Fee Waiver Order FullCal. Super. - 3rd Dist.July 31, 2017 Order on Court Fee Waiver Clerk stamps date here when form is filed. a (Superior Court) FILED Superior Court of California Person who asked the court to waive court fees: Name: Jeff Gilbreath Street or mailing address: 4711 Durhan ct City: Rocklin State: ca Zip: 95765 Lawyer, if person in O has one (name, address, phone number, e-mail, and State Bar number): _Janice Dudensing (SBN: 279561) __ 925 G STREET. SACRAMENTO CA 95814 (916) il la court name end syvetaddress: Ane 4199 * Superior Court of California, County of WT CALIF URINIA -R enier Drive A request to waive court fees was filed on (date): [] The court made a previous fee waiver order in this case on (date); 9 ‘Joo 5) VA S0001-9072 Fill in case number and name: caseutinbbt) [) 59 7 TX Read this form carefully. All checked boxes are court orders. Case Name: 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. After reviewing your: oT Renee to Waive Court Fees [] Request to Waive Additional Court Fees the court makes the following orders: STH The court grants your request, as follows: (1) ee 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: * Filing papers in Superior Court * Giving notice and certificates * Making copies and certifying copies * Sending papers to another court department * Sheriff ’s fee to give notice * Court-appointed interpreter in small claims court * Court fee for phone hearing * Reporter’s fee for attendance at hearing or trial, if reporter provided by the court * 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) 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. [] Jury fees and expenses L_] Fees for a peace officer to testify in court y P Aiea L) Fees for court-appointed experts (] Court-appointed interpreter fees for a witness [] Other (specify): Revised July 1.2018 Mondsiory Fa Order on Court Fee Waiver (Superior Court) FW-003, Page 1 of 2 Government Code, § 68634(e) Cal. Rules of Court, rule 3.52 Case Number: Your name: b. [J 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. (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 your fees and costs, or * File a new revised request that includes the items listed below (specify incomplete items): (2)() The court denies your request because the information you provided on the request shows that you are not eligible for the fee waiver you requested (specify reasons): The court has enclosed a blank Request for Hearing About Court Fee Waiver Order (Superior Court), form FW-006.You have 10 days after the clerk gives notice of this order (see date of service below) to: * Pay your 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 to request hearing.) c. [_] The court needs more information to decide whether to grant your request. You must go to court on the date below. The hearing will be about (specify questions regarding eligibility): L] Bring the following proof to support your request if reasonably available: Hearing |” Date: Time: vate Dept.: Room: 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 your fees. If you miss t dline, the court cannot process the court papers you filed with your request. If the papers wer€ a notice o eal, the appeal may be dismissed. Name and address of court if different from above: Date: Signature of (check one): [] Judicial Offi Request for Accommodations. Assistive listening systems, computer-assisted real-time ¢apfioning, 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 I certify that I am not involved in this case and (check one): L] A certificate of mailing is attached. JPA handed a copy of this order to the party and attOKniey, if any, listed in) and (2) at the-eeurt,on the date below. g 3d in) and (2), , Deputy from (city): , California on the date below. Date: \\ | 3 1 201 l Clerk, by This is a Court Order, Rac hy 1, BNE Order on Court Fee Waiver (Superior Court) J FW-003, Page 2 of 2
