APP 016 FW Order On Court Fee Waiver (Court Of Appeal Or Supreme Court) Fw016

User Manual: 016

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APP-016/FW-016 Order on Court Fee Waiver (Court
of Appeal or Supreme Court)
Person who asked the court to waive court fees:
Name:
Street address:
Zip:
State:
City:
Phone number:
Lawyer, if person in has one: (Name, address, phone number, e-mail,
and State Bar number):
On (date): you filed a Request to Waive Court Fees (form
FW-001).Court of Appeal or Supreme Court
Case Number:
The court reviewed your request and makes the following order:
The court grants your request and waives your court fees and costs listed below. You do not have to pay
fees for the following:
a.
Other (specify):
b. The court denies your request for the following reasons:
APP-016/FW-016, Page 1 of 2
Judicial Council of California, www.courts.ca.gov
Rev. July 1, 2010
Government Code, § 68634.5
Clerk stamps date here when form is filed.
• Pay your fees and costs, or
• File more information that shows you are eligible.
• Filing notice of appeal, petition for writ, or petition for review
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(1) Your request is incomplete. You have 10 days from the date this notice was sent to:
• Pay your fees and costs, or
• File a new revised request that includes the items listed below (specify incomplete items):
(2) The information you provided on the request shows that you are not eligible for the fee waiver you
requested (specify reasons):
(3) The court finds there is substantial question regarding your eligibility (describe issue regarding
eligibility):
You have 10 days from the date this notice was sent to:
• Pay your fees and costs, or
• File the following additional documents to support your request:
You have 10 days from the date this notice was sent to:
Warning! If you miss the deadline for paying your fees and costs or providing the additional items required by the
court and you are the appellant, your appeal may be dismissed.
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Order on Court Fee Waiver
(Court of Appeal or Supreme Court)
Fill in court name and street address:
To keep other people from
seeing what you entered on
your form, please press the
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end of the form when finished.
The court needs more information. You must go to court on the date below.
c.
Dept.:
Date: Time:
Hearing
Date Name and address of the court if different from page 1:
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 your hearing date, the court will deny your
request to waive court fees and you will have 10 days to pay your fees. If you are the appellant and you do not pay
your filing fees, your appeal may be dismissed.
Date: Signature of (check one): Judicial Officer Clerk, Deputy
Rev. July 1, 2010 APP-016/FW-016, Page 2 of 2
Court of Appeal/Supreme Court
Case Number:
Court of Appeal/
Supreme Court Case Name:
>
_
Order on Court Fee Waiver
(Court of Appeal or Supreme Court)
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