COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): : Plaintiff(s) TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): Index No. Calendar No. FL-665 FOR COURT USE ONLY : : : : JUDICIAL SUBPOENA -against- FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: Defendant(s) BRANCH NAME: : ...................................................... PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: THE PEOPLE OF THE STATE OF NEW YORK OTHER PARENT: CASE NUMBER: TO FINDINGS AND RECOMMENDATION OF COMMISSIONER 1. Name (specify): hearing this matter as a temporary judge. objected to Commissioner (name): 2. THIS MATTER PROCEEDED AS FOLLOWS a. GREETINGS: By court hearing, appearances as follows: Dept.: Judicial officer: (1) Date: Petitioner/plaintiff present Attorney present (name): (2) WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before the Honorable Respondent/defendant present at the present (name): Court (3) Attorney Other parent present located at (4) of Attorney present (name): County (5) by (name): in room Local child, support agency attorney (Family Code, §§ 17400, 17406)o'clock in the on the day of , 20 , at noon, and at any recessed (6) Other (specify): or adjourned date, to testify and give evidence as a witness in this action on the part of the b. The obligor (the parent ordered to pay support) is the petitioner/plaintiff respondent/defendant other parent. 3. Attached is a computer printout showing the parents' income and percentage of time each parent spends with the child(ren). The printout, which shows the calculation of child support payable, will become the court's findings. This recommended order comply with this subpoena is punishable as a contempt of court and will make you liable to 4. Your failure to is based on the attached documents (specify): 5. THE COMMISSIONER RECOMMENDS THE FOLLOWING result of your failure to comply. a. All orders previously made in this action remain in full force and effect except as modified below. mother father b. (Name of parent): Witness, , one of the mother father (Name of parent): Honorable are the parents of the children listed below. of Court in County, day , 20 c. Obligor must pay current child support as follows: Name Date of birth , the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Justices of the Monthly support amount (Attorney must sign above and type name below) (1) Other (specify): Attorney(s) for payable on the: day of each month (2) (3) For a total of: $ beginning (date): Office and The low-income adjustment applies. The low-income adjustment does not apply because (specify reasons): P.O. Address Telephone No.: NOTICE: Any party required to pay child support must pay interest on overdue amounts at the legal rate, which is Facsimile No.: currently 10 percent per year. Form Adopted for Alternative Mandatory Use instead of Form FL-692 Judicial Council of California FL-665 [Rev. July 1, 2005] E-Mail Address: FINDINGS AND RECOMMENDATION Mobile Tel. No.: OF COMMISSIONER (Governmental) Page 1 of 3 Family Code, § 4251 www.courtinfo.ca.gov American LegalNet, Inc. www.USCourtForms.com PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT: CASE NUMBER: 5. c. (4) Any support ordered will continue until further order of court, unless terminated by operation of law. d. Obligor must pay child support for past periods and in the amounts set forth below: Date of birth Period of support Name Amount (1) (2) (3) e. Other (specify): For a total of: $ beginning (date): Interest accrues on the entire principal balance owing and not on each installment as it becomes due. payable: $ on the: day of each month Obligor owes support arrears as follows, as of (date): (1) (2) (3) Child support: $ Spousal support: $ Family support: $ Interest is not included and is not waived. on the: day of each month Payable: $ beginning (date): (4) Interest accrues on the entire principal balance owing and not on each installment as it becomes due. f. No provision of this judgment/order may 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. g. All payments must be made to (name and address of agency): i. h. An Order/Notice to Withhold Income for Child Support (form FL-195) must issue. must (1) provide and maintain health insurance coverage for the children if it is available Obligee Obligor through employment or a group plan, or otherwise available at no or reasonable cost, and must keep the local child support agency 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 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; (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 must issue. j. The parents must notify the local child support agency in writing within 10 days of any change in residence or employment. k. The Notice of Rights and Responsibilities and Information Sheet on Changing a Child Support Order (form FL-192) is attached. 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 (specify): to (specify): The court further recommends (specify): n. Date: COMMISSIONER 6. Number of pages attached: SIGNATURE FOLLOWS LAST ATTACHMENT FL-665 [Rev. July 1, 2005] FINDINGS AND RECOMMENDATION OF COMMISSIONER (Governmental) Page 2 of 3 PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT: CASE NUMBER: CLERK'S CERTIFICATE OF MAILING OR SERVICE I certify that I am not a party to this cause and that 1. Personal service. A true copy of this Findings and Recommendation of Co