
CONFIDENTIAL
Request for Hearing About Court
Fee Waiver Order (Superior Court)
Clerk stamps date here when form is
Your Information (person who asked the court to waive court fees):
Name:
Street or mailing address:
Zip:
State:City:
Phone number:
Fill in court name and street address:
Date of order denying your request to waive court fees
(month/day/year):
(Check here if you have a copy of the order denying your
request, and attach it to this form.)
I ask the court for a hearing on my fee waiver request so that I can bring more information
about my financial situation.
Date:
Print your name here
Request for Accommodations. Assistive listening systems, computer-assisted real-time captioning, or sign
language interpreter services are available if you ask at least five days before your hearing. Contact the
clerk’s office for Request for Accommodation, form MC-410.
Judicial Council of California, www.courtinfo.ca.gov
New July 1, 2009, Mandatory Form
Government Code, § 68634(e)(3)
Request for Hearing About Court
Fee Waiver Order (Superior Court)
FW-006, Page 1 of 1
FW-006
Fill in case number and case name:
1
2
3
4
5
The additional facts that support my request for a fee waiver are (describe):
(Use this space if you want to tell the court in advance what facts you want considered at the hearing. If the
space below is not enough, attach form MC-025. Or attach a sheet of paper and write Additional Facts and your
name and case number at the top. You may also attach copies of documents you want the court to look at.)
Case Number:
Case Name:
Superior Court of California, County of
Your lawyer, if you have one(name, address, phone number, e-mail, and
State Bar number):