FW-016 - Order on Court Fee Waiver (Court of Appeal or Supreme Court)

Summary

Order on Court Fee Waiver (Court of Appeal or Supreme Court)

Text

Form ID: APP-016
Title: Order on Court Fee Waiver (Court of Appeal or Supreme Court)
Effective Date: 2010-07-01
Mandatory Form: no
Languages: español
Info Page: https://selfhelp.courts.ca.gov/jcc-form/APP-016
Primary Download URL: https://www.courts.ca.gov/documents/app016.pdf
Alternate Download URLs: https://www.courts.ca.gov/documents/app016s.pdf
Form Detail Page:
Order on Court Fee Waiver (Court of Appeal or Supreme Court)
(APP-016)
States a decision (order) about whether a party (other than a guardian or conservator) who asked for a fee waiver has to pay court fees and costs in a civil case in a Court of Appeal or the Supreme Court.
Get form APP-016
español
Get form APP-016 in Spanish
(Spanish)
Effective: July 1, 2010
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PDF Text:
Judicial Council of California, www.courts.ca.gov 
Rev. July 1, 2010 
Government Code, § 68634.5
Order on Court Fee Waiver 
(Court of Appeal or Supreme Court)
APP-016/FW-016 Order on Court Fee Waiver 
(Court of Appeal or Supreme Court)
Clerk stamps date here when form is filed.
Fill in court name and street address:
Court of Appeal or Supreme Court  
Case Number:
1 Person who asked the court to waive court fees:
Name:
Street address:
City: State: Zip:
Phone number:
2 Lawyer, if person in  1  has one: (Name, address, phone number, e-mail, 
and State Bar number):
3 On (date):  you filed a Request to Waive Court Fees 
(form FW-001).
4 The court reviewed your request and makes the following order:
a. The court grants your request and waives your court fees and 
costs listed below. You do not have to pay fees for the following: 
Filing notice of appeal, petition for writ, or petition for review
Other (specify):
b. The court denies your request for the following reasons:
(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):
You have 10 days from the date this notice was sent to:
Pay your fees and costs, or
File more information that shows you are eligible.
(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:
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.
APP-016/FW-016, Page 1 of 2

For your protection and privacy, please press the Clear 
This Form button after you have printed the form.
Rev. July 1, 2010 Order on Court Fee Waiver 
(Court of Appeal or Supreme Court)
Court of Appeal/ 
Supreme Court Case Name: 
Court of Appeal/Supreme Court  
Case Number:
4 c. The court needs more information. You must go to court on the date below.
Hearing 
Date
Date: Time: Dept.:
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   4   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
APP-016/FW-016, Page 2 of 2

Retrieval chunks

• #1

  Form ID: APP-016 Title: Order on Court Fee Waiver (Court of Appeal or Supreme Court) Effective Date: 2010-07-01 Mandatory Form: no Languages: español Info Page: https://selfhelp.courts.ca.gov/jcc-form/APP-016 Primary Download URL: https://www.courts.ca.gov/documents/app016.pdf Alternate Download URLs: https://w…

• #2

  Pay your fees and costs, or File the following additional documents to support your request: 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. APP-016/FW-016, Page 1 of 2 For your protec…