Court Fee Waiver Questionnaire - Superior Court Docs | Legal Document Assistance | Eviction Paperwork | Divorce Paperwork

Step 1 of 9

We do not share your information with any third parties. This questionnaire will take approximately five (5) to ten (10) minutes of your time. Any questions marked with an asterisk (*) require an answer to progress through the questionnaire. If you have any questions about this questionnaire, for an immediate response you may live chat us or call 888-731-1500.

Your Information

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Case Number

Case Name (Example: Smith (Plaintiff/Petitioner) v. Johnson (Defendant/Respondent))

Employment Information

Your Job Title

Name of Employer

Employer's Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Why are you asking the court to waive your court fees (Choose one of a, b, or c)

a) I receive check all that apply see form FW001INFO for definitions

I receive check all that apply see form FW001INFO for definitions

Food Stamps

Supp Sec Inc

SSP

MediCal

County ReliefGen Assist

IHSS

CalWORKS or Tribal TANF

CAPI

WIC

Unemployment

b) My gross monthly household income (before taxes) is less than:

Family of 1: $2,265.00

Family of 2: $3,051.67

Family of 3: $3,838.34

Family of 4: $4,625.00

Family of 5: $5,411.67

Family of 6: $6,198.34

More than 6 in Family

If more than six (6) in the family, provide household income

c) I do not have enough income to pay for my households basic needs and the court fees I ask the

waive all court fees and costs

waive some of the court fees

let me make payments over time

Additional Information:

Check here if you asked the court to waive your court fees for this case in the last six months

Check here if your income changes a lot from month to month

Your Gross Monthly Income

Check here if your income changes a lot from month to month

Source of Income 1

Monthly Amount from Source of Income 1

Source of Income 2

Monthly Amount from Source of Income 2

Source of Income 3

Monthly Amount from Source of Income 3

Source of Income 4

Monthly Amount from Source of Income 4

Total Monthly Amount from All Sources of Income

Household Income

Name of Person Living in Your Home 1

Age & Relationship 1

Gross Monthly Income 1

Name of Person Living in Your Home 2

Age & Relationship 2

Gross Monthly Income 2

Name of Person Living in Your Home 3

Age & Relationship 3

Gross Monthly Income 3

Name of Person Living in Your Home 4

Age & Relationship 4

Gross Monthly Income 4

Your Money and Property

Cash

All financial accounts (List bank name and amount):

Bank Name 1

Amount in Bank 1

Bank Name 2

Amount in Bank 2

Bank Name 3

Amount in Bank 3

Cars, boats, and other vehicles

Make/Year 1

Fair Market Value 1

How much you still owe 1

Make/Year 2

Fair Market Value 2

How much you still owe 2

Make/Year 3

Fair Market Value 3

How much you still owe 3

Real Estate

Address 1

Fair Market Value 1

How much you owe 1

Address 2

Fair Market Value 2

How much you owe 2

Other Personal Property (jewelry, furniture, furs, stocks, bonds, etc.):

Describe 1

Fair Market Value 1

How much you still owe 1

Describe 2

Fair Market Value 2

How much you still owe 2

Your Monthly Deductions and Expenses

a. List any payroll deductions and the monthly amount below:

Payroll Deductions 1

Amount 1

Payroll Deductions 2

Amount 2

Payroll Deductions 3

Amount 3

Payroll Deductions 4

Amount 4

Rent or house payment

Food and household supplies

Utilities and telephone

Clothing

Laundry and cleaning

Medical and dental expenses

Insurance

School, child care

Child, spousal support

Transportation

Installment Payment 1

Amount of Installment Payment 1

Installment Payment 2

Amount of Installment Payment 2

Installment Payment 3

Amount of Installment Payment 3

Wages/earnings withheld by court order

Any other monthly expenses 1

Amount of any other monthly expenses 1

Any other monthly expenses 2

Amount of any other monthly expenses 2

Any other monthly expenses 3

Amount of any other monthly expenses 3

Total monthly expenses

YOU ARE ALMOST DONE, click submit, wait a second, and electronically initial and sign the agreement to complete the process. Thank you for choosing Superior Court Docs.

We charge $99.00 to prepare all of the judicial council documents relating to court fee waivers.

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Court Fee Waiver

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