FW-001-GC Request to Waive Court Fees (Ward or Conservatee)

Please read “Waiver of Court Fees” in the general Conservatorship webpage as it will give you more information on understanding fee waiver.
I would take a cursory look at the Request to Waive Court Fees to make sure that your (proposed) conservatee may qualify before filling out the form and filing.

The Califorina Courts has a self-help webpage on fee waiver. http://www.courts.ca.gov/selfhelp-feewaiver.htm

Some courts may require a separate fw-001 and fw-003 for the husband and wife asking for the waiver. I suspect that this is a confused court clerk as the fee waiver is being asked by the over 18-year-old person who is under consideration for conservatorship. The wavier is based on the parent’s child income. The parents are just asking on their child’s behalf.

Some courts may require a separate county Superior Court form for waving of the court investigation fee. For most courts, the fw-001 and fw-003 forms are all that are needed to wave all fees.

Form Links

Filled in Example FW-001-GC Form

Filled in Example MC-025 Form

- You can edit it to your situation print, and file it at your local California Superior Court. The form is the same as the one you can get from a California Superior Court Website.

Blank FW-001-GC Form

Blank MC-025 Form

Blank FW-001-INFO Form

http://www.courts.ca.gov/forms.htm?filter=GC California Probate Conservatorship Complete List Downloadable

Content

The each page notes are below the respective image of the form page.

FW-001-GC Page 1 Notes

FW-001-GC Page 2 Notes

FW-001-GC Page 3 Notes

FW-001-GC Page 4 Notes

MC-025 Form

FW-001-GC Form in HTML so it can be Translated

MC-025 Form in HTML so it can be Translated

FW-001-INFO Form in HTML so it can be Translated

Page 1 Notes:

The “heading” on form FW-001-GC is different than the other conservatorship forms. Note the case name box “Conservatorship of” name of conservatee.

5. State that your 18 year old is a high school student.

Top
fw-001-gc page 2

Page 2 Notes:

6. You really only have to check Superior Court. It is doubtful full your conservatee will need to go to other courts in the future, but you can always refile for a fee waiver then.

FW-001-INFO can be found here: http://www.courts.ca.gov/documents/fw001info.pdf

It is also included on this webpage here: FW-001-INFO in html form so that it can be translated into other languages.

Top
fw-001-gc page 3

Page 3 Notes:

11. Make sure you check “Person only, no estate” box.

13. Check the boxes correct to your situation.

I check b. in the example to give an example of form MC-025. A first party trust counts as part of a (proposed) conservatee’s estate. A third part “Special Needs Trust” does not count as a (proposed) conservatee’s estate.

Top
fw-001-gc page 4

Page 4 Notes:

Most of this page will probably be blank for an 18 year old adult child with autism that needs to be conserved. The form is written to include senior citizens or adults that become disabled enough to need to be conserved.

On this form you do not include any parent, guardian or conservator’s income or property. You only enter income or expenses that are directly under the (proposed) conservatee.

15. If your adult child receives social security SSI you would add that here.

18. Estimate various monthly expense amounts even if you the parent(s) pays for them out of your pocket.

Top

MC-025 Form

Page 1 Notes:

This is an example of stating a trust which is a third party “Special Needs Trust”. It includes the Trustee names, the declaration of the “Special Needs Trust”, if the ward has received any distribution (which is probably not necessary) and current value.

Trusts that are not third party will likely result in the fee waiver being denied.

Make sure to fill in attachment number at the top of the form and page numbers at the bottom of the form.

Top

FW-001-GC Form in HTML so it can be Translated

The FW-001-GC form is reproduced here in html so that it can easily be translated into multiple languages. You can not use this form to submit to court in any language. You have to use the FW-001-GC pdf form and English.

Request to Waive Court Fees (Ward or Conservatee)	CONFIDENTIAL
This form must be used by a guardian or conservator, or by a petitioner for the appointment of a guardian or conservator, to request a waiver of court fees in the guardianship or conservatorship court proceeding or in any other civil action in which the guardian or conservator represents the interests of the ward or conservatee as a plaintiff or defendant.	Clerk stamps date here when form is filed.

Fill in court name and street address:

Superior Court of California,
County of
San Francisco
400 MCALLISTER STREET
SAN FRANCISCO, CA 94102

Fill in case number and name:

CASE NUMBER:
PCN-16-123456

Case Name
Conservatorship of Terry Morgan Doe

If the ward or conservatee (including a proposed ward or conservatee if a petition for appointment of a guardian or conservator has been filed but has not yet been decided by the court) directly receives public benefits or is supported by public benefits received by another for his or her support, is a low-income person, or does not have enough income to pay for his or her household’s basic needs and the court fees, you may use this form to ask the court to waive the court fees. The court may order you to answer questions about the finances of the ward or conservatee. If the court waives the fees, the ward or conservatee, his or her estate, or someone with a duty to support the ward or conservatee, may still have to pay later if:
• You cannot give the court proof of the ward’s or conservatee’s eligibility,
• The ward’s or conservatee’s financial situation improves during this case, or
• You settle the civil case on behalf of the ward or conservatee for $10,000 or more. The trial court that waives fees will have a lien on any such
settlement in the amount of the waived fees and costs. The court may also charge the ward or conservatee, or his or her estate, any collection costs.

Your Information (guardian or conservator, or person asking the court to appoint a guardian or conservator):

Name: John Doe & Jane Doe Phone number: 415-123-4567

Street or mailing address: 1234 ABC Street

City: San Francisco State: CA Zip: 94102

Your Lawyer(if you have one): Name:

Firm or Affiliation: State Bar No.:

Address: Telephone:

City: State: Zip: E-mail:

a. The lawyer has agreed to advance all or a portion of court fees or costs (check one): Yes small form box No

b. (If yes, your lawyer must sign here.) Lawyer’s signature:
     If your lawyer is not providing legal-aid type services based on your or the ward’s or conservatee’s low
     income, you may have to go to a hearing to explain why you are asking the court to waive the fees.

Ward’s or Conservatee’s Information (file a separate Request for each ward in a multi-ward case):

Name: Terry Morgan Doe Age and date of birth (ward only):

Street or mailing address: 1234 ABC Street Age 18 January 1, 1998

City: San Francisco State: CA Zip: 94102

Phone number: 415-123-4567

Ward's or Conservatee's Lawyer, if any: Name:

Firm or Affiliation: State Bar No.:

Address: Telephone:

City: State: Zip: E-mail:

Ward or Conservatee’s Job (job title; if not employed, so state): High School Student

Name of employer: Best High School

Employer’s address: 1234 Best Lane State: CA Zip: 94103

Judicial Council of California, www.courts.ca.gov
Rev. March 1, 2016. Mandatory Form
Government Code, §68633
California Rules of Court, rules 3.51, 7.5

Request to Waive Court Fees
(Ward and Conservatoree)

FW-001-GC, Page 1 of 4

Name of (Proposed) Ward or Conservatee:
Terry Morgan Doe

CASE NUMBER:
PCN-16-123456

What court’s fees or costs are you asking to be waived?

Superior Court (See Information Sheet on Waiver of Superior Court Fees and Costs (form FW-001-INFO).)
small form box

Supreme Court, Court of Appeal, or Appellate Division of Superior Court (See Information Sheet on Waiver of
Appellate Court Fees (form APP-015/FW-015-INFO).)

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

(If your previous request is reasonably available, please attach it to this form and check here): small form box

Why are you asking the court to waive the ward’s or conservatee’s court fees?

The ward or one or both of the ward's parents, or the conservatee or the conservatee's spouse or
registered domestic partner, receive (check all that apply):
small form box check

Supplemental Security Income (SSI) small form box

State Supplemental Payment (SSP) small form box

SNAP (Food Stamps)
small form box

IHSS (In-Home Supportive Services) small form box

CalWORKS or Tribal TANF small form box check

Medi-Cal

County Relief/General Assistance small form box

CAPI (Cash Assistance Program for Aged, Blind, and Disabled)
(Names and relationships to ward or conservatee of persons who receive the public benefits listed above):

The gross monthly income of the ward’s or conservatee’s household (before deductions for taxes) is not
more than the amount listed below. (If you check 8b, you must fill out items 14, 15, and 16 on page 4 of
this form.)*

Family Size	Family Income	Family Size	Family Income	Family Size	Family Income
1	$1,237.50	3	$2,100.00	5	$2,962.50
2	$1,668.75	4	$2,531.25	6	$3,393.75

If more than 6 people at home, add $433.34 for each extra person.

c. small form box The ward’s or conservatee’s household does not have enough income to pay for its basic needs and the
court fees. I ask the court to (check one, and you must fill out items 14, 15, 16, 17, and 18 on page 4):*

(i)

Waive all court fees and costs. (ii) small form box check

Waive some court fees and costs.
(iii) small form box check

Let the (proposed) guardian or conservator, on behalf of the (proposed) ward or conservatee, make
payments over time.

*(Do not include income of guardian or conservator living in the household in 8b. or 8c. or count him or her in family size in 8b. unless he or she is a parent of the ward or the spouse or registered domestic partner of the conservatee.)

Guardians or petitioners for their appointment must complete items 9 and 10.

Ward’s Estate: small form box check

Person only, no estate. small form box

Inventory or petition estimated value:

Source (e.g., gift, inheritance, settlement, judgment, insurance): Est. collection date:

Ward’s Parents’ Information:

a. Name of ward’s father: John Doe small form box

Deceased (date of death):
     Street or mailing address: 1234 ABC Street
     City: San Francisco                     State: CA    Zip: 94102
     Phone number: 415-123-4567
b. Name of ward’s mother: Jane Doe                             small form box

Deceased (date of death):
     Street or mailing address: 1234 ABC Street
     City: San Francisco                    State: CA    Zip: 94102
     Phone number: 415-123-4567
c. Ward’s parents are (check all that apply): small form box check

married

living together small form box

separated

divorced
Support order for ward? small form box

Yes Payable to (name):
     Payor (name):
     Court:                                                                                      Case Number:
     Date of order (if multiple, date of latest):                              Monthly amount:

Rev. March 1, 2016

Request to Waive Court Fees
(Ward and Conservatoree)

FW-001-GC, Page 2 of 4

Name of (Proposed) Ward or Conservatee:
Terry Morgan Doe

CASE NUMBER:
PCN-16-123456

Conservators or petitioners for their appointment must complete items 11–13.

Conservatee’s Estate: small form box check

Person only, no estate.

small form box Inventory or petition estimated value: Est. collection date:

Conservatee’s Spouse’s or Registered Domestic Partner’s Information:

Name of conservatee’s spouse or registered domestic partner: small form box

Spouse

Partner
Date of marriage or partnership: small form box

Deceased (date of death):
Street or mailing address:                                                              Phone Number:
City:                                                            State:                   Zip:
Name of employer (if none, so state):
Employer’s address:                                                                  State:                              Zip:
The conservatee’s spouse or partner small form box

is not managing or, following appointment of a conservator is planning to manage, some or all of the couple’s community property outside the conservatorship estate. If you selected “is” above: The income, money, and property shown on page 4 small form box

includes

does not include the income and property managed, or expected to be managed, by the spouse/partner outside the estate.
small form box

Divorced (date of final judgment or decree ):
Court:
Case Number:              Support order for conservatee? small form box

Yes
Date of support order (if multiple, date of latest): Monthly amount:

The Conservatee and Trusts:

The conservatee:

Is not a trustor or settlor of a trust.
b. small form box check

Is not beneficiary of a trust.
If you selected “Is” to complete any of the above statements, identify and provide, in an attachment to this Request, the current address and telephone number of the current trustee(s) of each trust, describe the general terms of and value of each trust and the nature and value of the conservatee’s interest in each trust, and the amount(s) and frequency of any distributions to or for the benefit of the conservatee prior to your appointment as conservator of which you are aware. (You may use Judicial Council form MC-025 for this purpose.)

All applicants who checked item 8b or item 8c on page 2 must continue to and follow the
instructions for completion of items 14–16 or items 14-18 at the top of page 4, before signing below.

The information I have provided on this form and all attachments about the (proposed) ward or conservatee is true and correct to the best of my information and belief. The information I have provided on this form and all attachments concerning myself is true and correct. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date:

John Doe & Jane Doe
Print your name here	Sign here

Rev. March 1, 2016

Request to Waive Court Fees (Ward and Conservatoree)

FW-001-GC, Page 3 of 4

Name of (Proposed) Ward or Conservatee:
Terry Morgan Doe

CASE NUMBER:
PCN-16-123456

If you checked 8a on page 2, do not fill out below. If you checked 8b, you must answer questions 14–16. If you checked 8c, you must answer questions 14–18. If you need more space, attach form MC-025 or attach a sheet of paper, and write “Financial Information” and the ward’s or conservatee’s name and case number at the top.

Ward’s or Conservatee’s Household's

Money and Property

a. Cash                                          $
b. All financial accounts (list bank name and amount):
(1)                                                 $
(2)                                                 $
(3)                                                 $
c. Cars, boats, and other vehicles

Make / Year

Fair Market
Value

How Much You
Still Owe

(1)                                  $                  $
(2)                                  $                  $
(3)                                  $                  $
d. Real estate

Address

Fair Market
Value

How Much You
Still Owe

(1)                                  $                  $
(2)                                  $                  $
e. Other personal property (jewelry, furniture, furs,
    stocks, bonds, etc.):

Describe

Fair Market
Value

How Much You
Still Owe

(1) $ $
(2) $ $

Ward's or Conservatee's Household's
          Monthly Deductions and Expenses

a. List any payroll deductions and the monthly amount below:
(1)                                                 $
(2)                                                 $
(3)                                                 $
(4)                                                 $
b. Rent or house payment and
    maintenance                               $
c. Food and household supplies        $
d. Utilities and telephone                  $
e. Clothing                                      $
f. Laundry and cleaning                    $
g. Medical and dental expenses         $
h. Insurance (life, health, accident,
    etc.)                                          $
i. School, child care                          $
j. Child, spousal support (another
    marriage)                                   $
k. Transportation, gas, auto repair
    and insurance                             $
l. Installment payments (list each below):
       Paid to:
(1)                                                 $
(2)                                                 $
(3)                                                 $
m. Wages/earnings withheld by court
     order                                        $
n. Any other monthly expenses (list
     each below).                             $
    Paid to:                                         How Much?
(1)                                                 $
(1)                                                 $
(1)                                                 $
            Total monthly expenses
                 (add 18a - 18n above):   $

Check here if the ward’s or conservatee’s income

changes a lot from month to month. If it does, complete the form based on his or her average income for the past 12 months.

Ward’s or Conservatee’s Gross Monthly Income

a. List the source and amount of any income the ward or conservatee gets each month, including: wages or other income from work before deductions, spousal/child support, retirement, social security, disability, unemployment, military basic allowance for quarters (BAQ), veterans payments, dividends, interest, trust income, annuities, net business or rental income, reimbursement for job-related expenses, gambling or lottery winnings, etc.
(1)                                                 $
(2)                                                 $
(3)                                                 $
(4)                                                 $
(5)                                                 $
b. Total monthly income:               $

Ward’s or Conservatee’s Household's Income

a. List the income of all other persons living in the ward’s or conservatee’shome who depend in whole or in part on him or her for support, or on whom he or she depends in whole or in part for support.
        Name      Age Relationship Gross Monthly Income
(1)                                                 $
(2)                                                 $
(3)                                                 $
(4)                                                 $
(5)                                                 $
(6)                                                 $
(7)                                                 $
(8)                                                 $
(9)                                                 $
(10)                                               $
b. Total monthly income of
     persons above:                        $

Total monthly income and household income
(15b plus 16b): $

To list any other facts you want the court to know, such as the (proposed) ward’s or conservatee’s unusual medical expenses, etc, attach form MC-025 or attach a sheet of paper and write “Financial Information” and the (proposed) ward’s or conservatee’s name and case number at the top.
Check here if you attach another page. small form box

Important! If the ward’s or conservatee’s financial situation or ability to pay court fees improves, you must notify the court within five days on form FW-010-GC.

Do not include income of guardian or conservator living in the household in item 16, his or her money and property in item 17, or his or her deductions and expenses in item 18 unless he or she is a parent of the ward or the spouse or registered domestic partner of the conservatee.

Rev. March 1, 2016

Request to Waive Court Fees (Ward and Conservatoree)

FW-001-GC, Page 4 of 4

Top

MC-025 Form in HTML so it can be Translated

The MC-025 form is reproduced here in html so that it can easily be translated into multiple languages. You can not use this form to submit to court in any language. You have to use the MC-025 pdf form and English.

MC-025

Short Title:
The Terry Doe Special Needs Trust

CASE NUMBER:
PCN-16-123456

ATTACHMENT (Number): 1

(This Attachment may be used with any Judicial Council form.)

The trust is a Third Party Special Needs Trust.
Trustees
John Doe and Jane Doe
1234 ABC Street
San Francisco, CA 94102
415-123-4567

Beneficiary has a disability and will likely require government assistance during Grantor's life and after Grantor's death. The nature of the disability is: Autism and Mental Retardation.
Grantor creates this special needs trust to enhance Beneficiary's quality of life while at the same time preserving Beneficiary's eligibility for government support and medical assistance programs, including SSI, Medicaid, or other similar programs. Grantor intends this Declaration of Trust to be interpreted in light of this purpose.

The ward has not received any distributions or benefits.
Value: 11,000.32

(If the item that this Attachment concerns is made under penalty of perjury, all statements in this Attachment are made under penalty of perjury.)

Page 1 of 1
(Add pages as required)

Form Approved for Optional Use
Judicial Council of California
MC-025 [Rev. July 1, 2009]

ATTACHMENT
to Judicial Council Form

www.courts.ca.gov

Top

FW-001-INFO Form in HTML so it can be Translated

The FW-001-INFO form is reproduced here in html so that it can easily be translated into multiple languages.

FW-001-INFO

INFORMATION SHEET ON WAIVER OF SUPERIOR COURT FEES AND COSTS

If you have been sued or if you wish to sue someone, if you are filing or have received a family law petition, or if you are asking thecourt toappoint a guardian for a minor ora conservator for an adult or arean appointedguardianor conservator, and if you (or your ward or conservatee) cannot afford to pay court fees and costs, you may not have to pay them in order to go to court. If you (or your ward or conservatee) are getting public benefits, are a low-income person, or do not have enough income to pay for your (or his or her) household’s basic needs and your court fees, you may ask the court to waive all or part of those fees.

1. To make a request to the court to waive y our fees in superior court, com plete the Request to Waive C ourt Fees

(form FW-001) or, if you are petitioning for the appointm ent of a guardian or conservator or are an appointe d guardian or conservator, com plete the Request to Waive Court Fees (Ward or Conservatee) (form FW-0 01-GC). If you qualify, the court will waive all or part of its fees for the following:
• Filing papers in superior court (other than for an appeal in a case with a value of over $25,000)

• Making and certifying copies	• Giving notice and certificates
• Sheriff’s fee to give notice	• Sending papers to another court department
• Court fee for telephone hearing	• Having a court-appointed interpreter in small claims court

  • Reporter’s fee for attendance at hearing or trial, if a reporter is provided by the court.
  • Assessment for court investigations under Probate Code section 1513, 1826, or 1851.
  • Preparing, certifying, copying, and sending the clerk’s transcript on appeal.
  • Holding in trust the deposit for a reporter’s transcript on appeal under rule 8.833 or 8.834.
  • Making a transcript or copy of an official electronic recording under rule 8.835

2. You may ask the court to waive other court fees during your case in superior court as well. To do that, complete a

Request to Waive Additional Court Fees (Superior Court) (form FW-002) or Request to Waive Additional Court Fees (Superior Court) (Ward or Conservatee) (form FW-002-GC). The court will consider waiving fees for items such as the following, or other court services you need for your case:

• Jury fees and expenses	• Fees for a peace officer to testify in court
• Fees for court-appointed experts	• Court-appointed interpreter fees for a witness

• Other necessary court fees

3. If you want the Appellate Division of Superior Court or the Court of Appeal to review an order or judgment against

you and you want the court fees waived, ask for and follow the instructions on Information Sheet on Waiver of Appellate Court Fees, Supreme Court, Court of Appeal, Appellate Division (form APP-015/FW-015-INFO).

IMPORTANT INFORMATION!

• You are signing your request under penalty of perjury. Answer truthfully, accurately, and completely.

• The court may ask you for information and evidence. You may be ordered to go to court to answer questions about your ability, or the ability of your ward or conservatee, to pay court fees and costs and to provide proof of eligibility. Any initial fee waiver you or your ward or conservatee are granted may be ended if you do not go to court when asked. You or your ward’s or conservatee’s estate may be ordered to repay amounts that were waived if the court finds you were not eligible for the fee waiver.

• Public benefits programs listed on the application form. In item 5 on the Request to Waive Court Fees (item 8 of the Request to Waive Court Fees (Ward or Conservatee)), there is a list of programs from which you (or your ward or conservatee) may be receiving benefits, listed by the abbreviations they are commonly known by. The full names of those programs can be found in Government Code section 68632(a), and are also listed here:

• Medi-Cal • Food Stamps—California Food Assistance Program , CalFresh Program, or SNAP
• Supp. Sec. Inc.—Supplemental Security Income (not Social Security) • SSP—State Supplemental Payment
• County Relief/General Assistance—County Relief, General Relief (GR) or General Assistance (GA)
• IHSS—In-Home Supportive Services
• CalWORKS—California Work Opportuni ty and Responsibility to Kids Act
• Tribal TANF—Tribal Temporary Assistance for Needy Families
• CAPI—Cash Assistance Program for Aged, Blind, or Disabled Legal Immigrants

Judicial Council of California, www.courts.ca.gov
Revised September 1, 2015
Government Code, §§ 68630-68640
California Rules of Court, rules 3.51, 7.5

Information Sheet on Waiver of
Superior Court fees and Costs

FW-001-INFO,Page 1 of 2

FW-001-INFO

• If you receive a fee waiver, you must tell the court if there is a change in your finances, or the finances of your ward or conservatee. You must tell the court within five days if those finances improve or if you, or your ward or conservatee, become able to pay court fees or costs during this case. (File Notice to Court of Improved Financial Situation or Settlement (form FW-010) or Notice to Court of Improved Financial Situation or Settlement (Ward or Conservatee) (form FW-010-GC) with the court.) You may be ordered to repay any amounts that were waived after your eligibility, or the eligibility of your ward or conservatee, came to an end.

• If you receive a judgment or support order in a family law matter: You may be ordered to pay all or part of your waived fees and costs if the court finds your circumstances have changed so that you can afford to pay. You will have the opportunity to ask the court for a hearing if the court makes such a decision.

• If you win your case in the trial court: In most circumstances the other side will be ordered to pay your waived fees and costs to the court. The court will not enter a satisfaction of judgment until the court is paid. (This does not apply in unlawful detainer cases. Special rules apply in family law cases and in guardianships and conservatorships. (Government Code, section 68637(d), (e), and Cal. Rules of Court, rule 7.5.)

• If you settle your civil case for $10,000 or more: Any trial court waived fees and costs must first be paid to the court out of the settlement. The court will have a lien on the settlement in the amount of the waived fees and costs. The court may refuse to dismiss the case until the lien is satisfied. A request to dismiss the case (use form CIV-110) must have a declaration under penalty of perjury that the waived fees and costs have been paid. Special rules apply to family law cases.

• The court can collect fees and costs due to the court. If waived fees and costs are ordered paid to the trial court, or if you fail to make the payments over time, the court can start collection proceedings and add a $25 fee plus any additional costs of collection to the other fees and costs owed to the court.

• The fee waiver ends. The fee waiver expires 60 days after the judgment, dismissal, or other final disposition of the case or earlier if a court finds that you or your ward or conservatee are not eligible for a fee waiver. If the case is a guardianship or conservatorship proceeding, see California Ru les of Court, rule 7.5(k) for information on the final disposition of that matter.

• If you are in jail or state prison: Prisoners may be required to pay the full cost of the filing fee in the trial court but may be allowed to do so over time. See Government Code section 68635.

FW-001-INFO (Rev. September 1, 2015)

Information Sheet on Waiver of
Superior Court fees and Costs

FW-001-INFO,Page 2 of 2

Top