Fee Waiver Order DenyCal. Super. - 6th Dist.April 23, 2021‘3, “m Order 0n Court Fee waiver Clerk slamps date here when formr's filed. (Superior Court) ® Personw oasked the courtto waive courtfees: Name= ‘L m Mimm 7 Streetoerlinga'ddress: 3Q” \NQ \MAWM Citwanm AO‘QQ ‘ grate: C&A Zip: Q&Ofi Lawyer, if persgn in (“D has one (name, firm name, address, phone number. e-mai]. and State Bar number): ( Fill in court name and street address: Superior Court of California. County ofSWW Cé‘iflum1 , ~ r. San losaCfl Wag Fill in case number and name: Case Number:® A request to waive court fees was filed 0n (dare): _ 15 - mlagg[ D The court made a previous fee waiver order in this case .on (dale): 3 \QU %%\ 0%Kb © 3e Name; Read thisform careftdly. All ch ecked boxes Mare court orders. ialld' l ‘PP VEdema Notice: The court may order you to answer questions about yOur finances and later order you to pay back the waived fees. Ifthis happens and you d0 not pay, the court can make you pay the fees and also charge you collection fees. Ifthere is a change in your financial circumstances during this case that increases your ability t0 pay fees and, costs, you must notify the trial court within five days. (Use form FW-O 1 0.) lfyou win your case, the trial court may order the other side to pay the fees. [fyou settle your Civil case for $10,000 0r more, the trial court will have a lien on the settlement in the amount ofthe waived fees. The trial c/ourt may not dismiss the case until the lien is paid. After reviewing your: d Requestfo Waive Cow? Fees D Request t0 Waive Addilional Court Fees the court makes the following orders: a. D The court grants your request, as follows: (l) D Fee Waiver. The court grants your request and waives your court fees and costs listed below: (Cal, Rules ofCourt. rules 3.55 and 8.818.) You do n01 have to pay the court fees for the following: - Filing papers in superior court ° Court fee for phone hearing - Making copies and certifying, copies - Giving notice and certificates - Sheriff‘s fee to give notice - Sending papers to another court department ° Reporter’s fee for attendance at hearing or trial, ifthe 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 15 13, 1826, 0r 185] ° Preparing, certifying, copying, and sending the clerk’s transcript on appeal - Holding in trust the deposit for a reporter’s transcript 0n appeal under rule 8. I30 0r 8.834 ' Making a transcript 0r copy ofan official electronic recording under rule 8.835 (2) D Additional Fee Waiver. The court grants your request and waives your additional superior court fees and costs that are checked below. (Cal. Rules ofCourt, rule 3.56.) You do not have to pay for the checked items. V D Jury fees and expenses D Fees for a peace officer t0 teétify in court D Fees for court-appointed experts D Court-appointed interpreter fees for a witness D Other (specifi): gitss‘ifimflmémfififiafiw Order on Court Fee Waiver (Superior Court) FW-003. Page1 of3 Govemenx Code, § 68634te) Cal. Rmes of Court, rule 3.52 Filed June 1, 2021 County of Santa Clara Superior Court of CA Clerk of the Court 21CV381083 By: lquach Case Number: Your name: b. B The court denies your fee waiver request because: Warning! If you‘ miss the deadline below. the court cannot process your request for hearing or the court papérs you filed with your original request. If the papers were a notice of appeal. the appeal may be dismissed. ~ (1) D Your request is incomplete. You have 10 days after the clerk gives notice ofthis Order (see date of service 0n next page) t0: ' - - Pay your fees and costs, or ' File a new revised request that inbludes the incomplete items listed: D Below D 0n Attachment 413(1) (2) D The information you provided 0n the request'shows that you are not eligible for the fee waiver you requested forthe reasons stated: [J Below D On Attachment4b(2) The court has enclosed a blank Requestfor HearingAbour Couri Fee Waiver Order (Superiof Court) (form FW-00.6).You have 10 days after the clerk gives notice ofthis Order (see date ofservice below) t0: ' Pay your fees and costs in full or the amount listed in c below, or o Ask for a hearing in order to show the court mor_e information. (Useform FW-006 I0 request hearing.) c. (1) D The court needé more information to decide whether t0 grant your rehuest. You must g0 t0 court 0n the date on page 3. The hearing will be about the questions regarding your eligibility that are stated: D Below D On Attachment 40(1) (2) D Bring the items ofproofto support your request, ifreasonably available, that are listed: D Below U On Attachment 4c(2) ReV-Sep'emberm‘g Order on Court Fee Waiver (Superior Court) FW-003. Page 2 0f3 .r-‘x' x x Based upon household income stated in Fee Waiver Application Case Number: Your name: Name and address of court ifdifferent from abOVC: Hearing ' Date:. - Time: Date Dept; Room: V Warning! lf 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 1O days to pay your fees. lf you miss that deadline, the court cannot process the court papers you filed with your request. 1f the papers were a notice of appeal, the appeal may be dismissed. Date: Signature of(c/zeck one): D Judicial Oflicer D Clerk. Deputy Request for Accommodations Assistive listening systems, computer-assisted real-time captioning, or sign ianguage interpreter services ' ". are available ifyou ask at least five days before the hearing. Contact the clerk’s office for Requestfor r . Accommodalions by Persons Wirh Disabilh‘ies and Response (form MC-4 10). (Civ. Code, § 54.8.) n‘ Isak.) ‘- 'b"_.. 19m Clerk's Certificate of Service l certify that I am not involved in this case and (check one): D I handed a copy ofthis Order to the party and attorney, ifany, listed in G) and@, at the court, on the date below. D This order was mailed first class, postage paid, to the party and anomey, ifany, at the addresses listed in®and ®, , California, 0n the date below.from (éiw): D A certificate ofmailing is attached. Date: Clerk, by a Deputy Name: i?“ v 4... “away . .n.. 9.1.2- ReV-Sep‘embe”-2°‘9 Order on Court Fee Waiver (Superior Court) 1b- .- FW-003, Page 3 of 3 Signed: 5/27/2021 02:15 PM Signed: 6/1/2021 10:37 AM x San Jose 06/01/21
