Free FL-401 APPLICATION FOR DISBURSEMENT AND ORDER FOR DISBURSEMENT FROM CHILD SUPPORT SECURITY DEPOSIT - California


File Size: 60.2 kB
Pages: 1
Date: June 24, 2009
File Format: PDF
State: California
Category: Court Forms - State
Author: U0018446
Word Count: 506 Words, 3,239 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.courtinfo.ca.gov/forms/documents/fl401.pdf

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Preview FL-401 APPLICATION FOR DISBURSEMENT AND ORDER FOR DISBURSEMENT FROM CHILD SUPPORT SECURITY DEPOSIT
COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. TELEPHONE NO.: ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and address): : Index No. :
ATTORNEY FOR (Name):

FL-401
FOR COURT USE ONLY

Calendar No.

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

Plaintiff(s)

: : : :

JUDICIAL SUBPOENA

-against-

PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT:

Defendant(s) : ......................................................

CASE NUMBER:

APPLICATION FOR DISBURSEMENT AND ORDER FOR DISBURSEMENT FROM CHILD SUPPORT SECURITY DEPOSIT

THE PEOPLE OF THE STATE OF NEW YORK TO
APPLICATION FOR DISBURSEMENT FROM CHILD SUPPORT SECURITY DEPOSIT

1. The undersigned is entitled to receive child support payments. A deposit has been established to secure payment of the child support. The support is more than 10 days late, as follows: Amount due Date due Amount paid Amount due as child support

GREETINGS: 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 in room , on the day of , 20 , at o'clock in the noon, and at any recessed Total amount due: or adjourned date, to testify and give evidence as a witness in this action on the part of the
2. I request that the court order disbursement of the amount due from the child support security deposit. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Date: result of your failure to comply. Witness, Honorable , one of the Justices of the Court in County, on the obligor and proof of,its service attached to the original that is filed with the court. day of 20 A copy of this application must be served
ORDER FOR DISBURSEMENT FROM CHILD SUPPORT SECURITY DEPOSIT AND ORDER TO REPLENISH FUNDS
3. The following financial institution (name): must pay the following amount: $ support (name):
(Attorney must sign above and type name below) to the following person who is entitled to receive payment of child
(TYPE OR PRINT NAME) (SIGNATURE)

Attorney(s) for 4. The obligor (name): must replenish the child support security deposit by depositing the following amount: $ not later than (date): The original evidence of replenishment must be filed with the court. A copy of the evidence of replenishment must be served on the person entitled to receive payment of the child support.
Date:

Office and P.O. Address
JUDGE OF THE SUPERIOR COURT

5. I certify that the foregoing order is a copy of the original on file with the court. Date:
Form Adopted for Mandatory Use Judicial Council of California FL-401 [Rev. January 1, 2003]

DISBURSEMENT FROM CHILD SUPPORT SECURITY DEPOSIT

Telephone No.: No.: E-Mail Address: APPLICATION FOR DISBURSEMENTMobile Tel. No.: AND ORDER FOR
Clerk, Facsimile by

, Deputy
Page 1 of 1 Family Code, §§ 4570­4573 www.courtinfo.ca.gov

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