FW-011 Notice to Appear for Reconsideration of Fee Waiver

Source: https://www.courts.ca.gov/documents/fw011.pdf

Notice to Appear for Clerk stamps date here when form is filed. FW-011 To keep other people from Reconsideration of Fee Waiver seeing what you entered on your form, please press the Warning: If you do not go to the hearing on the date and time below, the Clear This Form button at the court may cancel your fee waiver. end of the form when finished. 1 Name of person who asked the court to waive court fees:

Street or mailing address:
City: State: Zip:

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

3 The court has information that (check all that apply): a. Your financial situation may have changed, or you may no longer be eligible for a fee waiver because (explain): Fill in case number and name: Case Number:

Case Name:
b. You may be increasing the costs of your case unnecessarily. The
fee waiver for the court services you are using may be limited
because (explain):

c. Your case is coming to an end, and the court requires some information about your eligibility to have your
court fees waived.

4 You must go to court on the date below: Name and address of court if different from above: Hearing Î Date: Time: Date Dept.: Rm.:

Bring the following information if reasonably available:

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 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 notice to the party and attorney, if any, listed in 1 and 2 , at the court, on the date below. This notice 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.

Date: Clerk, by , Deputy

Judicial Council of California, www.courtinfo.ca.gov New July 1, 2009, Mandatory Form Notice to Appear for Reconsideration FW-011, Page 1 of 1 Government Code, § 68636 of Fee Waiver

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