Minutes And Order Or Judgment

FL-692 SUPERIOR COURT OF CALIFORNIA, COUNTY OF FOR COURT USE ONLY STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT: ORDER CASE NUMBER: JUDGMENT MINUTES AND RECOMMENDED ORDER This form may be used for preparation of court minutes and/or as an alternative to form FL-615, FL-625, FL-630, FL-665, or FL-687. If this form is prepared as both court minutes and an alternative to one of these forms, then the parties do not need to prepare any additional form of order. 1. This matter proceeded as follows: Uncontested By stipulation Contested a. Date: Time: Department: b. Judicial officer (name): Judge pro Tempore Commissioner Court reporter (name): Court clerk (name): Bailiff (name): Interpreter(s) present (name): c. for (name): (specify language): Petitioner present Attorney present (name): d. e. Attorney present (name): Respondent present f. Other parent present Attorney present (name): g. Attorney for local child support agency (name): h. The parent ordered to pay support for purposes of this order is the i. Other (specify): 2. petitioner respondent other parent. This is a recommended order/judgment based on the objection of (specify name): 3. a. b. c. This matter is taken off calendar. This entire matter is denied with This matter is continued at the request of the other parent petitioner respondent to: Date: (Specify issues): Petitioner Respondent d. without prejudice. local child support agency Time: Department: Other parent is ordered to appear at that date and time. The court takes the following matters under submission (specify): 4. Order of examination The petitioner respondent Examination was held outside of court. 5. Referrals a. b. c. other (specify): was sworn and examined. The parties are referred to family court services or mediation. Respondent is referred to the family law facilitator. Petitioner Other parent Other (specify): THE COURT FINDS Respondent Petitioner Other parent was 6. Respondent Petitioner Other parent admits 7. The parents of the children named below in item 14a are (specify names): 8. was not denies served regarding this matter. parentage. Page 1 of 4 Form Adopted for Alternative Mandatory Use Instead of Form FL-615, FL-625, FL-630, FL-665, or FL-687 Judicial Council of California FL-692 [Rev. July 1, 2011] MINUTES AND ORDER OR JUDGMENT (Governmental) Family Code, §§ 17400, 17406 www.courts.ca.gov American LegalNet, Inc. www.FormsWorkFlow.com FL-692 PETITIONER/PLAINTIFF: CASE NUMBER: RESPONDENT/DEFENDANT: OTHER PARENT: 9. Respondent Petitioner Other parent has read, understands, and has signed the Advisement and Waiver of Rights for Stipulation (Governmental) (form FL-694). He or she gives up those rights and freely agrees that a judgment may be entered in accordance with these findings. 10. a. Guideline support amount: $ b. This order is is not based on the guideline. c. The attached Guideline Findings Attachment (Governmental) (form FL-693) is incorporated into these findings. d. A printout, which shows the calculation of child support payable, is attached and must become the court's findings. The child support agreed to by the parents is below above the statewide child support guideline. e. The amount of support that would have been ordered under the guideline formula is $ per month. The parties have been fully informed of their rights concerning child support. Neither party is acting out of duress or coercion. Neither party is receiving public assistance, and no application for public assistance is pending. The needs of the children will be adequately met by this agreed-upon amount of child support. The order is in the best interest of the children. If the order is below the guideline, no change of circumstance will be required for the court to modify this order. If the order is above the guideline, a change of circumstance will be required for the court to modify this order. The low-income adjustment applies. f. The low-income adjustment does not apply because (specify reasons): Arrearages from (specify date): are $ including interest 11. through (specify date): interest not computed and not waived. THE COURT ORDERS 12. All orders previously made in this action must remain in full force and effect except as specifically modified below. 13. Genetic testing must be coordinated by the local child support agency. a. b. 14. a. Respondent Petitioner Mother of the children Other (specify): and the minor children must each submit to genetic testing as directed by the local child support agency. The parent ordered to pay support must reimburse the local child support agency for genetic testing costs of $ . The parent ordered to pay support is the parent of the children listed below and must pay current child support for them. The court finds that there is sufficient evidence that the parent ordered to pay support is the parent of the children listed below and therefore there is sufficient evidence to enter a support order. Name of child Date of birth Monthly basic support amount b. c. d. e. Additional children are listed on an attached page. The parent ordered to pay support must pay additional support monthly for actual child-care costs: one-half percent of said costs. (specify amount): $ (specify percent): Payments must be made to the State Disbursement Unit other party child-care provider. The parent ordered to pay support must pay reasonable uninsured health-care costs for the children: (specify amount): $ one-half (specify percent): percent of said costs. health-care provider. Payments must be made to the State Disbursement Unit other party The parent ordered to pay support must pay additional support monthly for the following (specify): (specify amount): $ one-half (specify percent): Payments must be made to the Other (specify): State Disbursement Unit other party. 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. FL-692 [Rev. July 1, 2011] MINUTES AND ORDER OR JUDGMENT (Governmental) Page 2 of 4 FL-692 PETITIONER/PLAINTIFF: CASE NUMBER: RESPONDENT/DEFENDANT: OTHER PARENT: 14. f. For a total of $ payable on the beginning (date): The low-income adjustment applies. The low-income adjustment does not apply because (specify reasons): g. day of each month h. i. 15. 16. 17. Any support ordered will continue until further order of court, unless terminated by operation of law. As provided in Family Code section 4007.5, the obligation of the person ordered to pay support will be temporarily suspended for any period after the first 90 consecutive days in which the person ordered to pay support is incarcerated or involuntarily institutionalized, unless that person has the ability to pay support during that time or has committed certain crimes. Immediately after the person ordered to pay support is released from incarceration or involuntary institutionalization, the support order will restart in the same amount as it was before it was temporarily suspended. The parent ordered to pay support The parent receiving support must (1) provide and maintain health insurance coverage for the children if available at no or reasonable cost and keep the local child support agency informed of the availability of the coverage (the cost is presumed to be reasonable if it does not exceed 5% of gross income to add a child); (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. The parent ordered to provide health insurance must seek continuation of coverage for the child after the child attains the age when the child is no longer considered eligible for coverage as a dependent under the insurance contract, if the child is incapable of self-sustaining employment because of a physically or mentally disabling injury, illness, or condition and is chiefly dependent upon the parent providing health insurance for support and maintenance. The parent ordered to pay support may claim the children for tax purposes as long as all child support payments are current as of the last day of the year for which the exemptions are claimed. Petitioner Respondent Other parent must pay to petitioner respondent other parent as spousal support family support payable on the 18. $ per month, beginning (date): day of each month. The parent ordered to pay support must pay child support for the following past periods and in the following amounts: Name of child a. For a total of $ Amount Other (specify): b. Period of support payable $ on the day of each month beginning (date): c. 19. Interest accrues on the entire principal balance owing and not on each installment as it becomes due. The parent ordered to pay support owes support arrears as follows, as of (date): a. b. c. d. Spousal support: $ Family support: $ Other: $ Child support: $ Interest is not computed and is not waived. on the day of each month Payable: $ beginning (date): Interest accrues on the entire principal balance owing and not on each installment as it becomes due. 20. No provision of this judgment can operate to limit any right to collect all sums owing in this matter as otherwise provided by law. 21. All payments, unless specified in items 14b, c, and d above, must be made to the State Disbursement Unit at the address listed below (specify address): FL-692 [Rev. July 1, 2011] MINUTES AND ORDER OR JUDGMENT (Governmental) Page 3 of 4 FL-692 PETITIONER/PLAINTIFF: CASE NUMBER: RESPONDENT/DEFENDANT: OTHER PARENT: 22. An earnings assignment order is issued. 23. In the event that there is a contract between a party receiving support and a private child support collector, the party ordered to pay support must pay the fee charged by the private child support collector. This fee must not exceed 33 1/3 percent of the total amount of past due support nor may it exceed 50 percent of any fee charged by the private child support collector. The money judgment created by this provision is in favor of the private child support collector and the party receiving support, jointly. 24. If “The parent ordered to pay support” box is checked in item 15, a health insurance coverage assignment must issue. 25. Job search. (Specify name(s)): must seek employment for at least (specify number): jobs per week and report those job applications and results to the court and the local child support agency at the continuance date. These job applications are to be made in person, not by phone, fax, or e-mail. 26. For purposes of the licensing issue only, the parent ordered to pay support is found to be in compliance with the support order in this action. The local child support agency must issue a release of license(s). 27. Notwithstanding any noncompliance issues with the support order in this action, the court finds that the needs of the party ordered to pay support warrant a conditional release. The local child support agency must issue a release of license(s). Such release is effective only as long as the parent ordered to pay support complies with all payment terms of this order. 28. A warrant of attachment/bench warrant issues for (specify name): a. Bail is set in the amount of $ b. Service is stayed until (date): 29. The court retains jurisdiction to make orders retroactive to (date): 30. The court reserves jurisdiction over all issues the issues of (specify): 31. The parents must notify the local child support agency in writing within 10 days of any change in residence or employment. 32. The Notice of Rights and Responsibilities (Health-Care Costs and Reimbursement Procedures) and Information Sheet on Changing a Child Support Order (form FL-192) are attached and incorporated. 33. The following person (the “other parent”) is added as a party to this action (name): 34. The court further orders (specify): Approved as conforming to court order. Date: (SIGNATURE OF ATTORNEY FOR THE PARENT ORDERED TO PAY SUPPORT) Date: (SIGNATURE OF ATTORNEY FOR LOCAL CHILD SUPPORT AGENCY) JUDICIAL OFFICER Signature follows last attachment. Number of pages attached: FL-692 [Rev. July 1, 2011] MINUTES AND ORDER OR JUDGMENT (Governmental) Page 4 of 4