Free fee waiver worksheet (FW-001)

Before you start

You type your own answers. Each question has the same number as the official form FW-001, so you can copy your answers onto it.
Your answers stay on this phone or computer. Nothing is sent to us or anyone else.
Never type your Social Security number or full benefit ID numbers. The form doesn't ask for them.
Have ready: your monthly income, the people in your home, and which benefits you get.

This tool explains what each item on the form asks and adds up your numbers. It does not tell you what to answer, and it is not legal advice. Only the judge decides.

Save my answers on this device so I can finish later (don't use this on a shared computer)

Built from form FW-001, revised March 1, 2026. Checked November 2026. Official form page

The court and your case

Item Top

Court name and street address

The top box of the form. Use the courthouse where your case is or will be filed. It's on your other court papers.

Superior Court of California, County of

Court street address

Item Top

Case number and name

If you haven't filed your case yet, leave these blank. The clerk adds the case number.

Case number

Case name (for example, Smith v. Jones)

About you

Item 1

Your information

The person asking the court to waive the fees.

Name

Street or mailing address

City

State

Zip

Phone

Item 2

Your job, if you have one

Leave blank if you don't have a job.

Job title

Name of employer

Employer's address

Item 3

Your lawyer, if you have one

Most people filling this out on their own leave item 3 blank. If you do have a lawyer, the form asks for their name, firm, address, phone and State Bar number.

I have a lawyer for this case

Which court and why

Item 4

Which court's fees?

Most first-time cases are in the Superior Court (the trial court). The other choice is for appeals.

Superior CourtSupreme Court, Court of Appeal, or Appellate Division of Superior Court

Item 5

Why are you asking?

The form gives three reasons. Read each one and check what is true for you. What you check decides how much of page 2 you fill out.

5b. My gross monthly household income (before taxes) is less than the amount in this table.

Family size	Family income
1	$2,660.00
2	$3,606.67
3	$4,553.33
4	$5,500.00
5	$6,446.67
6	$7,393.33

More than 6 people at home: add $946.67 for each extra person. If you check 5b, you fill out items 7, 8 and 9 on page 2.

5c. I don't have enough income to pay for my household's basic needs and the court fees.

Item 6

Asked before?

Check if you asked the court to waive fees for this same case in the last six months. If you have that earlier request, the form asks you to attach it.

I asked for a fee waiver in this case in the last six monthsI'm attaching my earlier request

Page 2: income

Gross means before taxes and other deductions. If you need more lines than the form has, the form says to attach form MC-025 or a sheet titled Financial Information with your name and case number.

Item 7

Income that changes

If your income changes a lot from month to month, the form says to use your average for the past 12 months.

My income changes a lot from month to month

Item 8

Your gross monthly income

List each source and its monthly amount: wages before deductions, child or spousal support, retirement, Social Security, disability, unemployment, military BAQ, veterans payments, dividends, interest, trust income, annuities, net business or rental income, job expense reimbursements, gambling or lottery winnings, and so on.

(1)

(2)

(3)

(4)

8b. Your total monthly income$0.00

Item 9

Household income

Other people living in your home who depend on you for support, or who you depend on, in whole or in part.

(1)

(2)

(3)

(4)

9b. Total monthly income of these people$0.00

Total monthly income and household income (8b plus 9b)$0.00

To compare, see the table in item 5b. Only the judge decides.

Page 2: money and property

You fill out items 10 and 11 because you checked 5c. Fair market value means about what it would sell for today.

Item 10

Your money and property

10a. Cash

10b. All financial accounts: bank name and amount. Don't type account numbers.

(1)

(2)

(3)

10c. Cars, boats and other vehicles: make and year.

(1)

(2)

(3)

10d. Real estate: address.

(1)

(2)

10e. Other personal property (jewelry, furniture, furs, stocks, bonds, etc.).

(1)

(2)

Page 2: monthly expenses

Item 11

Your monthly deductions and expenses

Monthly amounts. Leave a line blank if it doesn't apply.

11a. Payroll deductions (taken out of your paycheck) and the monthly amount.

(1)

(2)

(3)

(4)

11b. Rent or house payment & maintenance

11c. Food and household supplies

11d. Utilities and telephone

11e. Clothing

11f. Laundry and cleaning

11g. Medical and dental expenses

11h. Insurance (life, health, accident, etc.)

11i. School, child care

11j. Child, spousal support (another marriage)

11k. Transportation, gas, auto repair and insurance

11l. Installment payments (list each).

(1)

(2)

(3)

11m. Wages or earnings withheld by court order

11n. Any other monthly expenses (list each).

(1)

(2)

(3)

Total monthly expenses (11a through 11n)$0.00

Item Extra

Other facts for the court

The form says: to list other facts you want the court to know, such as unusual medical expenses, attach form MC-025 or a sheet titled Financial Information with your name and case number, and check the box on page 2.

Notes to copy onto your attached page (optional)

I'm attaching another page

Your copy sheet

Copy my answers into the official form

We copy your answers into the official FW-001 PDF on this device. Nothing is sent to us. Open it, read every line, fix anything that's wrong, then print, date and sign it yourself.

The form is filed in English. If an answer uses letters the PDF can't print (some accents, Vietnamese marks, non-Latin letters), that whole box is left blank for you to write by hand.

Open the blank official form FW-001

The court's form can be typed into on a computer, or printed and filled out by hand.

What to do next

Copy each answer onto FW-001 next to the same item number.
Page 2: if you checked only 5a, skip it. If you checked 5b, fill out 7, 8 and 9 only. If you checked 5c, fill out all of page 2.
Put your name and case number at the top of page 2.
Read everything. Then date it, print your name and sign page 1 yourself. You sign under penalty of perjury that it's true and correct.
Make a copy for yourself. File FW-001 with your other court papers at the clerk's window, or with your e-filing.
The court answers on form FW-003. If it asks for more information or sets a hearing, follow what the order says.
Later, if your money situation gets better, the form says you must tell the court within five days on form FW-010.

From the form: you may still have to pay later if you can't show proof you qualify, your finances improve during the case, or you settle a civil case for $10,000 or more (the court gets a lien for the waived fees).

Questions about a word or step?

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Fill out your fee waiver yourself

Before you start

The court and your case

Court name and street address

Case number and name

About you

Your information

Your job, if you have one

Your lawyer, if you have one

Which court and why

Which court's fees?

Why are you asking?

Asked before?

Page 2: income

Income that changes

Your gross monthly income

Household income

Page 2: money and property

Your money and property

Page 2: monthly expenses

Your monthly deductions and expenses

Other facts for the court

Your copy sheet

Copy my answers into the official form

What to do next

Questions about a word or step?

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