Free FL-630 Judgment Regarding Parental Obligations (Governmental) - California

FL-630
GOVERNMENTAL AGENCY (under Family Code, §§ 17400,17406): FOR COURT USE ONLY

TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name):

FAX NO. (Optional):

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

PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT:

JUDGMENT REGARDING PARENTAL OBLIGATIONS
AMENDED 1. a. SUPPLEMENTAL

CASE NUMBER:

NOTICE: THIS IS A PROPOSED JUDGMENT. This Judgment Regarding Parental Obligations will be entered by the court and will become legally binding unless you fill out and file the Answer to Complaint or Supplemental Complaint Regarding Parental Obligations (Governmental) (form FL-610) with the court clerk within 30 days of the date you were served with the Summons and Complaint or Supplemental Complaint Regarding Parental Obligations (Governmental) (form FL-600). If you need form FL-610, you may get one from the local child support agency's office, the court clerk, or the family law facilitator. The family law facilitator will help you fill out the forms. To file the answer, follow the procedures listed in the attached instructions. b. NOTICE: THIS IS A JUDGMENT. It is now legally binding. 2. This matter proceeded as follows: a. Judgment entered under Family Code section 17430. b. By court hearing, appearances as follows: (1) Date: Judicial officer: Dept.: Attorney present (name): Petitioner/plaintiff present (2) Attorney present (name): (3) Respondent/defendant present Attorney present (name): (4) Other parent present (5) Local child support agency attorney (Family Code, §§ 17400,17406) (name): Other (specify): (6) c. The obligor (the parent ordered to pay support) is the petitioner/plaintiff respondent/defendant other parent. 3. This order is based on presumed income for the obligor under Family Code section 17400. 4. Attached is a computer printout showing the parents' incomes and percentage of time each parent spends with the children. The printout, which shows the calculation of child support payable, will become the court's findings. 5. This order is based on the attached documents (specify):

THE COURT ORDERS 6. a. The mother and father listed in the complaint are the parents of the children named in item 6b. b. Obligor must pay current child support as follows: Date of birth Monthly support amount Name

(1) (2)

Other (specify): For a total of: $ beginning (date): payable on the: day of each month

NOTICE: Any party required to pay child support must pay interest on overdue amounts at the legal rate, which is currently 10 percent per year.
Page 1 of 2 Form Adopted for Alternative Mandatory Use instead of Form FL-692 Judicial Council of California FL-630 [Rev. July 1, 2008]

JUDGMENT REGARDING PARENTAL OBLIGATIONS
(Governmental)

Family Code, §§ 17400,17402, 17404,17430 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkflow.com

FL-630
PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT:
CASE NUMBER:

6. b. (3)

The low-income adjustment applies. The low-income adjustment does not apply because (specify reasons):

(4) Any support ordered will continue until further order of court, unless terminated by operation of law. c. Obligor must pay child support for the past periods and in the amounts set forth below: Name Date of birth Period of support Amount

(1) (2) (3)

Other (specify): $ on the: For a total of: $ payable: day of each month beginning (date): Interest accrues on the entire principal balance owing and not on each installment as it becomes due.

d. If this is a judgment on a Supplemental Complaint, it does not modify or supersede any prior judgment or order for support or arrearage, unless specifically provided. e. No provision of this judgment can operate to limit any right to collect the principal (total amount of unpaid support) or to charge and collect interest and penalties as allowed by law. All payments ordered are subject to modification. f. All payments must be made to (name and address of agency):

g. An Income Withholding for Support (form FL-195) will issue. must: (1) provide and maintain health insurance coverage for the children if it is available h. Obligor Obligee through employment or a group plan, or otherwise available at no or reasonable cost, and must keep the local child support agency office informed of the availability of the coverage; (2) if health insurance is not available, provide coverage when it becomes available; (3) within 20 days of the local child support agency's request, complete and return a health insurance form; (4) provide to the local child support agency all information and forms necessary to obtain health-care services for the children; (5) present any claim to secure payment or reimbursement to the other parent or caretaker who incurs costs for health-care services for the children; and (6) assign any rights to reimbursement to the other parent or caretaker who incurs costs for health-care services for the children. If the "Obligor" box is checked, a health insurance coverage assignment will issue. i. The parents must notify the local child support agency in writing within 10 days of any change in residence or employment. j. The form Notice of Rights and Responsibilities--Health-Care Costs and Reimbursement Procedures and Information Sheet on Changing a Child Support Order (form FL-192) is attached. k. l. m. The following person (the "other parent") is added as a party to this action under Family Code section 17404 (name): Obligor must pay costs of: $ The court further orders (specify):

Date:
JUDICIAL OFFICER

7. Number of pages attached:
SIGNATURE FOLLOWS LAST ATTACHMENT

Approved as conforming to court order: Date:

(SIGNATURE OF ATTORNEY FOR OBLIGOR)

FL-630 [Rev. July 1, 2008]

JUDGMENT REGARDING PARENTAL OBLIGATIONS
(Governmental)

Page 2 of 2