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FW-003

Order on Court Fee Waiver
(Superior Court)

Person who asked the court to waive court fees:
Name:

Street or mailing address:

City:

State:

Zip:

Lawyer, if person in       has one (name, firm name, address, 
phone number, e-mail, and State Bar number):

1

Clerk stamps date here when form is filed.

Fill in court name and street address:
Superior Court of California, County of

A request to waive court fees was filed on (date):

 The court made a previous fee waiver order in this case  on (date):

Fill in case number and name:

Case Number:

Case Name:

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

(cid:254)

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.

Request to Waive Court Fees

Request to Waive Additional Court Fees

4

After reviewing your:
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  
• Making copies and certifying copies  
• Sheriff’s fee to give notice
• 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

• Court fee for phone hearing  
• Giving notice and certificates  
• Sending papers to another court department 

(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 court-appointed experts 
   Other

    (specify):

Fees for a peace officer to testify in court  
Court-appointed interpreter fees for a witness

Judicial Council of California, www.courts.ca.gov 
Revised September 1, 2019, Mandatory Form 
Government Code, § 68634(e) 
Cal. Rules of Court, rule 3.52

Order on Court Fee Waiver (Superior Court)

FW-003, Page 1 of 3

Your name:

b. 

The court denies your fee waiver request because:

Case Number:

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: 

On Attachment 4b(2)

Below

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)

Rev. September 1, 2019

 Order on Court Fee Waiver (Superior Court)

FW-003, Page 2 of 3

This is a Court Order.

Your name:

Case Number:

Name and address of court if different from above:

Hearing 
Date

g

Date:

Dept.:

Time:

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       and      , at the court, on the date below.

2

1

This order was mailed first class, postage paid, to the party and attorney, if any, at the addresses listed in      and      , 
from 

, California, on the date below.

(city):

1

2

  A certificate of mailing is attached.

Date:

Clerk, by ________________________________
Name:

, Deputy

Rev. September 1, 2019

 Order on Court Fee Waiver (Superior Court)

FW-003, Page 3 of 3

This is a Court Order.