Clerk stamps date here when form is filed.
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`-
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`FHLE|
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`APR 1 B 2019
`FRESNO SUPERIOR COURT
`DEPUTY
`
`By
`Fill in court name and street address:
`Superior Court of California, County of
`w
`, Jperior Court of California Conn of Fresno
`vil Divisidfi
`130 0 Street
`quéha CA 93724
`
`SC1
`
`.
`
`Fill in case number and name:
`
`Case Num/€E"6szaé’y
`
`Case Name:
`
`Order on Court Fee Waiver
`(Superior Court)
`Name: m mm» ream ézvfl/MZ?
`(D Person who asked the court to waive cburt fjs:
`Street or mailing address: f2 6 g - ifi e/zf/Myw flt/
`f» ”gé/M "
`Zip: 6gjfié.
`State: @‘4
`Lawyer, if person in ® has one (name, address, phone number,
`4/ A
`/(.L Vt,
`
`City:
`
`e—mail, and State Bar number):
`
`®
`
`A request to waive court fees was filed 0n (date):
`D The court made a previous fee waiver order in this case 0n (date):
`
`'
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`Read thisform carefully. All checked boxesM are court orders.
`
`“J
`
`r
`
`A
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`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-OlO.) If you win your case, the trial court may order the other side
`to pay the fees. If you settle your civil case for $1 0,000 or more, the trial court will have 'a lien on the settlement in the
`amount 0f the waived fees. The trial court may not dismiss the case until the lien is paid.
`D Request t0 Waive Additional CourtFees
`After reviewing your: Ma/Request to Waive Court Fees
`the court makes thefoll
`ing orders:
`Th
`ourt grants your request, as follows:
`a.
`*UD/Ijee 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 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
`o Assessment for court investigations under Probate Code section 15 13, 1826, or 1851
`- Preparing, certifying, copying, and sending the clerk’s transcript on appeal
`- Holding in tmst the deposit for a reporter‘s transcript on appeal under rule 8.130 0r 8.834
`- Making a transcript or copy of an official electronic recording under rule 8.835
`(2) D Additional Fee Waivef. 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.
`D Jury fees and expenses
`E] Fees for a peace officer to testify in court
`D Fees for court-appointed experts
`D Court-appointed interpreter fees for a witness
`D Other (specifiz):
`Order on Court Fee Waiver (Superior Court)
`
`and
`
`Fees
`
`Court
`
`01
`
`Walver
`
`Granllng
`
`190ECL02334
`
`635186
`
`WFG Order
`
`IH!lllllllllllIIHIIIIHIIIHIIIIIIIIll
`
`I
`
`Judicial Council of California. www.courts.ca.gov
`Revised July 1, 2015. Mandatory Form
`Government Code, § 68634(e)
`Cal. Rules of Court. rule 3.52
`
`FW-003, Page 1 of2
`
`

`

`lflflfl/ fl f€pég 5/7 gé/W
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`Case Number:
`
`Your name:
`b. D The court denies your fee waiver request, as follows:
`Warning! lf 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) D The court denies your request because it is incomplete. You have 10 days after the clerk gives notice 0f
`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 (specifi/ incomplete items):
`(2) D 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 r:eas0ns)
`
`The court has enclosed a blank Requestfor 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. (Useform FW-006 t0 request
`hearing.)
`C- D 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 (specifiz questions regarding eligibility):
`
`D Bring the following proof t0 support yofir request if reasbnably avéilable:
`Name and address of court if different from above:
`
`Date:M Signature of(check one) V D Judicial Officer fl Clerfk, @173:
`
`Hearing
`Date
`
`Date:
`Dept:
`
`Time:
`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 1O days to pay your 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.
`I
`
`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 RequestforAccommodation, Form‘MC-410. (Civil Code, § 54.8.)
`Clerk's Certificate of Service
`D A certificate of mailing is attached.
`/E’I handed a copy of this order to the party and attorney, if any, listed in® and ® at the court, on the date below.
`I certify thatI am not involved in this case and (check one).- '
`D This order was mailed first class, postage paid, to the party and attorney, if any, at the addresses listed in
`and®,
`f/Ey
`Clerk, by av?”
`from (city).
`APR gs 2mg
`Date:
`
`,Califomia on the date bel MW
`
`RBV'sedJU'v «2°15
`
`Order on Court Fee Waiver (Superior Court)
`
`FW-003: Page 2 °f2
`
`