Free FL-615V - California


File Size: 293.4 kB
Pages: 4
Date: June 24, 2009
File Format: PDF
State: California
Category: Court Forms - State
Author: eduardo
Word Count: 3,753 Words, 11,923 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.courtinfo.ca.gov/forms/documents/fl615v.pdf

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C Quan Chnh Ph (theo B Lut Gia nh, on 17400, 17406):

FL-615 Dnh cho Ta S Dng

S iOEn Thoi: S iOEn Sao (ty nghi): Lut S i DiOEn cho (tn): Ta Thܮng Thm California, Qun a Ch ܩng: a Ch Gi Th: Thnh Ph v Bu Chnh: Tn ca Ngnh:

S iOEn Sao (ty nghi):

Ch cho mc ch cung cp thng tin m thi. Khng trnh trc Ta.

ng n/Nguyn n: B n/B Co: Cha m Bn kia:

Tha Thun vS Phn Quyt Phn Quyt B Tc Lin Quan n Trch V Cha M v Phn Quyt 1. ViOEc ny ܮc tin hnh nh sau: a. b. Bng tha thun vit, khng ra ta. iSu trn trܧc ta, trnh diOEn nh sau: (1) Ngy: (2)

S H S:

Ban:

Vin chc php ls:

ng n/Nguyn n c mt Lut s c mt (tn) (3) B n/B co c mt Lut s c mt (tn) (4) Cha m bn kia c mt Lut s c mt (tn) (5) C quan a phng vS cp dܫng con (B Lut Gia nh, on 17400, 17406, (tn): (6) iSu khc (ni r): ng n/nguyn n b n/b co cha m bn kia

c. Ngܩi c trch v php ls (cha hay m c lOEnh phi tr cp dܫng) l 2. LOEnh ny ܮc da vo cc ti liOEu nh km (ni r):

3. Cc bn ng s l a. Ngui c trch v php ls c c v hi
Km theo l mt mu in ra t my iOEn ton cho thy li tc ca cha m v t> lOE thi gian mi ngܩi cha hay m dnh cho tr con. Mu in trn cho thy phn chit tnh tiSn cp dܫng con phi tr, s tr thnh phn nhn xt ca ta.

Lu s: Bn no bt buc phi tr cp dܫng con phi tr tiSn li trn s tiSn qu hn theo gi bi Form Adopted for Mandatory Use Judicial Council of California FL-663 [Rev. January 1, 2009]

Tha Thun vS Phn Quyt hoc Phn Quyt B Tc Lin Quan n Trch V Cha M v Phn Quyt
(Chnh Ph)

Trang 1 trn 4 Family Code 17400. 17402, 17406 www.courtinfo.ca.gov

FL-615
ng n/Nguyn n: B n/B Co: Cha m Bn kia: S H S:

3. d.

ng n/Nguyn n

B n/B Co

Cha m bn kia l cha m ca cc tr c tn trong mc 3e dܧi y. S tiSn cp dܫng hng thng

e. Ngܩi c trch v php ls phi tr cp dܫng con hiOEn ti theo nh sau: Tn Ngy sanh

(1) (2) (3)

iSu khc (ni r): Tng cng s tiSn: $ bt u (ngy): p dng iSu chnh li tc thp. Khng p dng iSu chnh li tc thp v (ni r ls do): tr vo ngy: mi thng

(4) Mi cp dܫng ܮc lOEnh s tip tc cho n khi c lOEnh sau ca ta, tr khi chm dt do iSu hnh f. ca Ngܩi c trch v php ls phi tr cp dܫng con trong thi gian qua v s tiSn ܮc tnh nh sau. Tn Ngy sanh Thi gian h tr

S tiSn

(1)

iSu khc (ni r):

(2) (3)

Tng cng s tiSn: $

ngy: tr vo: $ bt u (ngy): TiSn li tch ly vo ton th< tiSn vn thiu v khng tnh trn mi k ng tiSn khi o hn.

mi thng

g. Nu l mt phn quyt vS mt Khiu Ni B Tc, iSu ny khng thay ǰi hoc thay th mi phn quyt hay lOEnh trܧc vS cp dܫng hoc n qu hn, tr khi ܮc ni r. h. Khng ܮc thi hnh iSu khon no ca phn quyt ny < gii hn mi quySn < thu tiSn vn (tng s tiSn cp dܫng cha tr) hoc tnh v thu tiSn li v tiSn pht theo lut cho php. Tt c tiSn tr theo lOEnh c th< ܮc thay ǰi. i. Tt c tiSn tr phi ghi tr cho (tn v a ch ca c quan):

j. Mt LOEnh Gi Li Tc < Cp Dܫng (mu FL-195/OMB S. 0970-0154) s ܮc ban hnh. k. Ngܩi nhn trch v php ls phi (1) cung cp v gi bo hi
FL-615 [Rev. January 1, 2009]

Tha Thun vS Phn Quyt hoc Phn Quyt B Tc Lin Quan n Trch V Cha M v Phn Quyt
(Chnh Ph)

Trang 2 trn 4

FL-615
ng n/Nguyn n: B n/B Co: Cha m Bn kia: S H S:

3. I. Cha m phi thng bo bng vn bn cho c quan a phng cp dܫng tr vS mi thay ǰi ni c tr hoc viOEc lm trong vng 10 ngy. m. nh km Thng Bo vS QuySn Hn v Trch NhiOEm -- Chi Ph Chm Sc Sc Khe v Th Tc Bi Hon v T Thng Tin vS Thay i LOEnh Cp Dܫng Con (mu FL - 192). n. Ngui c trch v php ls phi tr chi ph: $ v iSu kiOEn sau y (ni r): cho (ni r) theo iSu khon

o.

Ngܩi sau y ("cha m bn kia") ܮc thm vo nh l mt bn ca v kiOEn ny th< theo B Lut Gia nh on 17404 (tn):

p. Ngy:

iSu khc (ni r):

(nh My hoc Vit Tn Ch In)

(CH Ks cA LUT S C QUAN a PhNG vS Cp DUnG CON)

Ngy:
(nh My hoc Vit Tn Ch In)

(CH ks cA ng N)

Ngy:
(nh My hoc Vit Tn Ch In) (CH ks cA LUT S NG DON)

Ngy:
(nh My hoc Vit Tn Ch In) (Ch Ks ca B n)

Ngy:
(Ch Ks ca Lut S B n)

(nh My hoc Vit Tn Ch In)

Ngy:
(nh My hoc Vit Tn Ch In) (Ch Ks ca Cha m Bn kia)

Ngy:
(nh My hoc Vit Tn Ch In) (Ch Ks ca Lut S Bn Cha m Bn kia)

4. Sau y Ta Ra LOEnh. Ngy:

Phn Quyt

Vin Chc Php Ls

5. S trang nh km:
Ch Ks Sau T nh Km Cht

FL-615 [Rev. January 1, 2009]

Tha Thun vS Phn Quyt hoc Phn Quyt B Tc Lin Quan n Trch V Cha M v Phn Quyt
(Chnh Ph)

Trang 3 trn 4

FL-615
ng n/Nguyn n: B n/B Co: Cha m Bn kia: S H S:

iSu C Vn v Bi B QuySn trong Tha Thun 1. QuySn ܮc i DiOEn Bi Mt 5. Chp Nhn v Bi B QuySn. Ti 8. Ti tha thun theo iSu khon ca tha thun ny mt cch t do hi (nh My hoc Vit Tn Ch In) (Ch Ks ca Bn KiOEn)

Ngy:

Ti hi (nh My hoc Vit Tn Ch In) (Ch Ks ca Bn KiOEn)

Pht Bi
Ti chng nhn chiu theo hnh pht khai man th< theo lut ca Ti (nh My hoc Vit Tn Ch In)

Ngy:
(nh My hoc Vit Tn Ch In)

(Ch Ks) FL-615 [Rev. January 1, 2009] )

(Ch Ks) Trang 4 trn 4

Tha Thun vS Phn Quyt hoc Phn Quyt B Tc Lin Quan n Trch V Cha M v Phn Quyt
(Chnh Ph)