Free FL-616 DECLARATION FOR AMENDED PROPOSED JUDGMENT (Governmental) - California

COURT
GOVERNMENTAL AGENCY (under Family Code §§ 17400, 17406):

COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TELEPHONE : AND FAX NOS.: Index No. : Plaintiff(s) : : : : Defendant(s) : ..................................... Calendar No.

FL-616
FOR COURT USE ONLY

JUDICIAL SUBPOENA

-againstSUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME:

PETITIONER/PLAINTIFF:

................ RESPONDENT/DEFENDANT:.
OTHER PARENT:

THE PEOPLE OF THE STATE OF NEW YORK TO

DECLARATION FOR AMENDED PROPOSED JUDGMENT

CASE NUMBER:

1. The local child support agency is providing enforcement services in this case. a Summons and Complaint Regarding Parental Obligations (form FL-600) was filed requesting 2. On (date): the GREETINGS: support based on the California support guideline. The amount of the support requested was based on the Obligor pay child Obligor's gross monthly income as follows (check one): a.

3. Since the service of the Summons and Complaint Regarding Parental Obligations (form FL-600) a.

WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of per month. Known income of: $ b. in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the
Presumed income as provided by law. the local child support agency has received additional income information that would result in a different support order. According to this information, Obligor's gross monthly income is: $ Your failure to comply with this subpoena is punishable as aincome is: $ court and will make you liable contempt of Obligee's gross monthly

to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a of your failure to comply. b. resultObligor's income has become unknown.
c. OtherWitness, Honorable (specify):

, one of the Justices of the day of , 20

4. An amended proposed judgment is attached.

Court in

County,

I declare under penalty of perjury under the laws of the State of California that(Attorney must sign above and type name below) the foregoing is true and correct. Date:

Attorney(s) for

(TYPE OR PRINT NAME)

(SIGNATURE OF DECLARANT)

Office and P.O. Address

Form Adopted for Mandatory Use Judicial Council of California FL-616 [Rev. January 1, 2003]

Telephone No.: Facsimile No.: E-Mail Address: DECLARATION FOR AMENDED PROPOSED JUDGMENT Mobile Tel. No.: (Governmental)

Page 1 of 2 Family Code, § 17400, 17406 www.courtinfo.ca.gov

American LegalNet, Inc. www.USCourtForms.com

PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT:

CASE NUMBER:

PROOF OF SERVICE
5. I served this declaration and the attached amended proposed judgment on the Obligor. a. Personal delivery. I personally delivered this declaration and judgment to the Obligor as follows: (1) Name: (2) Address where delivered: (3) Date of delivery: (4) Time of delivery: b. Mail. I deposited this declaration and judgment in the United States mail, in a sealed envelope with postage fully prepaid. I used first-class mail. The envelope was addressed and mailed as follows: (1) Name: (2) Address: (3) Date of mailing: (4) Place of mailing (city and state): I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date:

(TYPE OR PRINT NAME)

(SIGNATURE OF PERSON WHO SERVED OBLIGOR)

6. I served this declaration and the attached amended proposed judgment on the other parent. a. Personal delivery. I personally delivered this declaration and judgment to the other parent as follows: (1) Name: (2) Address where delivered: (3) Date of delivery: (4) Time of delivery. b. Mail. I deposited this declaration and judgment in the United States mail, in a sealed envelope with postage fully prepaid. I used first-class mail. The envelope was addressed and mailed as follows: (1) Name: (2) Address: (3) Date of mailing: (4) Place of mailing (city and state): I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date:

(TYPE OR PRINT NAME) FL-616 [Rev. January 1, 2003]

(SIGNATURE OF PERSON WHO SERVED OTHER PARENT) Page 2 of 2

DECLARATION FOR AMENDED PROPOSED JUDGMENT (Governmental)