FW-005 Notice: Waiver of Court Fees (Superior Court)

Source: https://www.courts.ca.gov/documents/fw005.pdf

Clerk stamps date here when form is filed. Notice: Waiver of Court Fees FW-005 (Superior Court)

Person who asked the court to waive court fees: 1
Name:
Mailing address:
City: State: Zip:
Phone number:

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

Court fills in case number when form is filed.
Your Request to Waive Court Fees was filed on (date): 3 Case Number:

Case Name:

4 Your request is granted by operation of law because no court action was taken within five days after it was filed. A fee waiver is granted for the following court fees and costs (Cal. Rules of Court, rule 3.55):

• Filing papers • Making copies and certifying copies • Giving notice and certificates • Sheriff’s fee to give notice • Sending papers to another court department • Court fee for phone hearing • 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 rules 8.130 or 8.834 • Making a transcript or copy of an official electronic recording under rule 8.835 Date: Clerk, by , Deputy 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. Clerk's Certificate of Service I certify that I am not involved in this case and (check one): 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. A certificate of mailing is attached. Date: Clerk, by , Deputy

Judicial Council of California, www.courts.ca.gov FW-005, Page 1 of 1Revised September 1, 2019, Mandatory Form Notice: Waiver of Court Fees Government Code, § 68634(f) For your protection and privacy, please press the Clear This Form button after you have printed the form. Print this form Save this form Clear this form