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Here is the text we could read:

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,
•   Your financial situation improves during this case, or
•   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):

Fill in court name and street address:

Superior Court of California, County of

Name:
Street or mailing address:
City:
Phone:

2 Your Job, if you have one (job title):

Name of employer:
Employer’s address:

State:

Zip:

Fill in case number and name:

Case Number:

Case Name:

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
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.

No 

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.

b.

c.

Supp. Sec. Inc.

I receive (check all that apply; see form FW-001-INFO for definitions): 
 Food Stamps 
CalWORKS or Tribal TANF  
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.)

County Relief/Gen. Assist. 

Medi-Cal
WIC

Unemployment

SSP
CAPI

IHSS

Family Size

Family Income

Family Size

Family Income

Family Size

Family Income

1
2

$2,265.00
$3,051.67

3
4

$3,838.34
$4,625.00

5
6

$5,411.67
$6,198.34

If more than 6 people  
at home, add $786.67  
for each extra person.

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

Judicial Council of California,   
Revised August 1, 2022, Mandatory Form 
Government Code, § 68633  
Cal. Rules of Court, rules 3.51, 8.26, and 8.818

Request to Waive Court Fees

FW-001, Page 1 of 2

Sign here

Your name:

Case Number:

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.

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 
the past 12 months.

10 Your Money and Property

a. Cash

b. All financial accounts (List bank name and amount):

8 Your Gross Monthly Income

a. List the source and amount of any income you get each month, 
including: wages or other income from work before deductions, 
spousal/child support, retirement, social security, disability, 
unemployment, military basic allowance for quarters (BAQ), 
veterans payments, dividends, interest, trust income, annuities, 
net business or rental income, reimbursement for job-related 
expenses, gambling or lottery winnings, etc.

(1)

(2)

(3)

(4)

(1)

(2)

(3)

(4)

b. Your total monthly income:

9 Household Income

a. List the income of all other persons living in your home who 

depend in whole or in part on you for support, or on whom you 
depend in whole or in part for support.

Name

Age Relationship

Gross Monthly 
Income
$

b. Total monthly income of persons above: $

Total monthly income and 

household income (8b plus 9b):

$

$

$
$

$

$

$

$

$

c. Cars, boats, and other vehicles

Make / Year

Fair Market  
Value

d. Real estate

Address

Fair Market 
Value

How Much You 
Still Owe
$
$
$

How Much You 
Still Owe
$

e. Other personal property (jewelry, furniture, furs, 

stocks, bonds, etc.):

Describe

Fair Market 
Value

How Much You 
Still Owe
$

$
$
$

$

$

$

$

11 Your Monthly Deductions and Expenses

a. List any payroll deductions and the monthly amount below:

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.
i. School, child care
j.
k.
l.

Child, spousal support (another marriage)
Transportation, gas, auto repair and insurance 
Installment payments (list each below):

Insurance (life, health, accident, etc.)

Paid to:

(1)

(2)

(3)

(1)

(2)

(3)

(1)

(2)

(1)

(2)

(1)

(2)

(3)

(4)

(1)

(2)

(3)

(1)

(2)

(3)

$

$

$
$
$
$

$

$

$

$

$
$
$
$
$
$
$
$
$
$

$

$

$

$

$

$

$

To list any other facts you want the court to know, such as 
unusual medical expenses, etc., attach form MC-025 or 
attach a sheet of paper and write Financial Information and 
your name and case number at the top. 
                 

  Check here if you attach another page. 

Important! If your financial situation or ability to pay 
court fees improves, you must notify the court within five 
days on form FW-010.

m. Wages/earnings withheld by court order
n. Any other monthly expenses (list each below).

Paid to:

How Much?

Total monthly expenses (add 11a –11n above): $

Revised August 1, 2022

Request to Waive Court Fees

FW-001, Page 2 of 2

Request to Waive Court Fees

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 2
Fields(s): 129
Average fields per page: 64
Reading Level: Grade 7
LIST Grouping(s): Unknown

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

f_w_page_right_court_info was FW-001[0].Page1[0].RightCaption[0].CourtInfo[0] (0.47 conf)
f_w_page_right_case_number was FW-001[0].Page1[0].RightCaption[0].CaseNumber[0] (0.34 conf)
f_w_page_right_case_name was FW-001[0].Page1[0].RightCaption[0].CaseName[0] (0.34 conf)
f_w_page_list_item_name was FW-001[0].Page1[0].List1[0].item1[0].PetitionerName1[0] (0.32 conf)
f_page_item_str_address was FW-001[0].Page1[0].List1[0].item1[0].PetitionerStrAddress[0] (0.32 conf)
f_w_page_list_item_city was FW-001[0].Page1[0].List1[0].item1[0].PetitionerCity[0] (0.32 conf)
f_w_page_list_item_state was FW-001[0].Page1[0].List1[0].item1[0].PetitionerState[0] (0.32 conf)
f_w_page_list_item_petitioner_zip was FW-001[0].Page1[0].List1[0].item1[0].PetitionerZip[0] (0.32 conf)
f_w_page_list_item_petitioner_tel was FW-001[0].Page1[0].List1[0].item1[0].PetitionerTel[0] (0.32 conf)
f_page_list_item_job_title was FW-001[0].Page1[0].List2[0].item2[0].PetitionerJobTitle[0] (0.30 conf)
page_list_item_employer_name was FW-001[0].Page1[0].List2[0].item2[0].PetitionerEmployerName[0] (0.31 conf)
f_page_list_item_employer was FW-001[0].Page1[0].List2[0].item2[0].PetitionerEmployerAdd[0] (0.31 conf)
f_w_page_list_info was FW-001[0].Page1[0].List3[0].PetitionerLawyerInfo[0] (0.30 conf)
f_page_list_lawyer_advance_fees__1 was FW-001[0].Page1[0].List3[0].Lia[0].PetLawyerAdvanceFeesY[0] (0.40 conf)
f_page_list_lawyer_advance_fees__2 was FW-001[0].Page1[0].List3[0].Lia[0].PetLawyerAdvanceFeesY[1] (0.40 conf)
f_w_page_list_lib_line was FW-001[0].Page1[0].List3[0].Lib[0].PetLawyerSigLine[0] (0.33 conf)
f_list_item_waive_superior_fee was FW-001[0].Page1[0].List4[0].item4[0].WaiveSuperiorCrtFee[0] (0.37 conf)
page_list_item_waive_review_fee was FW-001[0].Page1[0].List4[0].item4[0].WaiveReviewCrtFee[0] (0.37 conf)
f_page_list_public_received was FW-001[0].Page1[0].List5[0].Lia[0].PublicBenefitReceived[0] (0.38 conf)
f_w_page_list_benefit_p was FW-001[0].Page1[0].List5[0].Lia[0].PublicBenefitSNAP[0] (0.41 conf)
f_w_page_list_public_benefit__1 was FW-001[0].Page1[0].List5[0].Lia[0].PublicBenefitSSI[0] (0.42 conf)
f_w_page_list_public_p was FW-001[0].Page1[0].List5[0].Lia[0].PublicBenefitSSP[0] (0.42 conf)
f_page_list_public_benefit_medi was FW-001[0].Page1[0].List5[0].Lia[0].PublicBenefitMediCal[0] (0.41 conf)
f_w_page_list_lia_public_benefit_cty_g was FW-001[0].Page1[0].List5[0].Lia[0].PublicBenefitCtyGA[0] (0.37 conf)
f_w_page_list_public_benefit__2 was FW-001[0].Page1[0].List5[0].Lia[0].PublicBenefitIHHS[0] (0.42 conf)
f_w_page_list_public_benefit__3 was FW-001[0].Page1[0].List5[0].Lia[0].PublicBenefitCalWORKSTANF[0] (0.38 conf)
f_page_list_public_benefit_cap__1 was FW-001[0].Page1[0].List5[0].Lia[0].PublicBenefitCAPI11[0] (0.36 conf)
f_page_list_public_benefit_cap__2 was FW-001[0].Page1[0].List5[0].Lia[0].PublicBenefitCAPI12[0] (0.36 conf)
f_page_list_public_benefit_cap__3 was FW-001[0].Page1[0].List5[0].Lia[0].PublicBenefitCAPI13[0] (0.36 conf)
f_list_gross_month_income_less was FW-001[0].Page1[0].List5[0].Lib[0].GrossMonthIncomeLess[0] (0.32 conf)
f_page_list_income_request was FW-001[0].Page1[0].List5[0].Lic[0].IncomeInsufficientRequest[0] (0.35 conf)
f_w_page_list_fee_request__1 was FW-001[0].Page1[0].List5[0].Lic[0].FeeRequestDef[0] (0.35 conf)
f_w_page_list_fee_request__2 was FW-001[0].Page1[0].List5[0].Lic[0].FeeRequestDef[1] (0.35 conf)
f_w_page_list_fee_request__3 was FW-001[0].Page1[0].List5[0].Lic[0].FeeRequestDef[2] (0.35 conf)
f_w_list_item_waive_request__1 was FW-001[0].Page1[0].List6[0].item6[0].PrevWaiveRequest[0] (0.32 conf)
f_w_list_item_waive_request__2 was FW-001[0].Page1[0].List6[0].item6[0].PrevWaiveRequestAtt[0] (0.29 conf)
f_w_page_sign_sig_date was FW-001[0].Page1[0].Sign[0].SigDate[0] (0.34 conf)
f_w_page_sign_petitioner_name was FW-001[0].Page1[0].Sign[0].PetitionerName[0] (0.32 conf)
f_w_page_p_x_caption_petitioner_name was FW-001[0].Page2[0].pXCaption[0].PetitionerName1[0] (0.33 conf)
f_w_page_p_x_case_number was FW-001[0].Page2[0].pXCaption[0].CaseNumber[0] (0.36 conf)
f_w_list_item_income was FW-001[0].Page2[0].List7[0].item7[0].IncomeFluctuates[0] (0.32 conf)
f_w_page_list_income_source__1 was FW-001[0].Page2[0].List8[0].Lia[0].IncomeSource1[0] (0.33 conf)
f_w_page_list_income_amount__1 was FW-001[0].Page2[0].List8[0].Lia[0].IncomeAmount1[0] (0.33 conf)
f_w_page_list_income_source__2 was FW-001[0].Page2[0].List8[0].Lia[0].IncomeSource2[0] (0.33 conf)
f_w_page_list_income_amount__2 was FW-001[0].Page2[0].List8[0].Lia[0].IncomeAmount2[0] (0.33 conf)
f_w_page_list_income_source__3 was FW-001[0].Page2[0].List8[0].Lia[0].IncomeSource3[0] (0.33 conf)
f_w_page_list_income_amount__3 was FW-001[0].Page2[0].List8[0].Lia[0].IncomeAmount3[0] (0.33 conf)
f_w_page_list_income_source__4 was FW-001[0].Page2[0].List8[0].Lia[0].IncomeSource4[0] (0.33 conf)
f_w_page_list_income_amount__4 was FW-001[0].Page2[0].List8[0].Lia[0].IncomeAmount4[0] (0.33 conf)
f_w_page_list_total_income__1 was FW-001[0].Page2[0].List8[0].Lib[0].TotalIncome[0] (0.34 conf)
f_page_list_household_income_name__1 was FW-001[0].Page2[0].List9[0].Lia[0].HouseholdIncomeName1[0] (0.33 conf)
f_page_list_household_income_age__1 was FW-001[0].Page2[0].List9[0].Lia[0].HouseholdIncomeAge1[0] (0.33 conf)
f_page_list_household_income_rel__1 was FW-001[0].Page2[0].List9[0].Lia[0].HouseholdIncomeRel1[0] (0.33 conf)
w_list_household_income_amount__1 was FW-001[0].Page2[0].List9[0].Lia[0].HouseholdIncomeAmount1[0] (0.33 conf)
f_page_list_household_income_name__2 was FW-001[0].Page2[0].List9[0].Lia[0].HouseholdIncomeName2[0] (0.33 conf)
f_page_list_household_income_age__2 was FW-001[0].Page2[0].List9[0].Lia[0].HouseholdIncomeAge2[0] (0.33 conf)
f_page_list_household_income_rel__2 was FW-001[0].Page2[0].List9[0].Lia[0].HouseholdIncomeRel2[0] (0.33 conf)
w_list_household_income_amount__2 was FW-001[0].Page2[0].List9[0].Lia[0].HouseholdIncomeAmount2[0] (0.33 conf)
f_page_list_household_income_name__3 was FW-001[0].Page2[0].List9[0].Lia[0].HouseholdIncomeName3[0] (0.33 conf)
f_page_list_household_income_age__3 was FW-001[0].Page2[0].List9[0].Lia[0].HouseholdIncomeAge3[0] (0.33 conf)
f_page_list_household_income_rel__3 was FW-001[0].Page2[0].List9[0].Lia[0].HouseholdIncomeRel3[0] (0.33 conf)
w_list_household_income_amount__3 was FW-001[0].Page2[0].List9[0].Lia[0].HouseholdIncomeAmount3[0] (0.33 conf)
f_page_list_household_income_name__4 was FW-001[0].Page2[0].List9[0].Lia[0].HouseholdIncomeName4[0] (0.33 conf)
f_page_list_household_income_age__4 was FW-001[0].Page2[0].List9[0].Lia[0].HouseholdIncomeAge4[0] (0.33 conf)
f_page_list_household_income_rel__4 was FW-001[0].Page2[0].List9[0].Lia[0].HouseholdIncomeRel4[0] (0.33 conf)
w_list_household_income_amount__4 was FW-001[0].Page2[0].List9[0].Lia[0].HouseholdIncomeAmount4[0] (0.33 conf)
f_w_page_list_household was FW-001[0].Page2[0].List9[0].Lib[0].HouseholdTotalncome[0] (0.33 conf)
f_w_page_list_total_income__2 was FW-001[0].Page2[0].List9[0].Lib[0].TotalAllIncome[0] (0.31 conf)
f_w_page_list_lia_cash was FW-001[0].Page2[0].List10[0].Lia[0].Cash[0] (0.40 conf)
f_page_list_lib_account_name__1 was FW-001[0].Page2[0].List10[0].Lib[0].FinanialAccountName1[0] (0.41 conf)
f_list_financial_account_amount__1 was FW-001[0].Page2[0].List10[0].Lib[0].FinancialAccountAmount1[0] (0.39 conf)
f_page_list_lib_account_name__2 was FW-001[0].Page2[0].List10[0].Lib[0].FinanialAccountName2[0] (0.41 conf)
f_list_financial_account_amount__2 was FW-001[0].Page2[0].List10[0].Lib[0].FinancialAccountAmount2[0] (0.39 conf)
f_page_list_lib_account_name__3 was FW-001[0].Page2[0].List10[0].Lib[0].FinanialAccountName3[0] (0.41 conf)
f_list_financial_account_amount__3 was FW-001[0].Page2[0].List10[0].Lib[0].FinancialAccountAmount3[0] (0.39 conf)
f_w_page_list_lic_vehicle_make_yr__1 was FW-001[0].Page2[0].List10[0].Lic[0].VehicleMakeYr1[0] (0.40 conf)
f_w_list_fair_market_val__1 was FW-001[0].Page2[0].List10[0].Lic[0].VehicleFairMarketVal1[0] (0.39 conf)
f_page_list_vehicle_amount_owed__1 was FW-001[0].Page2[0].List10[0].Lic[0].VehicleAmountOwed1[0] (0.40 conf)
f_w_page_list_lic_vehicle_make_yr__2 was FW-001[0].Page2[0].List10[0].Lic[0].VehicleMakeYr2[0] (0.40 conf)
f_w_list_fair_market_val__2 was FW-001[0].Page2[0].List10[0].Lic[0].VehicleFairMarketVal2[0] (0.39 conf)
f_page_list_vehicle_amount_owed__2 was FW-001[0].Page2[0].List10[0].Lic[0].VehicleAmountOwed2[0] (0.40 conf)
f_w_page_list_lic_vehicle_make_yr__3 was FW-001[0].Page2[0].List10[0].Lic[0].VehicleMakeYr3[0] (0.40 conf)
f_w_list_fair_market_val__3 was FW-001[0].Page2[0].List10[0].Lic[0].VehicleFairMarketVal3[0] (0.39 conf)
f_page_list_vehicle_amount_owed__3 was FW-001[0].Page2[0].List10[0].Lic[0].VehicleAmountOwed3[0] (0.40 conf)
f_page_list_lid_real_add__1 was FW-001[0].Page2[0].List10[0].Lid[0].RealEstateAdd1[0] (0.37 conf)
f_page_list_real_fair_val__1 was FW-001[0].Page2[0].List10[0].Lid[0].RealEstateFairMarketVal1[0] (0.37 conf)
page_list_real_estate_amount_owed__1 was FW-001[0].Page2[0].List10[0].Lid[0].RealEstateAmountOwed1[0] (0.36 conf)
f_page_list_lid_real_add__2 was FW-001[0].Page2[0].List10[0].Lid[0].RealEstateAdd2[0] (0.37 conf)
f_page_list_real_fair_val__2 was FW-001[0].Page2[0].List10[0].Lid[0].RealEstateFairMarketVal2[0] (0.37 conf)
page_list_real_estate_amount_owed__2 was FW-001[0].Page2[0].List10[0].Lid[0].RealEstateAmountOwed2[0] (0.36 conf)
f_w_page_list_lie_desc__1 was FW-001[0].Page2[0].List10[0].Lie[0].OtherPropertyDesc1[0] (0.39 conf)
f_page_list_fair_market_val__1 was FW-001[0].Page2[0].List10[0].Lie[0].OtherPropertyFairMarketVal1[0] (0.39 conf)
f_page_list_property_amount_owed__1 was FW-001[0].Page2[0].List10[0].Lie[0].OtherPropertyAmountOwed1[0] (0.38 conf)
f_w_page_list_lie_desc__2 was FW-001[0].Page2[0].List10[0].Lie[0].OtherPropertyDesc2[0] (0.39 conf)
f_page_list_fair_market_val__2 was FW-001[0].Page2[0].List10[0].Lie[0].OtherPropertyFairMarketVal2[0] (0.39 conf)
f_page_list_property_amount_owed__2 was FW-001[0].Page2[0].List10[0].Lie[0].OtherPropertyAmountOwed2[0] (0.38 conf)
f_w_page_list_payroll_deduct__1 was FW-001[0].Page2[0].List11[0].Lia[0].PayrollDeduct1[0] (0.41 conf)
f_w_page_list_lia_payroll_amt__1 was FW-001[0].Page2[0].List11[0].Lia[0].PayrollAmt1[0] (0.41 conf)
f_w_page_list_payroll_deduct__2 was FW-001[0].Page2[0].List11[0].Lia[0].PayrollDeduct2[0] (0.41 conf)
f_w_page_list_lia_payroll_amt__2 was FW-001[0].Page2[0].List11[0].Lia[0].PayrollAmt2[0] (0.41 conf)
f_w_page_list_payroll_deduct__3 was FW-001[0].Page2[0].List11[0].Lia[0].PayrollDeduct3[0] (0.41 conf)
f_w_page_list_lia_payroll_amt__3 was FW-001[0].Page2[0].List11[0].Lia[0].PayrollAmt3[0] (0.41 conf)
f_w_page_list_payroll_deduct__4 was FW-001[0].Page2[0].List11[0].Lia[0].PayrollDeduct4[0] (0.41 conf)
f_w_page_list_lia_payroll_amt__4 was FW-001[0].Page2[0].List11[0].Lia[0].PayrollAmt4[0] (0.41 conf)
f_w_page_list_expense_housing was FW-001[0].Page2[0].List11[0].Lib[0].ExpenseHousing[0] (0.38 conf)
f_w_page_list_expense_supplies was FW-001[0].Page2[0].List11[0].Lic[0].ExpenseFoodSupplies[0] (0.36 conf)
page_list_expense_utilities_phone was FW-001[0].Page2[0].List11[0].Lid[0].ExpenseUtilitiesPhone[0] (0.39 conf)
f_w_page_list_lie_expense was FW-001[0].Page2[0].List11[0].Lie[0].ExpenseClothes[0] (0.38 conf)
f_w_page_list_expense_laundry was FW-001[0].Page2[0].List11[0].Lif[0].ExpenseLaundry[0] (0.38 conf)
f_w_page_list_expense_medical was FW-001[0].Page2[0].List11[0].Lig[0].ExpenseMedicalDental[0] (0.39 conf)
f_w_page_list_expense_insurance was FW-001[0].Page2[0].List11[0].Lih[0].ExpenseInsurance[0] (0.38 conf)
page_list_expense_school_child_care was FW-001[0].Page2[0].List11[0].Lii[0].ExpenseSchoolChildCare[0] (0.36 conf)
f_w_page_list_expense_support was FW-001[0].Page2[0].List11[0].Lij[0].ExpenseSupport[0] (0.38 conf)
f_page_list_expense_transportation was FW-001[0].Page2[0].List11[0].Lik[0].ExpenseTransportation[0] (0.38 conf)
f_w_page_list_payment__1 was FW-001[0].Page2[0].List11[0].Lil[0].InstallmentPaymentTo1[0] (0.35 conf)
f_page_list_payment_amount__1 was FW-001[0].Page2[0].List11[0].Lil[0].InstallmentPaymentAmount1[0] (0.35 conf)
f_w_page_list_payment__2 was FW-001[0].Page2[0].List11[0].Lil[0].InstallmentPaymentTo2[0] (0.35 conf)
f_page_list_payment_amount__2 was FW-001[0].Page2[0].List11[0].Lil[0].InstallmentPaymentAmount2[0] (0.35 conf)
f_w_page_list_payment__3 was FW-001[0].Page2[0].List11[0].Lil[0].InstallmentPaymentTo3[0] (0.35 conf)
f_page_list_payment_amount__3 was FW-001[0].Page2[0].List11[0].Lil[0].InstallmentPaymentAmount3[0] (0.35 conf)
f_w_page_list_earnings was FW-001[0].Page2[0].List11[0].Lim[0].EarningsWithholding[0] (0.35 conf)
f_w_page_list_lin_expense__1 was FW-001[0].Page2[0].List11[0].Lin[0].OtherExpense1[0] (0.39 conf)
f_w_page_list_expense_amount__1 was FW-001[0].Page2[0].List11[0].Lin[0].OtherExpenseAmount1[0] (0.39 conf)
f_w_page_list_lin_expense__2 was FW-001[0].Page2[0].List11[0].Lin[0].OtherExpense2[0] (0.39 conf)
f_w_page_list_expense_amount__2 was FW-001[0].Page2[0].List11[0].Lin[0].OtherExpenseAmount2[0] (0.39 conf)
f_w_page_list_lin_expense__3 was FW-001[0].Page2[0].List11[0].Lin[0].OtherExpense3[0] (0.39 conf)
f_w_page_list_expense_amount__3 was FW-001[0].Page2[0].List11[0].Lin[0].OtherExpenseAmount3[0] (0.39 conf)
f_w_list_total was FW-001[0].Page2[0].List11[0].Total[0].Totalmonthlyexpenses[0] (0.40 conf)
f_w_page_note_overflow was FW-001[0].Page2[0].Note[0].Overflow[0] (0.38 conf)

We've done our best to group similar variables togther to avoid overwhelming the user.

Suggested Screen 0:

f_w_page_right_court_info
f_w_page_right_case_number
f_w_page_right_case_name
f_w_page_sign_petitioner_name
f_w_page_p_x_caption_petitioner_name
f_w_page_p_x_case_number
f_w_page_note_overflow

Suggested Screen 1:

f_page_item_str_address

Suggested Screen 2:

f_w_page_list_item_name
f_w_page_list_item_city
f_w_page_list_item_state
f_w_page_list_item_petitioner_zip
f_w_page_list_item_petitioner_tel
f_w_page_list_lib_line
f_w_list_item_income

Suggested Screen 3:

f_page_list_item_job_title
page_list_item_employer_name
f_page_list_item_employer

Suggested Screen 4:

page_list_item_waive_review_fee

Suggested Screen 5:

f_w_page_list_info
f_w_page_list_benefit_p
f_w_page_list_public_p

Suggested Screen 6:

f_page_list_public_received
f_w_page_list_public_benefit__1
f_page_list_public_benefit_medi
f_w_page_list_lia_public_benefit_cty_g
f_w_page_list_public_benefit__2
f_w_page_list_public_benefit__3
f_page_list_public_benefit_cap__1
f_page_list_public_benefit_cap__2
f_page_list_public_benefit_cap__3

Suggested Screen 7:

f_w_page_list_fee_request__1
f_w_page_list_fee_request__2
f_w_page_list_fee_request__3
f_w_page_sign_sig_date
f_w_page_list_payment__1
f_page_list_payment_amount__1
f_w_page_list_payment__2
f_page_list_payment_amount__2
f_w_page_list_payment__3
f_page_list_payment_amount__3

Suggested Screen 8:

f_list_item_waive_superior_fee
f_w_list_item_waive_request__1
f_w_list_item_waive_request__2

Suggested Screen 9:

f_w_page_list_income_source__1
f_w_page_list_income_amount__1
f_w_page_list_income_source__2
f_w_page_list_income_amount__2
f_w_page_list_income_source__3
f_w_page_list_income_amount__3
f_w_page_list_income_source__4
f_w_page_list_income_amount__4
f_w_page_list_total_income__1
f_w_page_list_household
f_w_page_list_total_income__2
f_w_page_list_earnings
f_w_page_list_expense_amount__1
f_w_page_list_expense_amount__2
f_w_page_list_expense_amount__3

Suggested Screen 10:

f_page_list_household_income_name__1
f_page_list_household_income_name__2
f_page_list_household_income_name__3
f_page_list_household_income_name__4

Suggested Screen 11:

f_list_gross_month_income_less
w_list_household_income_amount__1
w_list_household_income_amount__2
w_list_household_income_amount__3
w_list_household_income_amount__4

Suggested Screen 12:

f_page_list_household_income_rel__1
f_page_list_household_income_rel__2
f_page_list_household_income_rel__3
f_page_list_household_income_rel__4

Suggested Screen 13:

f_page_list_income_request
f_page_list_household_income_age__1
f_page_list_household_income_age__2
f_page_list_household_income_age__3
f_page_list_household_income_age__4

Suggested Screen 14:

f_page_list_lib_account_name__1
f_page_list_lib_account_name__2
f_page_list_lib_account_name__3

Suggested Screen 15:

f_list_financial_account_amount__1
f_list_financial_account_amount__2
f_list_financial_account_amount__3

Suggested Screen 16:

f_w_page_list_lic_vehicle_make_yr__1
f_w_page_list_lic_vehicle_make_yr__2
f_w_page_list_lic_vehicle_make_yr__3

Suggested Screen 17:

f_page_list_lid_real_add__1
f_page_list_lid_real_add__2

Suggested Screen 18:

f_w_list_fair_market_val__1
f_w_list_fair_market_val__2
f_w_list_fair_market_val__3
f_page_list_real_fair_val__1
f_page_list_real_fair_val__2
f_page_list_fair_market_val__1
f_page_list_fair_market_val__2

Suggested Screen 19:

f_page_list_lawyer_advance_fees__1
f_page_list_lawyer_advance_fees__2
f_page_list_vehicle_amount_owed__1
f_page_list_vehicle_amount_owed__2
f_page_list_vehicle_amount_owed__3
page_list_real_estate_amount_owed__1
page_list_real_estate_amount_owed__2
f_page_list_property_amount_owed__1
f_page_list_property_amount_owed__2

Suggested Screen 20:

f_w_page_list_payroll_deduct__1
f_w_page_list_payroll_deduct__2
f_w_page_list_payroll_deduct__3
f_w_page_list_payroll_deduct__4

Suggested Screen 21:

f_w_page_list_lia_payroll_amt__1
f_w_page_list_lia_payroll_amt__2
f_w_page_list_lia_payroll_amt__3
f_w_page_list_lia_payroll_amt__4

Suggested Screen 22:

f_w_page_list_expense_housing
f_w_page_list_expense_supplies
f_w_page_list_lie_expense
f_w_page_list_expense_laundry
f_w_page_list_expense_medical
f_w_page_list_expense_insurance
f_w_page_list_expense_support
f_page_list_expense_transportation

Suggested Screen 23:

page_list_expense_utilities_phone

Suggested Screen 24:

page_list_expense_school_child_care

Suggested Screen 25:

f_w_page_list_lia_cash
f_w_page_list_lie_desc__1
f_w_page_list_lie_desc__2
f_w_page_list_lin_expense__1
f_w_page_list_lin_expense__2
f_w_page_list_lin_expense__3

Suggested Screen 26:

f_w_list_total

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02