A request to waive court fees was filed on (date):
Read this form carefully. All checked boxes are court orders.
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(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:
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.
• Court fee for phone hearing
• Giving notice and certificates
• 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)
Jury fees and expenses Fees for a peace officer to testify in court
Court-appointed interpreter fees for a witness
Fees for court-appointed experts
Order on Court Fee Waiver (Superior Court)
FW-003, Page 1 of 3
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
• Filing papers in superior court
• Making copies and certifying copies
• Sheriff’s fee to give notice
Person who asked the court to waive court fees:
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.
a.
The court grants your request, as follows:
Name:
Street or mailing address:
City:
State:
Zip:
The court made a previous fee waiver order in this case on (date):
FW-003
Order on Court Fee Waiver
(Superior Court)
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Fill in case number and name:
Case Number:
Case Name:
Request to Waive Court Fees
Request to Waive Additional Court Fees
After reviewing your:
the court makes the following orders:
Lawyer, if person in has one (name, firm name, address,
phone number, e-mail, and State Bar number):
1
2
3
4
1
(specify): Other
CONTRA COSTA
751 PINE STREET
P.O. BOX 911
MARTINEZ, CA 94553