Free FL-632 Notice Regarding Payment of Support (Governmental) - California

FL-632
GOVERNMENTAL AGENCY (under Family Code, §§ 17400, 17406): RECORDING REQUESTED BY AND WHEN RECORDED MAIL TO:

FOR RECORDER'S USE ONLY TELEPHONE NO.: FAX NO.: FOR COURT USE ONLY

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

PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT:

NOTICE REGARDING PAYMENT OF SUPPORT
NOTICE OF ASSIGNED SUPPORT SUBSTITUTION OF PAYEE

CASE NUMBER:

1. The obligor (the person paying support) in this proceeding is (name and last known address):

2. a.

The local child support agency is providing the following services (check all that apply): Current support (1) Support arrears (2) Medical support (3) The local child support agency is no longer providing the services under title IV-D of the Social Security Act. The substituted payee is: The local child support agency (specify): a. Other (specify): b. An abstract or notice of support judgment or support judgment was recorded as follows: Date of recording County Book number Instrument number

b. 3.

4.

Page number

5. All payments must be made as follows (check all that apply): a. Income withholding payments must be directed to the State Disbursement Unit at (specify address): b. c. d. All current support payments other than income withholding payments must be sent to (specify): All arrears payments other than income withholding payments must be sent to (specify): Other (specify):

THE SUBSTITUTED PAYEE MUST BE CONTACTED WHEN NOTICE TO A LIENHOLDER MAY OR MUST BE GIVEN.
Page 1 of 2 Family Code, §§ 4200, 4201, 4204, 4350, 4351, 4506.3, 17400 www.courtinfo.ca.gov

Form Adopted for Mandatory Use Judicial Council of California FL-632 [Rev. July 1, 2008]

NOTICE REGARDING PAYMENT OF SUPPORT
(Governmental)

FL-632
PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT:
CASE NUMBER:

6.

An assignment of support rights by operation of law under Welfare and Institutions Code section 11477(a) has been made to the county of (specify): Each parent must notify the local child support agency in writing within 10 days of any change in residence or employment. Each parent must complete a Child Support Case Registry Form (FL-191) and deliver it to the court within 10 days of any change in residence or employment.

7. a. b.

Date:

(TYPE OR PRINT NAME)

(SIGNATURE)

NOTICE:
No acknowledgment is required when this form is recorded by a local child support agency.

ACKNOWLEDGMENT
(To be completed when this form is recorded by a person or entity other than a local child support agency.)
STATE OF CALIFORNIA COUNTY OF ) )

, before me, (here insert name and title of the officer) On personally appeared who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal.

,

(SIGNATURE OF NOTARY)

(Seal)

FL-632 [Rev. July 1, 2008]

NOTICE REGARDING PAYMENT OF SUPPORT
(Governmental)

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