Application for 		Give Details	
	Exemption from Paying Court		File Number:
	
Federal Court of Australia
Federal Circuit and Family Court of Australia (Division 2)	Fees or Reduction- Financial Hardship		File name:
	
	Federal Court and Federal Circuit and Family Court Regulations 2022
Section 2.06
Section 2.06A		Date lodged:
	
•	Cross boxes where applicable. Type or print clearly providing all details required.
•	Attach an extra page if you need more space for any of the details requested
•	Only an individual (i.e. a natural person) can apply for an exemption of a court fee on the basis of financial hardship
NOTE: Exemptions only apply to court fees and do not apply to any other fees or expenses in relation to the proceedings, including service fees, transcript charges or lawyers’ costs and expenses.
Notice to applicant for exemption or reduction of court fees on the basis of financial hardship	

For approval for a court fee to be exempted or reduced, you will need to show that your income, day-to-day living expenses, liabilities and assets are at such that payment of the fee would cause you financial hardship.  Depending on your circumstances, this might be brief. Where possible provide documentary evidence to support general claims (for example a letter from a charitable organisation to verify that its assistance is your sole means of support).

If you are applying for an exemption or reduction of a filing fee, then this form must be lodged at the same time as the document on which that fee must be paid is lodged. If you are applying for the exemption of a setting-down or hearing fee, then this form must be lodged once the hearing date is set. Your hearing date will usually be set at either a court hearing or conference.

If your application for exemption of court fees relates to an existing proceeding, it will assist if you include the file number and file name (e.g. Smith v Commonwealth of Australia) in the fields at the top right hand corner of this page.

In considering your application the Registrar/Authorised Officer may ask you to provide additional documentary evidence to support your claims. In that case, your application will be returned to you with instructions in the ‘Notice of request for more information’ on page 5.

An exemption is valid only for the fee you are applying to have exempted.  If a further fee is payable you will need to apply again.
	WARNING
Under the Criminal Code any person who knowingly makes an untrue representation or statement to obtain a benefit or advantage from the Commonwealth is guilty of an offence and, if found guilty, can be fined or imprisoned.
A	Details of the individual applying for the fee exemption or reduction, court and fee type	
1	Name		family name (surname)
     		given names
     	
						
	Address, Email Address and Daytime Phone Number		address to which documents for you can be sent	      					  post code       		
			email address   	     	telephone       	
						
	Occupation and
Employment		occupation	     	
			name of employer	     	
			work address	     	
						
2	Court in which exemption is sought and fee type		   Federal Court		  Federal Circuit and Family Court (Division 2)	
			 Filing fee (except Federal Circuit and Family Court Application – Migration Act)  	 Filing fee (reduced or exemption) for Federal Circuit and Family Court (Division 2) Application –Migration Act)  	
			 Setting down fee     	 Fee for taxation of a bill of costs (Federal Court only)	
			 Hearing fee	 Other fee  	
			 Mediation fee		

B	Details of income 	

1.	The details of my and my dependants’ (if any) income (including government pensions, benefits and allowances, workers' compensation, superannuation, rent, board, interest, dividends), calculated fortnightly, are as follows [if no relevant income, write "nil" in the appropriate field below]:
	[Generally, dependants are persons who rely on you or on whom you rely for financial support and included spouse, de facto partner and children]

Nature of Income	My amount	My dependents’ amount	
Fortnightly pay (after tax)	$		
Government pension, benefit or allowance (please specify)
.....................................................................................
.....................................................................................	$		
Workers’ compensation	$		
Superannuation received	$		
Interest on deposits/debentures	$		
Child support, spousal and child maintenance	$		
Other income (eg rent or board paid to you, share dividends)	$		
TOTAL	$		
Please note you may be asked to provide documentary evidence to support your claim.
2.	The full name of each of my dependants is: 

Full Name	Relationship to me	

		

3.	I receive financial support or a financial contribution from family and others, calculated fortnightly, as follows [if no financial support or contribution write "nil" below]:

Name of person providing support	Nature of support	Value in $ per fortnight	
		$	
		$	
TOTAL	$	

C	Details of property and assets 	
["Property and assets" include land, houses, money in bank accounts and other investments, cars, boats, shares, moneys owed to you, interests in a deceased estate, and interests in a trust.  If any property or asset is owned jointly with someone other than a dependant, give the name of the other owner.]
4.	My property and assets (other than bank accounts) are as follows [if no assets write "nil" below]:
	My details (my share/interest)	My dependents’ amount	
1. Liquid Assets (other than bank accounts)			
Cash (not in a bank account)	$		
Other investments (eg shares, debentures, bonds)	$		
Money owed to you	$		
Sub total  - liquid assets	$		

2. Non-liquid Assets			
House / Land			
- Market value	$			
- Amount of Mortgage	$			
- Net value	$		
Motor Vehicle			
- Market value	$			
- Amount owing on vehicle	$			
- Net value	$		
Value of household furniture and electrical goods	$		
Other assets	$		
Interest in a trust, business or partnership	$		
Sub total – non-liquid assets	$		
TOTAL of property and assets	$		

5.	Money in bank, credit union, building society accounts and other financial institutions in my name or that of my dependants’

Account Name	Name of Bank	Amount in account	
		$	
		$	
		$	
	TOTAL	$	
Please note you may be asked to provide documentary evidence to support your claim.
D	Details of expenses 	

6.	My day-to-day living expenses (including living expenses of my dependants that are normally paid by me), calculated fortnightly, are as follows:
	
Nature of Expense	$ per fortnight	Nature of Expense	$ per fortnight	
Rent / Board		Gas/electricity/other utilities		
Mortgage repayments		Telephone		
Other loan repayments		Health care		
Council / Water rates		Child care		
Insurance premiums		Education		
Food		Other:		
Clothing		Other:		
Spouse/Child maintenance		Other:		
Travel and motor vehicle		Other:		
Total of Column 1	$	Total of Column 2	$	
Total of Column 1 and Column 2	$	
Please note you may be asked to provide documentary evidence to support your claim.

E	Details of liabilities 	

["Liabilities" include outstanding mortgages, credit card debts, other moneys owed by you.  If any liabilities are owed jointly with someone other than a dependant, give the name of the other person.]
 [if no liabilities write "nil" below]

7.	My liabilities are as follows:

	My details	My dependants’ details	
Amount owing on my mortgage	$	$	
Amount owing on other loans	$	$	
Credit card			
- Amount owing	$	$	
- Limit of the card	$	$	
Amount owing to any businesses or individuals (please include details of each liability)	$	$	
Other, please specify
			
TOTAL amount owing	$	$	
Please note you may be asked to provide documentary evidence to support your claim.
F	Additional information		
[Please set out any other information concerning your financial position which you believe will help the Registrar or Authorised Officer decide your application for exemption or reduction of court fees.]	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	

G	Affidavit of applicant (to be signed in the presence of the witness)	
I swear/affirm (cross out incorrect one) that:
1.	I am the applicant for an exemption or reduction of court fees
2.	I have read this application and the details and other information attached to it
3.	The facts in it that are within my personal knowledge are true
4.	All other facts are true to the best of my knowledge, information and belief
5.	I have disclosed all relevant financial information
6.	I am aware that it is an offence to provide information or a document in connection with this application that is false or misleading
7.	I will notify the Court Registry if there are any changes to my circumstances that alter the information given in this application while the Court is dealing with my case.	

Signature	Sworn/affirmed [Cross out incorrect one]
	Place:     	Date:      /     /               	

Before me (signature of witness)	Full name of witness (please print)
	     	

Justice of the Peace	Other authorised person    	specify      

This application was prepared by:		applicant	lawyer  

(print name if lawyer)	     	

(Office Use Only)
Notice of request for more information	
Having considered your application, the Registrar/Authorised Officer requests you to provide documentary evidence and/or additional information about your income, assets, liabilities and day-to-day living expenses to support your claim 
In particular, you will need to provide the following	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	
     	

The documents listed above should be provided within 14 days of the date on which this notice was issued.  You can provide the originals or photocopies to the Court attached to the back of this application.

		     /     /     
	Signature of officer	date issued

For Court Use Only

	Notice of Decision on Application for  		Give Details	
	Exemption from Paying Court Fees		File Number:
	
Federal Court of Australia	on the Basis of Financial Hardship		File name:
	
Federal Circuit and Family Court of Australia (Division 2)	Federal Court and Federal Circuit and Family Court Regulations 2022
Section 2.21		Date lodged:

To:		

Decision on claim for exemption from payment of court fees

 	I approve your application for exemption from court fees payable.

 	I refuse your application for exemption from court fees payable. 

 	For a Federal Circuit and Family Court (Division 2) Application – Migration Act only – I approve your application for exemption from paying the full fee and have determined that you may instead pay the reduced fee	
	Reason for refusal: 

		

		

		

		

		

Date:
		.................................................................................................
	Registrar / Authorised Officer
	[Cross out the inapplicable one]

NOTE TO APPLICANT: Subject to the Administrative Review Tribunal Act 2024 (Cth), application may be made to the Administrative Review Tribunal for review of a decision not to exempt a person from paying a court fee on the grounds of financial hardship within 28 days of the date of this decision (see section 2.21 of the Federal Court and Federal Circuit and Family Court Regulations 2022).

Authorised by Principal Registrar FCFCOA/General Counsel FCA 14/10/2024