FL-678 GOVERNMENTAL AGENCY (under Family Code, §§ 17400, 17406): TELEPHONE NO.: FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT: LEVYING OFFICER FILE NO.: COURT CASE NO.: ORDER DETERMINING CLAIM OF EXEMPTION THIRD-PARTY CLAIM for an order determining the 1. The application of (name): claim of exemption third-party claim of (name): by stipulation a. by court hearing, appearances as follows: b. Judicial officer: Dept.: (1) Date: Judgment debtor present (name): (2) Judgment debtor's attorney present (name): (3) Third-party claimant present (name): (4) Third-party claimant's attorney present (name): (5) Other parent present (name): (6) Other attorney present (name): (7) (8) Local child support agency attorney (Family Code, §§ 17400, 17406) (name): 2. The court considered the evidence. 3. IT IS ORDERED denied. granted The claim of exemption is a. The claim of exemption is granted in part (specify): b. proceeded c. d. denied . granted The third-party claim is The third-party claim is granted in part (specify): e. The following property must be released to (name): (specify property): f. The following property must be applied to the judgment (specify property): g. Other (specify): Date: (JUDICIAL OFFICER) Page 1 of 1 Form Adopted for Mandatory Use Judicial Council of California FL-678 [Rev. January 1, 2003] ORDER DETERMINING CLAIM OF EXEMPTION OR THIRD-PARTY CLAIM (Governmental) Code of Civil Procedure, § 703.550 www.courtinfo.ca.gov. 2002 © American LegalNet, Inc.