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CV-410A

Petition for Waiver of Fees and Costs - Declaration of Indigency

Wisconsin · Wisconsin Court System · Effective September 12, 2024

This form is used by an individual to ask the court to waive filing and service fees because they are poor. It requires the person to fill out details about their income, assets, and household members.

The court describes it as: To be completed by an individual seeking to waive fees and costs in commencing, prosecuting, or defending any matter in any circuit court. Available in Spanish and Hmong.

Open the official PDFfrom Wisconsin Court System

Where this fits in a case

Start a case

Stage: Start a case

This form is used when a person needs to start, continue, or defend a case in a circuit court but cannot afford the required fees.

Either party may file.

Official instructions

How-to guides published by the court for this form.

Common questions

Who should fill out this form?
The form is for an individual who is asking the court to waive fees and costs.
What information does this form ask for?
It asks for details about your income, any benefits you receive, and your assets, such as savings and vehicles.
Is there a fee associated with filing this form?
The form is used to request a waiver of fees, meaning the person is asking not to have to pay fees.

Revision history

No changes recorded since we started tracking this form on October 10, 2026. The current version took effect September 12, 2024.

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