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Self-Help Services SUPERIOR COURT OF CALIFORNIA COUNTY OF (The Superior Court of California - County of Orange)

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SELF-HELP FORM PACKET
Complete the attached forms in black ink.
Scan your completed forms and save as a single PDF file.
E-mail the PDF to SelfHelpProbate@occourts.org.
Self-Help Services can review your completed forms before you file them
with the Court. To request review of your completed forms:
1.
2.
3.
SHC-PB-12 (Rev. 01/01/2021)
SelfHelpProbate@occourts.org 657.622.7170
SUPERIOR COURT OF CALIFORNIA
COUNTY OF ORANGE
Self-Help Services
www.occourts.org/self-help
• You cannot give the court proof of the ward’s or conservatee’s eligibility,
• The ward’s or conservatee’s financial situation improves during this case, or
• You settle the civil case on behalf of the ward or conservatee for $10,000 or
more. The trial court that waives fees will have a lien on any such
settlement in the amount of the waived fees and costs. The court may also
charge the ward or conservatee, or his or her estate, any collection costs.
Your Information (guardian or conservator, or person asking the court to appoint a guardian or conservator):
Name:
Street or mailing address:
State: Zip:City:
Phone:
No Yes
(If yes, your lawyer must sign here.) Lawyer’s signature: ___________________________________________
Name:
State Bar No.:
Address:
City: E-mail:State: Zip:
Firm or Affiliation:
Phone:
The lawyer has agreed to advance all or a portion of court fees or costs (check one):
If your lawyer is not providing legal-aid type services based on your or the ward’s or conservatee’s low income,
you may have to go to a hearing to explain why you are asking the court to waive the fees.
a.
b.
FW-001-GC
Request to Waive Court Fees
(Ward or Conservatee)
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:
CONFIDENTIAL
Judicial Council of California, www.courts.ca.gov
Rev. March 24, 2020, Mandatory Form
Government Code, § 68633
California Rules of Court, rules 3.51, 7.5
Request to Waive Court Fees
(Ward or Conservatee)
FW-001-GC, Page 1 of 4
This form must be used by a guardian or conservator, or by a petitioner for
the appointment of a guardian or conservator, to request a waiver of court
fees in the guardianship or conservatorship court proceeding or in any
other civil action in which the guardian or conservator represents the
interests of the ward or conservatee as a plaintiff or defendant.
If the ward or conservatee (including a proposed ward or conservatee if a
petition for appointment of a guardian or conservator has been filed but has not
yet been decided by the court) directly receives public benefits or is supported
by public benefits received by another for his or her support, is a low-income
person, or does not have enough income to pay for his or her household’s basic
needs and the court fees, you may use this form to ask the court to waive the
court fees. The court may order you to answer questions about the finances of
the ward or conservatee. If the court waives the fees, the ward or conservatee,
his or her estate, or someone with a duty to support the ward or conservatee,
may still have to pay later if:
Name:
Age and date of birth (ward only):
Phone:
Zip:State:City:
Street or mailing address:
1
2
3
4
5
Ward's or Conservatee's Information (file a separate Request for each ward in a multiward case):
Ward or Conservatee's Job (job title; if not employed, so state):
Employer’s address:
Name of employer:
Zip:State:
Your Lawyer (if you have one):
Name:
Ward's or Conservatee's Lawyer, if any:
State Bar No.:
Address:
City: E-mail:State: Zip:
Firm or Affiliation:
Phone:
The ward’s or conservatee’s household does not have enough income to pay for its basic needs and the court
fees. I ask the court to (check one, and you must fill out items 14, 15, 16, 17, and 18 on page 4):*
c.
Waive all court fees and costs.
Let the (proposed) guardian or conservator, on behalf of the (proposed) ward or conservatee, make
payments over time.
Why are you asking the court to waive the ward’s or conservatee’s court fees?
b.
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).)
The gross monthly income of the ward’s or conservatee’s household (before deductions for taxes) is less than
the amount listed below. (If you check 8b, you must fill out items 14, 15, and 16 on page 4 of this form.)*
a.
Medi-Cal
SNAP (Food Stamps)
State Supplemental Payment (SSP)
Supplemental Security Income (SSI)
County Relief/General Assistance
IHSS (In-Home Supportive Services)
CalWORKS or Tribal TANF
CAPI (Cash Assistance Program for Aged, Blind, and Disabled)
Family Size Family Income Family Size Family Income Family Size Family Income
1 $1,329.17 3 $2,262.50 5 $3,195.84
2 $1,795.84 4 $2,729.17 6 $3,662.50
If more than 6 people
at home, add $466.67
for each extra person.
(1)
(2)
Request to Waive Court Fees
(Ward or Conservatee)
FW-001-GC, Page 2 of 4
Rev. March 24, 2020
Name of (Proposed) Ward or Conservatee:
Case Number:
(Names and relationships to ward or conservatee of persons who receive the public benefits listed above):
Ward's Parents' Information:
a.
b.
Phone:
Zip:
State:City:
Street or mailing address:
Name of ward’s father:
City:
State: Zip:
Street or mailing address:
Name of ward’s mother:
Deceased
(date of death):Deceased
c.
Ward’s parents are (check all that apply):
living together
Court:
YesNo
Date of order (if multiple, date of latest):
Monthly amount:
Payable to (name):
(If your previous request is reasonably available, please attach it to this form and check here):
Check here if you asked the court to waive court fees for this case in the last six months.
Source (e.g., gift, inheritance, settlement, judgment, insurance):
Est. collection date:
Inventory or petition estimated value:
Person only, no estate.
Ward's Estate:
6
8
10
7
9
The ward or one or both of the ward’s parents, or the conservatee or the conservatee’s spouse or registered
domestic partner, receive (check all that apply):
Guardians or petitioners for their appointment must complete items 9 and 10.
separatedmarried divorced
Support order for ward?
Case Number:
Payor (name):
Waive some court fees and costs.
(3)
(date of death):
* (Do not include income of guardian or conservator living in the household in 8b or 8c or count him or her in family
size in 8b. unless he or she is a parent of the ward or the spouse or registered domestic partner of the conservatee.)
Phone:
✖
Sign here
Print your name here
Date:
The information I have provided on this form and all attachments about the (proposed) ward or conservatee is
true and correct to the best of my information and belief. The information I have provided on this form and all
attachments concerning myself is true and correct. I declare under penalty of perjury under the laws of the State
of California that the foregoing is true and correct.
FW-001-GC, Page 3 of 4
Request to Waive Court Fees
(Ward or Conservatee)
Rev. March 24, 2020
Case Number:
Name of (Proposed) Ward or Conservatee:
Conservators or petitioners for their appointment must complete items 11–13.
Zip:State:
Employer’s address:
Name of employer (if none, so state):
Phone:
Zip:State:City:
Street or mailing address:
Deceased
Name of conservatee’s spouse or registered domestic partner:
Conservatee's Spouse’s or Registered Domestic Partner's Information:
Spouse Partner
11
12
13
Est. collection date:Inventory or petition estimated value:
Person only, no estate.
Conservatee's Estate:
The conservatee’s spouse or partner
Date of marriage or partnership:
is
If you selected “is” above: The income, money, and property shown on page 4
is not
does not includeincludes
The Conservatee and Trusts:
The conservatee:
is notis a trustor or settlor of a trust.
is notis
a beneficiary of a trust.
If you selected “Is” to complete any of the above statements, identify and provide, in an attachment to this Request,
the current address and telephone number of the current trustee(s) of each trust, describe the general terms of and
value of each trust and the nature and value of the conservatee’s interest in each trust, and the amount(s) and
frequency of any distributions to or for the benefit of the conservatee prior to your appointment as conservator of
which you are aware. (You may use Judicial Council form MC-025 for this purpose.)
All applicants who checked item 8b or item 8c on page 2 must continue to and follow the
instructions for completion of items 14–16 or items 14–18 on page 4, before signing below.
(date of death):
a.
b.
Divorced
(date of final judgment or decree ):
Court:
YesNoSupport order for conservatee?
Case Number:
Monthly amount:
Date of support order (if multiple, date of latest):
planning to manage, some or all of the couple’s community property outside the conservatorship estate.
managing, or following appointment of a conservator is
the income and property managed, or expected to be managed, by the spouse/partner outside the estate.
Case Number:
Name of (Proposed) Ward or Conservatee:
$
$
$
$
Check here if the ward’s or conservatee’s income changes a lot
from month to month. If it does, complete the form based on his or
her average income for the past 12 months.
(1) $
(2) $
(3) $
(4) $
(5) $
$
$
$
$
$
$
$
$
$
$
If you checked 8a on page 2, do not fill out below. If you checked 8b, you must answer questions 14–16. If you checked
8c, you must answer questions 14–18. If you need more space, attach form MC-025 or attach a sheet of paper, and write
"Financial Information" and the ward’s or conservatee’s name and case number at the top.
Ward's or Conservatee's Household's Money and Property
Cash
All financial accounts (list bank name and amount):
$
(1) $
Ward's or Conservatee's Gross Monthly Income
(2) $
List any payroll deductions and the monthly amount below:
(3) $
(1) $ $
(2) $ $
$ $(3)
(1) $ $
(2) $ $
(1) $ $
Total monthly income:b.
(2) $ $
(1) $
(2)
$
Cars, boats, and other vehiclesc.
(3) $
Fair Market
Value
How Much You
Still Owe
(4) $
$
$
$
$
$
$
$
$
$
$
(1) $
(2) $
(3) $
$
(1)
$
(2)
$
(3)
$
To list any other facts you want the court to know, such as the
(proposed) ward’s or conservatee’s unusual medical expenses,
etc, attach form MC-025 or attach a sheet of paper and write
“Financial Information” and the (proposed) ward’s or
conservatee’s name and case number at the top.
Check here if you attach another page.
Make / Year
List the source and amount of any income the ward or conservatee
gets 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.
a.
Real estated.
Fair Market
Value
How Much You
Still OweAddress
e. Other personal property (jewelry, furniture, furs, stocks,
bonds, etc.):
Describe
Ward's or Conservatee's Household's Income
Ward's or Conservatee's Household's Monthly
Deductions and Expenses
List the income of all other persons living in the ward’s or conservatee’s
home who depend in whole or in part on him or her for support, or on
whom he or she depends in whole or in part for support.
Gross Monthly Income
b. Rent or house payment and maintenance
RelationshipName
c.
(1)
d.
(2)
e. Clothing
(3)
f. Laundry and cleaning
(4)
g.
b. Total monthly income of persons above:
i. School, child care
Child, spousal support (another marriage)j.
Total monthly income and
household income (15b plus 16b):
Transportation, gas, auto repair and insurance k.
l. Installment payments (list each below):
Paid to:
Wages/earnings withheld by court order
Any other monthly expenses (list each below).
Paid to: How Much?
Important! If the ward’s or conservatee’s financial situation or
ability to pay court fees improves, you must notify the court
within five days on form FW-010-GC.
Total monthly expenses
(add 18a –18n above):
a.
h.
Fair Market
Value
How Much You
Still Owe
a.
Age
b.
m.
n.
Food and household supplies
Utilities and telephone
Medical and dental expenses
Insurance (life, health, accident, etc.)
Rev. March 24, 2020
FW-001-GC, Page 4 of 4
Request to Waive Court Fees
(Ward or Conservatee)
a.
15
16
14
17
18
(5)
(6)
(7)
(8)
(9)
(10)
Do not include income of guardian or conservator living
in the household in item 16, his or her money and
property in item 17, or his or her deductions and expenses
in item 18 unless he or she is a parent of the ward or the
spouse or registered domestic partner of the conservatee.
Print this form
Save this form
Clear this form
For your protection and privacy, please press the Clear
This Form button after you have printed the form.
This form must be used by a guardian or conservator, or a petitioner for
the appointment of a guardian or conservator, in the guardianship or
conservatorship proceeding or in any other civil action in which the
guardian or conservator represents the interest of the ward or conservatee
as a plaintiff or defendant, to ask the court to waive additional court fees
that are not covered in a current order. If you have not already received an
order that waived or reduced your court fees, you must complete and file a
Request to Waive Court Fees (Ward or Conservatee), form FW-001-GC, along
with this form.
Your Information (guardian or conservator, or person asking the
court to appoint a guardian or conservator):
Name:
Street or mailing address:
Zip:
State:
City:
Phone number:
Request to Waive Additional Court Fees
(Superior Court) (Ward or Conservatee)
FW-002-GC, Page 1 of 2
Judicial Council of California, www.courts.ca.gov
New September 1, 2015, Mandatory Form
Government Code, §, 68633
California Rules of Court, rules 3.51, 3.56, 7.5
If your lawyer is not providing legal-aid type services based on the ward’s or conservatee’s low income, you
may have to go to a hearing to explain why you are asking the court to waive the fees.
The lawyer has agreed to advance all or a portion of your fees or costs (check one):
(If yes, your lawyer must sign here.) Lawyer’s signature:_____________________________________________
Yes
No
a.
b.
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:
CONFIDENTIAL
FW-002-GC
Request to Waive Additional
Court Fees (Superior Court)
(Ward or Conservatee)
Phone number:
Zip:State:City:
Street or mailing address:
Name:
Age and date of birth (ward only):
Ward’s or Conservatee’s Information (file a separate Request for each ward in a multi-ward case):
Date ward’s or conservatee’s last court fee waiver order, if any, was granted:
Has the ward’s or conservatee’s financial situation improved since your last Request to Waive Court Fees?
(If yes, you must fill out a new Request to Waive Court Fees, form FW-001-GC, and attach it to this form.)
No
Yes
1
2
3
4
5
6
Name:
Your Lawyer (if you have one):
State Bar No.:
Address:
City: E-mail:State: Zip:
Firm or Affiliation:
Telephone:
Name:
Ward's or Conservatee's Lawyer, if any:
State Bar No.:
Address:
City: E-mail:State: Zip:
Firm or Affiliation:
Telephone:
Name of (Proposed) Ward or Conservatee:
Case Number:
FW-002-GC, Page 2 of 2
New September 1, 2015
Request to Waive Additional Court Fees
(Superior Court) (Ward or Conservatee)
b.
What other fees do you want the court fee waiver order to cover? (Check all that apply):
Why does the ward or conservatee need these other services? (Explain):
Notice: The court may order you to answer questions about the finances of the ward or conservatee and later order
you, as guardian or conservator of his or her estate, to pay back waived fees. The court may also direct you to make
efforts to collect money to pay back waived fees from persons who owe a duty to support the ward or conservatee. If
the fees are not paid back, the court may also charge collection fees.
If there is a change in the financial circumstances of the ward or conservatee during this case that increases his or her
ability to pay fees and costs, you must notify the trial court within five days. (Use form FW-010-GC for this purpose.)
If this case is a civil action against another person on behalf of the ward or conservatee and you win it, the trial court
may order the other side to pay the fees. If you settle the case against another person for $10,000 or more payable to
the ward’s or conservatee’s estate, 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.
The court may also have a lien against the ward’s or conservatee’s estate that must be paid before the estate is
distributed, the guardianship or conservatorship proceeding is concluded, and you are discharged as guardian or
conservator.
I declare under penalty of perjury under the laws of the State of California that the information above is true and
correct.
a.
c.
d.
e.
Date:
Jury fees and expenses
Court-appointed interpreter fees for a witness
Fees for a peace officer to testify in court
Fees for court-appointed experts
Other
Print your name here
7
8
Sign here
(specify):
For your protection and privacy, please press the Clear
This Form button after you have printed the form.
Print this form
Save this form
Clear this form
A request to waive court fees was filed on (date):
Read this form carefully. All checked boxes are court orders.
Order on Court Fee Waiver
(Superior Court) (Ward or Conservatee)
FW-003-GC, Page 1 of 3
Judicial Council of California, www.courts.ca.gov
Revised September 1, 2019, Mandatory Form
Government Code, §§ 68631, 68634(e)
Cal. Rules of Court, rules 3.52 and 7.5
(Proposed) guardian or conservator who asked the court to
waive court fees for (proposed) ward or conservatee:
Name:
Street or mailing address:
City: State: Zip:
The court made a previous fee waiver order in this case on (date):
Lawyer for (proposed) ward or conservatee, if any:
Telephone:
Telephone:
FW-003-GC
Order on Court Fee Waiver
(Superior Court) (Ward or Conservatee)
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:
(Proposed) ward or conservatee:
Name:
Street or mailing address:
Zip:State:City:
1
2
5
3
4
6
Request to Waive Additional Court FeesRequest to Waive Court FeesAfter reviewing your:
the court makes the following orders:
The court grants your request concerning the ward's or conservatee's court fees and costs, as follows:a.
Fee Waiver. The court grants your request and waives the 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:
(1)
• Court fee for phone hearing
• Giving notice and certificates
• Sending papers to another court department
(List continued on next page.)
• Filing papers in superior court
• Making copies and certifying copies
• Sheriff’s fee to give notice
X
Notice: The court may order you to answer questions about the ward’s or conservatee’s finances after granting a waiver
and may later order payment of the waived fees from his or her estate. If this happens and the fees are not paid, the court
can also charge collection fees. The court may also direct you to make efforts to collect money to pay back waived fees
from persons who owe a duty to support the ward or conservatee. If there is a change in the ward’s or conservatee’s
financial circumstances during this case that increases his or her ability to pay fees and costs, you must notify the trial
court within five days. (Use form FW-010-GC.)
If this case is an action against another party and you win the case on behalf of the ward or conservatee, the trial court
may order the other side to pay some or all of the waived fees. If you settle the matter 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.
The court may also have a lien against the ward’s or conservatee’s estate that must be paid before the estate is
distributed, the guardianship or conservatorship proceeding is concluded, and you are discharged as guardian or
conservator.
Lawyer, if person in
1
Name:
State Bar No:
Street or mailing address:
Zip:State:City:
Firm or Affiliation:
Telephone:
E-mail:
Name:
State Bar No:
Street or mailing address:
State:City:
Firm or Affiliation:
Telephone:
E-mail:
Zip:
has one:
✖
(1)
The court denies your request because it is incomplete. You have 10 days after the clerk gives notice of
this order (see date of service on next page) to:
Pay the ward’s or conservatee’s fees and costs, or
(2)
Pay the 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-GC to request
hearing.)
Order on Court Fee Waiver
(Superior Court) (Ward or Conservatee)
FW-003-GC, Page 2 of 3
Revised September 1, 2019
•
•
•
b. The court denies your fee waiver request, as follows:
•
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.
The court denies your request because the information you provided on the request shows that the ward
or conservatee is not eligible for the fee waiver for the reasons specified:
Name of (Proposed) Ward or Conservatee:
Case Number:
The court has enclosed a blank Request for Hearing About Court Fee Waiver Order (Ward or
Conservatee)(Superior Court) (form FW-006-GC). You have 10 days after the clerk gives notice of this
order (see date of service on next page) to:
(2)
Additional Fee Waiver. The court grants your request and waives the 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 a peace officer to testify in court
Court-appointed interpreter fees for a witness
Fees for court-appointed experts
(specify):
Other
• Reporter’s fee for attendance at hearing or trial, if 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
(1)a.
Bring the items of proof to support your request, if reasonably available, that are listed:
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 questions regarding your eligibility specified:
6
Below
On Attachment 6b(1)
Below
On Attachment 6b(2)
Below
On Attachment 6c(1)
c.
(1)
(2)
Below
On Attachment 6c(2)
File a new revised request that includes the items listed:
Case Number:
Name of (Proposed) Ward or Conservatee:
Request for Accommodations. Assistive listening systems, computer-assisted real-time captioning, or sign
language interpreter services are available if you ask at least 5 days before your hearing. Contact the clerk’s
office for Request for Accommodation, Form MC-410. (Civil Code, § 54.8.)
Clerk's Certificate of Service
Order on Court Fee Waiver
(Superior Court) (Ward or Conservatee)
FW-003-GC, Page 3 of 3
Revised September 1, 2019
This is a Court Order.
Signature of (check one):
Date:
Date: Time:
Room:Dept.:
Hearing
Date
g
Name and address of court if different from above:
NOTE TO GUARDIAN or CONSERVATOR: If there are unpaid court fees after a denial of a request for a fee
waiver, your case—including the guardianship or conservatorship proceeding if the waiver is requested in that matter—
might not go forward. After a denial, you may choose to advance the court costs yourself to ensure that the case
proceeds. If you or another person is appointed as guardian or conservator, you would have an opportunity to be
reimbursed for such advances from the assets of the guardianship or conservatorship estate, if any, as allowable expenses
of administration. You might also have the right to reimbursement for advanced court costs from persons with an
obligation to support the ward or conservatee from assets not part of his or her estate, such as a parent of the ward, the
spouse or registered domestic partner of the conservatee who is managing the couple’s community property outside the
conservatorship estate, or the trustee of a trust of which the conservatee is a beneficiary.
Warning! If item c 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 the ward’s or conservatee’s 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.
Judicial Officer Clerk, Deputy
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
This order was mailed first class, postage paid, to the party and attorney, if any, at the addresses listed in and ,
from
Date:
, California, on the date below.
A certificate of mailing is attached.
1 2
(city):
1 2
, Deputy
Clerk, by ________________________________
Name:
, at the court, on the date below.and
Print this form
Save this form
Clear this form
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Self-Help Services SUPERIOR COURT OF CALIFORNIA COUNTY OF (The Superior Court of California - County of Orange)

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Completed 8 February 2021

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