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Here is the text we could read:

APP-016-GC/FW-016-GC

Order on Court Fee Waiver 
(Court of Appeal or Supreme Court)
(Ward or Conservatee)

Clerk stamps date here when form is filed.

1

3

(Proposed) guardian or conservator who asked the court to 
waive court fees for (proposed) ward or conservatee:
Name:
Street or mailing address:
City:
Telephone:

State:

Zip:

2 Lawyer, if person in      has one:

1

Name:
Firm or Affiliation:
Street or mailing address:
City:
Email:

State:

Zip:
Telephone:

(Proposed) ward or conservatee:
Name:
Street or mailing address:
City:
Telephone:

State:

Zip:

4 Ward's or Conservatee's Lawyer, if any: Name:

State Bar No:

Fill in court name and street address:

Court of Appeal or Supreme Court  
Case Number:

Firm or Affiliation:
Address:

City:

State:

Zip:

Email:

State Bar No.:
Telephone:

5 On (date):
6 The court reviewed your request and makes the following order:

, you filed a Request to Waive Court Fees (form FW-001-GC).

a. 

The court grants your request and waives the (proposed) ward’s or conservatee’s court fees and costs listed 
below. You do not have to pay fees for the following: 
• Filing notice of appeal, petition for writ, or petition for review

Other (specify):

b.

The court denies your request for the following reasons:

(1)

Your request is incomplete. You have 10 days from the date this notice was sent to:
•
•

 Pay the (proposed) ward’s or conservatee’s fees and costs, or
 File a new revised request that includes the items listed below (specify incomplete items):

Warning! If you miss the deadline for paying the (proposed) ward’s or conservatee’s fees and costs or 
providing the additional items required by the court and you are the appellant, your appeal may be dismissed.

Judicial Council of California,  
Rev. January 1, 2021, Optional Form 
Government Code, §§ 68634.5, 68636

www.courts.ca.gov

Order on Court Fee Waiver 
(Court of Appeal or Supreme Court) 
(Ward or Conservatee)

APP-016-GC/FW-016-GC, Page 1 of 2

Court of Appeal/Supreme Court Case Name: 

Court of Appeal or Supreme Court  
Case Number:

b. (2)

6

The information you provided on the request shows that the (proposed) ward or conservatee is not 
eligible for the fee waiver you  requested for the following reasons (specify):

You have 10 days from the date this notice was sent to:
•  Pay the (proposed) ward’s or conservatee’s fees and costs, or
• File more information that shows that the (proposed) ward or conservatee is eligible for a fee waiver.

(3)

The court finds there is substantial question regarding the (proposed) ward’s or conservatee’s eligibility 
(describe issue(s) regarding eligibility): 

You have 10 days from the date this notice was sent to:
•   Pay the (proposed) ward’s or conservatee’s fees and costs, or
• File the following additional documents to support your request:

c. 

The court needs more information. You must go to court on the date below.

Hearing 
Date

Date:
Name and address of court if different from page 1:

Time:

Dept.:

Bring the following proof to support your request, if it is reasonably available:

Warning!  If item       c. is checked and you do not go to court on the hearing date, the court will deny your request to 
waive court fees for the (proposed) ward or conservatee and you will have 10 days to pay those fees. If you are the 
appellant and you do not pay the filing fees, your appeal may be dismissed.

6

Date:

Rev. January 1, 2021 

Signature of (check one):              Judicial Officer

 Clerk, Deputy

Order on Court Fee Waiver 
(Court of Appeal or Supreme Court) 
(Ward or Conservatee)

APP-016-GC/FW-016-GC, Page 2 of 2

Order on Court Fee Waiver (Court of Appeal or Supreme Court) (Ward or Conservatee)

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): 56
Average fields per page: 28
Reading Level: Grade 7
LIST Grouping(s): CO-00-00-00-00.

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_c_page_p_stamp_case was FW-016-GC[0].Page1[0].P1[0].Stamp_court_case[0].CourtInfo_ft[0] (0.55 conf)
f_w_c_p_stamp_case_number was FW-016-GC[0].Page1[0].P1[0].Stamp_court_case[0].CaseNumber_ft[0] (0.38 conf)
f_w_c_p_item_person_name__1 was FW-016-GC[0].Page1[0].P1[0].List1[0].Item1[0].PersonWaivingName_ft[0] (0.39 conf)
f_w_c_page_p_item_fill__1 was FW-016-GC[0].Page1[0].P1[0].List1[0].Item1[0].FillText1[0] (0.38 conf)
f_w_c_page_p_item_fill__2 was FW-016-GC[0].Page1[0].P1[0].List1[0].Item1[0].FillText2[0] (0.38 conf)
f_w_c_page_p_item_fill__3 was FW-016-GC[0].Page1[0].P1[0].List1[0].Item1[0].FillText3[0] (0.38 conf)
f_w_c_page_p_item_fill__4 was FW-016-GC[0].Page1[0].P1[0].List1[0].Item1[0].FillText4[0] (0.38 conf)
f_w_c_page_p_item_fill__5 was FW-016-GC[0].Page1[0].P1[0].List1[0].Item1[0].FillText5[0] (0.38 conf)
f_w_c_page_p_item_name was FW-016-GC[0].Page1[0].P1[0].List2[0].Item1[0].WardName_ft[0] (0.40 conf)
f_w_c_page_p_item_fill__6 was FW-016-GC[0].Page1[0].P1[0].List2[0].Item1[0].FillText1[0] (0.38 conf)
f_w_c_page_p_item_fill__7 was FW-016-GC[0].Page1[0].P1[0].List2[0].Item1[0].FillText2[0] (0.38 conf)
f_w_c_page_p_item_fill__8 was FW-016-GC[0].Page1[0].P1[0].List2[0].Item1[0].FillText3[0] (0.38 conf)
f_w_c_page_p_item_fill__9 was FW-016-GC[0].Page1[0].P1[0].List2[0].Item1[0].FillText4[0] (0.38 conf)
f_w_c_page_p_item_fill__10 was FW-016-GC[0].Page1[0].P1[0].List2[0].Item1[0].FillText5[0] (0.38 conf)
f_w_c_page_p_item_fill__11 was FW-016-GC[0].Page1[0].P1[0].List2[0].Item1[0].FillText6[0] (0.38 conf)
f_w_c_page_p_item_fill__12 was FW-016-GC[0].Page1[0].P1[0].List2[0].Item1[0].FillText7[0] (0.38 conf)
f_w_c_page_p_item_fill__13 was FW-016-GC[0].Page1[0].P1[0].List2[0].Item1[0].FillText8[0] (0.38 conf)
f_w_c_p_item_person_name__2 was FW-016-GC[0].Page1[0].P1[0].List3[0].Item1[0].PersonWaivingName_ft[0] (0.39 conf)
f_w_c_page_p_item_fill__14 was FW-016-GC[0].Page1[0].P1[0].List3[0].Item1[0].FillText1[0] (0.38 conf)
f_w_c_page_p_item_fill__15 was FW-016-GC[0].Page1[0].P1[0].List3[0].Item1[0].FillText2[0] (0.38 conf)
f_w_c_page_p_item_fill__16 was FW-016-GC[0].Page1[0].P1[0].List3[0].Item1[0].FillText3[0] (0.38 conf)
f_w_c_page_p_item_fill__17 was FW-016-GC[0].Page1[0].P1[0].List3[0].Item1[0].FillText4[0] (0.38 conf)
f_w_c_page_p_item_fill__18 was FW-016-GC[0].Page1[0].P1[0].List3[0].Item1[0].FillText5[0] (0.38 conf)
f_w_c_page_p_list_item__1 was FW-016-GC[0].Page1[0].P1[0].List4[0].Item1[0].TextField1[0] (0.39 conf)
f_w_c_page_p_list_item__2 was FW-016-GC[0].Page1[0].P1[0].List4[0].Item1[0].TextField2[0] (0.39 conf)
f_w_c_page_p_list_item__3 was FW-016-GC[0].Page1[0].P1[0].List4[0].Item1[0].NumericField1[0] (0.39 conf)
f_w_c_page_p_list_item__4 was FW-016-GC[0].Page1[0].P1[0].List4[0].Item1[0].TextField4[0] (0.39 conf)
f_w_c_page_p_list_item__5 was FW-016-GC[0].Page1[0].P1[0].List4[0].Item1[0].TextField5[0] (0.39 conf)
f_w_c_page_p_list_item__6 was FW-016-GC[0].Page1[0].P1[0].List4[0].Item1[0].TextField6[0] (0.39 conf)
f_w_c_page_p_list_item__7 was FW-016-GC[0].Page1[0].P1[0].List4[0].Item1[0].TextField7[0] (0.39 conf)
f_w_c_page_p_list_item__8 was FW-016-GC[0].Page1[0].P1[0].List4[0].Item1[0].TextField8[0] (0.39 conf)
f_w_c_page_p_list_item__9 was FW-016-GC[0].Page1[0].P1[0].List4[0].Item1[0].TextField9[0] (0.39 conf)
f_w_c_p_list_item_date was FW-016-GC[0].Page1[0].P1[0].List5[0].Item1[0].OnDate[0] (0.39 conf)
f_w_c_p_item_check_box__1 was FW-016-GC[0].Page1[0].P1[0].List6[0].Item1[0].CheckBox1[0] (0.37 conf)
f_w_c_p_item_check_box__2 was FW-016-GC[0].Page1[0].P1[0].List6[0].Item1[0].CheckBox2[0] (0.37 conf)
f_w_c_page_p_item_fill__19 was FW-016-GC[0].Page1[0].P1[0].List6[0].Item1[0].FillText1[0] (0.38 conf)
f_w_c_p_b_check_box was FW-016-GC[0].Page1[0].P1[0].List6[0].List6b[0].CheckBox1[0] (0.37 conf)
f_w_c_p_b_item_check was FW-016-GC[0].Page1[0].P1[0].List6[0].List6b[0].List6b[0].Item1[0].CheckBox2[0] (0.36 conf)
f_w_c_p_b_item_fill was FW-016-GC[0].Page1[0].P1[0].List6[0].List6b[0].List6b[0].Item1[0].FillText1[0] (0.38 conf)
f_w_c_p_header_fill_text was FW-016-GC[0].Page2[0].P2[0].Header[0].FillText1[0] (0.40 conf)
f_w_g_c_page_p_number was FW-016-GC[0].Page2[0].P2[0].Header[0].CaseNumber_ft[0] (0.39 conf)
f_w_c_p_item_check_box__3 was FW-016-GC[0].Page2[0].P2[0].List6[0].Item1[0].CheckBox[0] (0.37 conf)
f_w_c_page_p_item_fill__20 was FW-016-GC[0].Page2[0].P2[0].List6[0].Item1[0].FillText1[0] (0.38 conf)
f_w_c_page_p_check_box was FW-016-GC[0].Page2[0].P2[0].List6[0].List63[0].CheckBox[0] (0.37 conf)
f_w_g_c_page_p_fill__1 was FW-016-GC[0].Page2[0].P2[0].List6[0].List63[0].FillText1[0] (0.38 conf)
f_w_g_c_page_p_fill__2 was FW-016-GC[0].Page2[0].P2[0].List6[0].List63[0].FillText2[0] (0.38 conf)
f_w_c_p_item_check_box__4 was FW-016-GC[0].Page2[0].P2[0].List6c[0].Item1[0].CheckBox1[0] (0.37 conf)
f_w_c_p_item_date_dt was FW-016-GC[0].Page2[0].P2[0].List6c[0].Item1[0].HearingDate_dt[0] (0.41 conf)
f_w_c_p_item_time_dt was FW-016-GC[0].Page2[0].P2[0].List6c[0].Item1[0].HearingTime_dt[0] (0.38 conf)
f_w_c_p_list_item_dept was FW-016-GC[0].Page2[0].P2[0].List6c[0].Item1[0].HearingDept_ft[0] (0.43 conf)
f_w_c_page_p_list_item__10 was FW-016-GC[0].Page2[0].P2[0].List6c[0].Item1[0].HearingAdd_gp[0].HearingCourt_ft[0] (0.39 conf)
f_w_c_p_item_check_box__5 was FW-016-GC[0].Page2[0].P2[0].List6c[0].Item1[0].CheckBox2[0] (0.37 conf)
f_w_c_page_p_item_fill__21 was FW-016-GC[0].Page2[0].P2[0].List6c[0].Item1[0].FillText[0] (0.38 conf)
f_w_c_page_p_sign_fill was FW-016-GC[0].Page2[0].P2[0].Sign[0].FillText1[0] (0.40 conf)
f_w_c_p_sign_check_box__1 was FW-016-GC[0].Page2[0].P2[0].Sign[0].CheckBox1[0] (0.38 conf)
f_w_c_p_sign_check_box__2 was FW-016-GC[0].Page2[0].P2[0].Sign[0].CheckBox2[0] (0.38 conf)

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

Order on Court Fee Waiver (Court of Appeal or Supreme Court) (Ward or Conservatee)

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

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