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ane Order on Court Fee Waiver Clerk stamps date here when form is filed.
(Superior Court) j L E
Person who asked the court to waive court fees:
FEB 26 2020
8 ie ne
By.
Name: Oakley Monroe
D. WAGNER
Streét or mailing address: 1115 W. Fourth Street
City: Antioch State: CA — Zip:94509
Lawyer, if person in (1) has one (name, firm name, address,
phone number, e-mail, and State Bar number):
Michael Shemtoub, Beverly Law, 4929 Wilshire Blvd. Suite 702, Los Fill in court name and street address:
Angeles CA 90010. 310-552-6959 253948 Superior Court of California, County of
Contra Costa
Fillin case number and name:
@ A request to waive court fees was filed on (date):
The court made a previous fee waiver order in this case on (date):
NOT = 003 9 5
Case Name:
Read this form carefully. All checked boxes Zare court orders.
Notice: The court may order you to answer questions about your finances and later order you to pay back the waived
fees. If this happens and you do not pay, the court can make you pay the fees and also charge you collection fees. If there
is a change in your financial circumstances during this case that increases your ability to pay fees and costs, you must
notify the trial court within five days. (Use form.FW-010.) If you win your case, the trial court may order the other side
to pay the fees. If you settle your civil case for $10,000 or more, the trial court will have a lien on the settlement in the
amount of the waived fees. The trial court may not dismiss the case until the lien is paid.
@ After reviewing your: Request to Waive Court Fees (1 Request to Waive Additional Court Fees
the court makes the following orders:
a. $4. The court grants your request, as follows:
(1) KL Fee Waiver. The court grants your request and waives your court fees and costs listed below. (Cal.
Rules of Court, rules 3.55 and 8.818.) You do not have to pay the court fees for the following:
+ Filing papers in superior court + Court fee for phone hearing
* Making copies and certifying copies * Giving notice and certificates
+ Sheriff's fee to give notice « Sending papers to another court department
+ Reporter’s fee for attendance at hearing or trial, if the court is not electronically recording the proceeding
and you request that the court provide an official reporter
+ 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 8.130 or 8.834
+ Making a transcript or copy of an official electronic recording under rule 8.835
(2) Additional Fee Waiver. The court grants your request and waives your additional superior court fees
and costs that are checked below. (Cal. Rules of Court, rule 3.56.) You do not have to pay for the
checked items.
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 (specify):
Meee Seneca sone nemucoutecegov Order on Court Fee Waiver (Superior Court) FW-003, Page 1 of 3
Government Code, § 68634(e)
Cal, Rules of Court, rule 3.62‘ tl i }
Case Number:
Yourname: Oakley Monroe
b. [] The court denies your fee waiver request because:
Warning! If you miss the deadline below, the court cannot process your request for hearing or the court papers
you filed with your original request. If the papers were a notice of appeal, the appeal may be dismissed.
(1) Your request is incomplete. You have 10 days after the clerk gives notice of this Order (see date of service []
on next page) to:
+ Pay your fees and costs, or
* File a new revised request that includes the incomplete items listed:
Below On Attachment 4b(1)
(2) The information you provided on the request shows that you are not eligible for the fee waiver you
requested for the reasons stated: Below On Attachment 4b(2)
The court has enclosed a blank Request for Hearing About Court Fee Waiver Order (Superior Court)
(form FW-006).Y ou have 10 days after the clerk gives notice of this order (see date of service below) to:
* Pay your fees and costs in full or the amount listed in c below, or
+ Ask for a hearing in order to show the court more information. (Use form FW-006 to request
hearing.)
ce. (1) The court needs more information to decide whether to grant your request. You must go to court on the
date on page 3. The hearing will be about the questions regarding your eligibility that are stated:
Below On Attachment 4c(1)
(2) Bring the items of proof to support your request, if reasonably available, that are listed:
Below On Attachment 4¢(2)
UUTEREE: Rexel te) ce[-1
Rev, September 1, 2019 Order on Court Fee Waiver (Superior Court) FW-003, Page 2 of 3Case Number:
Your name: Oakley Monroe
Name and address of court if different from above:
Date: Time:
Dept.: Room:
Warning! If item c(1) is checked, and you do not go to court on your hearing date, the judge will deny your
request to waive court fees, and you will have 10 days to pay your fees. If you miss that deadline, the court cannot
process the court papers you filed with your request. If the papers were a notice of appeal, the appeal may be
dismissed.
FEB 26
Date: an 1A We D. WAGNER
Signature of (check one): C1 Judicial Officer Clerk, Deputy
Request for Accommodations
Assistive listening systems, computer-assisted real-time captioning, or sign language interpreter services
are available if you ask at least five days before the hearing. Contact the clerk’s office for Request for
Accommodations by Persons With Disabilities and Response (form MC-410). (Civ. Code, § 54.8.)
Clerk's Certificate of Service
I certify that | am not involved in this case and (check one):
handed a copy of this Order to the party and attorney, if any, listed in @ and ®. at the court, on the date below.
This order was mailed first class, postage paid, to the party and attorney, if any, at the addresses listed in()and @),
from (city): , California, on the date below.
A certificate of mailing is attached.
Date:
Clerk, by , Deputy
Name:
LUEMEe: Retell ame) co(-ta
Rev. September 1, 2018 Order on Court Fee Waiver (Superior Court) FW-003, Page 3 of 3
Preview
ane Order on Court Fee Waiver Clerk stamps date here when form is filed. (Superior Court) j L E Person who asked the court to waive court fees: FEB 26 2020 8 ie ne By. Name: Oakley Monroe D. WAGNER Streét or mailing address: 1115 W. Fourth Street City: Antioch State: CA — Zip:94509 Lawyer, if person in (1) has one (name, firm name, address, phone number, e-mail, and State Bar number): Michael Shemtoub, Beverly Law, 4929 Wilshire Blvd. Suite 702, Los Fill in court name and street address: Angeles CA 90010. 310-552-6959 253948 Superior Court of California, County of Contra Costa Fillin case number and name: @ A request to waive court fees was filed on (date): The court made a previous fee waiver order in this case on (date): NOT = 003 9 5 Case Name: Read this form carefully. All checked boxes Zare court orders. Notice: The court may order you to answer questions about your finances and later order you to pay back the waived fees. If this happens and you do not pay, the court can make you pay the fees and also charge you collection fees. If there is a change in your financial circumstances during this case that increases your ability to pay fees and costs, you must notify the trial court within five days. (Use form.FW-010.) If you win your case, the trial court may order the other side to pay the fees. If you settle your civil case for $10,000 or more, the trial court will have a lien on the settlement in the amount of the waived fees. The trial court may not dismiss the case until the lien is paid. @ After reviewing your: Request to Waive Court Fees (1 Request to Waive Additional Court Fees the court makes the following orders: a. $4. The court grants your request, as follows: (1) KL Fee Waiver. The court grants your request and waives your court fees and costs listed below. (Cal. Rules of Court, rules 3.55 and 8.818.) You do not have to pay the court fees for the following: + Filing papers in superior court + Court fee for phone hearing * Making copies and certifying copies * Giving notice and certificates + Sheriff's fee to give notice « Sending papers to another court department + Reporter’s fee for attendance at hearing or trial, if the court is not electronically recording the proceeding and you request that the court provide an official reporter + 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 8.130 or 8.834 + Making a transcript or copy of an official electronic recording under rule 8.835 (2) Additional Fee Waiver. The court grants your request and waives your additional superior court fees and costs that are checked below. (Cal. Rules of Court, rule 3.56.) You do not have to pay for the checked items. 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 (specify): Meee Seneca sone nemucoutecegov Order on Court Fee Waiver (Superior Court) FW-003, Page 1 of 3 Government Code, § 68634(e) Cal, Rules of Court, rule 3.62‘ tl i } Case Number: Yourname: Oakley Monroe b. [] The court denies your fee waiver request because: Warning! If you miss the deadline below, the court cannot process your request for hearing or the court papers you filed with your original request. If the papers were a notice of appeal, the appeal may be dismissed. (1) Your request is incomplete. You have 10 days after the clerk gives notice of this Order (see date of service [] on next page) to: + Pay your fees and costs, or * File a new revised request that includes the incomplete items listed: Below On Attachment 4b(1) (2) The information you provided on the request shows that you are not eligible for the fee waiver you requested for the reasons stated: Below On Attachment 4b(2) The court has enclosed a blank Request for Hearing About Court Fee Waiver Order (Superior Court) (form FW-006).Y ou have 10 days after the clerk gives notice of this order (see date of service below) to: * Pay your fees and costs in full or the amount listed in c below, or + Ask for a hearing in order to show the court more information. (Use form FW-006 to request hearing.) ce. (1) The court needs more information to decide whether to grant your request. You must go to court on the date on page 3. The hearing will be about the questions regarding your eligibility that are stated: Below On Attachment 4c(1) (2) Bring the items of proof to support your request, if reasonably available, that are listed: Below On Attachment 4¢(2) UUTEREE: Rexel te) ce[-1 Rev, September 1, 2019 Order on Court Fee Waiver (Superior Court) FW-003, Page 2 of 3Case Number: Your name: Oakley Monroe Name and address of court if different from above: Date: Time: Dept.: Room: Warning! If item c(1) is checked, and you do not go to court on your hearing date, the judge will deny your request to waive court fees, and you will have 10 days to pay your fees. If you miss that deadline, the court cannot process the court papers you filed with your request. If the papers were a notice of appeal, the appeal may be dismissed. FEB 26 Date: an 1A We D. WAGNER Signature of (check one): C1 Judicial Officer Clerk, Deputy Request for Accommodations Assistive listening systems, computer-assisted real-time captioning, or sign language interpreter services are available if you ask at least five days before the hearing. Contact the clerk’s office for Request for Accommodations by Persons With Disabilities and Response (form MC-410). (Civ. Code, § 54.8.) Clerk's Certificate of Service I certify that | am not involved in this case and (check one): handed a copy of this Order to the party and attorney, if any, listed in @ and ®. at the court, on the date below. This order was mailed first class, postage paid, to the party and attorney, if any, at the addresses listed in()and @), from (city): , California, on the date below. A certificate of mailing is attached. Date: Clerk, by , Deputy Name: LUEMEe: Retell ame) co(-ta Rev. September 1, 2018 Order on Court Fee Waiver (Superior Court) FW-003, Page 3 of 3