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Fill and Sign the Waiver Fees Costs 497299049 Form

Fill and Sign the Waiver Fees Costs 497299049 Form

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ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address) : TELEPHONE NO.: ––––– ––––– ––––– ––––– ––––– ATTORNEY FOR (Name) : ––––– FOR COURT USE ONLY NAME OF COURT, JUDICIAL DISTRICT OR BRANCH COURT, IF ANY ––––– ––––– ––––– FW-003 PLAINTIFF: ––––– ––––– DEFENDANT: ––––– NOTICE OF WAIVER OF COURT FEES AND COSTS CASE NUMBER: ––––– 1. The application for waiver of court fees and costs was filed a. on (date): ––––– b. by (name): ––––– 2. The application was granted by operation of law. 3. The applicant may proceed in this action without payment of a. court fees and costs listed in rule 985(i) California Rules of Court. b. the following court fees and costs (specify): ––––– ––––– ––––– ––––– ––––– ––––– Dated: . . . . . . . . . . . . . . . . . . . Clerk, by . . . . . . . . . . . . . . . . . . . . . . (Deputy) CLERK'S CERTIFICATION (SEAL) I certify that the foregoing is a true copy of the original on file in my office. Dated: . . . . . . . . . . . . Clerk, by . . . . . . . . . . . . . . . . . . . . . . . (Deputy) page 1 of 1 Form Adopted by Rule 982 Judicial Council of California FW-005 [Rev. January 1, 2007] NOTICE OF WAIVER OF COURT FEES AND COSTS (IN FORMA PAUPERIS) Govt. Code § 68511.3 CRC Rule 985(e) Electronic Form Copyright © 1997-2007 www.lawca.com

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