Preview
,
4 Order on Court Fee Waiver
:
Clerk stamps date here when form is filed.
(Superior Court)
Person who asked the court to waive court fees
Name: Ean Soudeorrveh
Street or mailing address QAe Dinmend
We
City: Mies State: CAC Zip: aSQ3>
@ Lawyer, if person in (4) 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
gor Court
Supet
civilD ivisiod
4 Ni. First+
Jose: 95113
Fill in case number and name:
@) A request to waive court fees was filed on (date):
os Tel
(1 The court made a previous fee waiver order inn this case on (date): CV384689
Case Name:
Read this form carefully. All checked boxes Qare court orders. Diab VS Kail Rivas,
ond Ei lamina Herk
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. O Request to Waive Court Fees (1 Request to Waive Additional Court Fees
the court makes the following orders: t
1
a. CL] 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.
Oo Jury fees and expenses (1 Fees for a peace officer to testify in court
(1s Fees for court-appointed experts C1 Court-appointed interpreter fees for a witness
(1 Other (specify).
Judicial Counail of Califor, wnvw.courts ca.gov Order on Court Fee Waiver (Superior Court) FW-003, Page 1 of 3
Revised September 1, 2019. Mandatory Form
‘Govemment Coda, § 8634(0)
(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 cannet 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. -
() OQ) 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:
OD Below 1 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 states 1 Below (J On Attachment 4b(2)
The court has enclosed a blank Request for Hearing About Court Fee Waiver Order (Superior Court)
(form FW-006).¥ou 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.)
e (yO ‘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:
O Below (1 On Attachment 4c(1)
® D Bring the items of proof to support your request, if reasonably available, that are listed:
O Below [) On Attachment 4c(2)
tres
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:
Date: Time: eS
eS
Dept.: Room:
Warning! If item o(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
:
LZ. Ze
dismissed.
2,
Date:
Signature of (check one): Ll Audiéfat 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
( certify that [am not involved in this case and (check one):
(CO I handed a copy of this Order to the party and attorney, if any, listed in (1) and(@), at the court, on the date below.
DC This order was mailed first class, postage paid, to the party and attorney, if any, at the addresses listed in@)and@),
from (city): , California, on the date below,
OA certificate of mailingis attached.
Date:
Clerk, by , Deputy
Name: a
et
Rov. Seplember #, 2019
Order on Court Fee Waiver (Superior Court) FW-003, Page 3 of3
Preview
, 4 Order on Court Fee Waiver : Clerk stamps date here when form is filed. (Superior Court) Person who asked the court to waive court fees Name: Ean Soudeorrveh Street or mailing address QAe Dinmend We City: Mies State: CAC Zip: aSQ3> @ Lawyer, if person in (4) 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 gor Court Supet civilD ivisiod 4 Ni. First+ Jose: 95113 Fill in case number and name: @) A request to waive court fees was filed on (date): os Tel (1 The court made a previous fee waiver order inn this case on (date): CV384689 Case Name: Read this form carefully. All checked boxes Qare court orders. Diab VS Kail Rivas, ond Ei lamina Herk 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. O Request to Waive Court Fees (1 Request to Waive Additional Court Fees the court makes the following orders: t 1 a. CL] 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. Oo Jury fees and expenses (1 Fees for a peace officer to testify in court (1s Fees for court-appointed experts C1 Court-appointed interpreter fees for a witness (1 Other (specify). Judicial Counail of Califor, wnvw.courts ca.gov Order on Court Fee Waiver (Superior Court) FW-003, Page 1 of 3 Revised September 1, 2019. Mandatory Form ‘Govemment Coda, § 8634(0) (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 cannet 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. - () OQ) 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: OD Below 1 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 states 1 Below (J On Attachment 4b(2) The court has enclosed a blank Request for Hearing About Court Fee Waiver Order (Superior Court) (form FW-006).¥ou 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.) e (yO ‘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: O Below (1 On Attachment 4c(1) ® D Bring the items of proof to support your request, if reasonably available, that are listed: O Below [) On Attachment 4c(2) tres 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: Date: Time: eS eS Dept.: Room: Warning! If item o(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 : LZ. Ze dismissed. 2, Date: Signature of (check one): Ll Audiéfat 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 ( certify that [am not involved in this case and (check one): (CO I handed a copy of this Order to the party and attorney, if any, listed in (1) and(@), at the court, on the date below. DC This order was mailed first class, postage paid, to the party and attorney, if any, at the addresses listed in@)and@), from (city): , California, on the date below, OA certificate of mailingis attached. Date: Clerk, by , Deputy Name: a et Rov. Seplember #, 2019 Order on Court Fee Waiver (Superior Court) FW-003, Page 3 of3