Name: Street or mailing address: City: State: Zip:

Lawyer, if person in 1 has one (name, firm name, address, 2 phone number, e-mail, and State Bar number): Fill in court name and street address: Superior Court of California, County of Orange

Fill in case number and name:

A request to waive court fees was filed on (date): 3 Case Number: The court made a previous fee waiver order in this case on (date):

Case Name:

Read this form carefully. All checked boxes þ are court orders.

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. After reviewing your: Request to Waive Court Fees Request to Waive Additional Court Fees 4 the court makes the following orders: a. The court grants your request, as follows: (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: • Filing papers in superior court • Court fee for phone hearing • Making copies and certifying copies • Giving notice and certificates • Sheriff’s fee to give notice • 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) 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. Jury fees and expenses Fees for a peace officer to testify in court Fees for court-appointed experts Court-appointed interpreter fees for a witness Other (specify):

Judicial Council of California, www.courts.ca.gov Revised September 1, 2019, Mandatory Form Order on Court Fee Waiver (Superior Court) FW-003, Page 1 of 3 Government Code, § 68634(e) Cal. Rules of Court, rule 3.52

Case Number: Your name:

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.
(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:
• Pay your fees and costs, or
• File a new revised request that includes the incomplete items listed:
Below On Attachment 4b(1)

(2) The information you provided on the request shows that you are not eligible for the fee waiver you
requested for the reasons stated: Below On Attachment 4b(2)

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. (1) 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:
Below On Attachment 4c(1)

(2) Bring the items of proof to support your request, if reasonably available, that are listed:
Below On Attachment 4c(2)

This is a Court Order.

Rev. September 1, 2019 Order on Court Fee Waiver (Superior Court) FW-003, Page 2 of 3

Case Number: Your name:

Name and address of court if different from above:

Hearing g Date: Time:
Date Dept.: Room:

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

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.)

Clerk's Certificate of Service

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 1 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 1 and 2 , from (city): , California, on the date below. A certificate of mailing is attached.

Date:

Clerk, by ________________________________ , Deputy

Name:

This is a Court Order.

Rev. September 1, 2019 Order on Court Fee Waiver (Superior Court) FW-003, Page 3 of 3