Form AWA-O1304.5 "Order for Waiver of Court Fees (Appellate Court)" - Illinois

What Is Form AWA-O1304.5?

This is a legal form that was released by the Illinois Appellate Court - a government authority operating within Illinois. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2019;
  • The latest edition provided by the Illinois Appellate Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form AWA-O1304.5 by clicking the link below or browse more documents and templates provided by the Illinois Appellate Court.

ADVERTISEMENT
ADVERTISEMENT

Download Form AWA-O1304.5 "Order for Waiver of Court Fees (Appellate Court)" - Illinois

319 times
Rate (4.7 / 5) 22 votes
This form is approved by the Illinois Supreme Court and is required to be accepted in all Illinois Appellate Courts.
Instructions
THIS APPEAL INVOLVES A MATTER SUBJECT TO EXPEDITED DISPOSITION UNDER
RULE 311(a).
Check the box to the
right if your case
involves parental
responsibility or
parenting time
(custody/visitation
rights) or relocation of a
child.
Appellate Case No.:
Enter the Appellate
Court case number if
IN THE APPELLATE COURT OF
you have it.
ILLINOIS
Just below “In the
Appellate Court of
District
Illinois,” enter the
number of the appellate
district where the appeal
was filed.
Appeal from the Circuit Court
If the case name in the
In re
of
County
trial court began with
“In re” (for example,
“In re Marriage of
Trial Court Case No.:
Jones”), enter that
name. Below that, enter
the names of the parties
Plaintiff/Petitioner (First, middle, last names)
as they appeared in the
trial court, and check
Appellant
Appellee
Honorable
the correct boxes to
show which party filed
the appeal (“appellant”)
v.
Judge, Presiding
and which party is
responding to the appeal
(“appellee”).
Defendant/Respondent (First, middle, last names)
To the far right, enter the
trial court county, trial
Appellant
Appellee
court case number, and
trial judge's name.
ORDER FOR WAIVER OF COURT FEES
(APPELLATE COURT)
Enter your full name
Applicant Name:
as “Applicant." If the
First
Middle
Last
application was filled
out on behalf of a
The Court having reviewed the Application for Waiver of Court Fees hereby finds:
minor, enter the
1.  The applicant qualifies for a full waiver of all fees, costs, and charges because
(check
minor's full name.
:
only one)
a.  The applicant receives means-based government assistance under one or more of
the following programs:
Supplemental Security Income (SSI) (Not Social Security)
DO NOT check any
Aid to the Aged, Blind and Disabled (AABD)
boxes or fill in any
more blanks on this
Temporary Assistance for Needy Families (TANF)
form. The Appellate
SNAP (Food Stamps)
Court will decide if
General Assistance (GA), Transitional Assistance, or State Children and
your Application for
Family Assistance
Waiver of Court Fees
OR
is granted or denied
and complete the rest
b.  The applicant’s income is 125% or less of the of the current poverty level as
of this form.
established by the US Department of Health and Human Services and the Applicant's
non-exempt assets under
735 ILCS 5/12-901
and
735 ILCS 5/12-1001
are such that
the applicant is unable, without undue hardship, to pay the fees, costs, or charges;
AWA-O 1304.5
Page 1 of 3
(11/19)
This form is approved by the Illinois Supreme Court and is required to be accepted in all Illinois Appellate Courts.
Instructions
THIS APPEAL INVOLVES A MATTER SUBJECT TO EXPEDITED DISPOSITION UNDER
RULE 311(a).
Check the box to the
right if your case
involves parental
responsibility or
parenting time
(custody/visitation
rights) or relocation of a
child.
Appellate Case No.:
Enter the Appellate
Court case number if
IN THE APPELLATE COURT OF
you have it.
ILLINOIS
Just below “In the
Appellate Court of
District
Illinois,” enter the
number of the appellate
district where the appeal
was filed.
Appeal from the Circuit Court
If the case name in the
In re
of
County
trial court began with
“In re” (for example,
“In re Marriage of
Trial Court Case No.:
Jones”), enter that
name. Below that, enter
the names of the parties
Plaintiff/Petitioner (First, middle, last names)
as they appeared in the
trial court, and check
Appellant
Appellee
Honorable
the correct boxes to
show which party filed
the appeal (“appellant”)
v.
Judge, Presiding
and which party is
responding to the appeal
(“appellee”).
Defendant/Respondent (First, middle, last names)
To the far right, enter the
trial court county, trial
Appellant
Appellee
court case number, and
trial judge's name.
ORDER FOR WAIVER OF COURT FEES
(APPELLATE COURT)
Enter your full name
Applicant Name:
as “Applicant." If the
First
Middle
Last
application was filled
out on behalf of a
The Court having reviewed the Application for Waiver of Court Fees hereby finds:
minor, enter the
1.  The applicant qualifies for a full waiver of all fees, costs, and charges because
(check
minor's full name.
:
only one)
a.  The applicant receives means-based government assistance under one or more of
the following programs:
Supplemental Security Income (SSI) (Not Social Security)
DO NOT check any
Aid to the Aged, Blind and Disabled (AABD)
boxes or fill in any
more blanks on this
Temporary Assistance for Needy Families (TANF)
form. The Appellate
SNAP (Food Stamps)
Court will decide if
General Assistance (GA), Transitional Assistance, or State Children and
your Application for
Family Assistance
Waiver of Court Fees
OR
is granted or denied
and complete the rest
b.  The applicant’s income is 125% or less of the of the current poverty level as
of this form.
established by the US Department of Health and Human Services and the Applicant's
non-exempt assets under
735 ILCS 5/12-901
and
735 ILCS 5/12-1001
are such that
the applicant is unable, without undue hardship, to pay the fees, costs, or charges;
AWA-O 1304.5
Page 1 of 3
(11/19)
Enter the Case Number given by the Appellate Court Clerk: _________________________________
OR
c.  Payment of fees, costs or charges would result in undue hardship to the applicant or
his or her family.
2.  The applicant qualifies for a partial
waiver of all fees, costs and
(75%, 50%, or 25%)
charges because the applicant's household income is
:
(check one)
 more than 125% but not greater than 150%
; OR
(75% waived)
 more than 150% but not greater than 175%
; OR
(50% waived)
 more than 175% but not greater than 200%
(25% waived)
of the current poverty level as established by the US Department of Health and
Human Services and the Applicant's non-exempt assets under
735 ILCS 5/12-901
and
735 ILCS 5/12-1001
are such that the applicant is unable to pay the fees costs
and charges in full.
3.  The applicant must provide additional information and attend a hearing before the
court decides if the applicant qualifies for a fee waiver.
4.  The applicant does not qualify for a fee waiver because
:
(must state specific reason)
IT IS HEREBY ORDERED:
A.  Application for Waiver of Court Fees is GRANTED.
i.
 The applicant qualifies for a full waiver, and may participate in this case without payment
of fees, costs, or charges
OR
 The applicant qualifies for a partial fee waiver as follows
:
(check one)
ii.
75% of all fees, costs, and charges are waived (
and the applicant must pay 25% of
).
all fees, costs, and charges
50% of all fees, costs, and charges are waived (
and the applicant must pay 50% of
).
all fees, costs, and charges
25% of all fees, costs, and charges are waived (
and the applicant must pay 75% of
).
all fees, costs, and charges
 The applicant must pay fees, costs and charges currently due by:
Date
OR
 Upon good cause shown, the applicant may make payments as follows
(describe
:
deferral, installment plan, or other reasonable terms)
This order expires one year from the date of this order. The applicant may reapply before or
after the expiration date.
 Application for Waiver of Court Fees is SET FOR HEARING on
B.
Date
at
in courtroom:
Time
The applicant must bring the following documents:
AWA-O 1304.5
Page 2 of 3
(11/19)
Enter the Case Number given by the Appellate Court Clerk: _________________________________
C.
 Application for Waiver of Court fees is DENIED.
The applicant must pay all fees, costs, and charges currently due by:
Date
DO NOT complete
ENTERED:
this section. The
justice will sign and
date here.
Justice
Date
AWA-O 1304.5
Page 3 of 3
(11/19)
Print
Save
Reset Form
Page of 3