FL-455 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and address): FOR COURT USE ONLY TELEPHONE NO.: ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT: CASE NUMBER: STAY TERMINATION OF STAY OF SERVICE OF EARNINGS ASSIGNMENT ORDER APPLICATION FOR STAY (NOTICE: If this application is made separately from a hearing on support, you must get a hearing date from the clerk and give notice. See below.) I request that the court stay the service of the earnings assignment order in this case because (check one or more applicable reasons): I have paid fully and on time the previously ordered support for the last 12 months, and I do not owe any back support 1. (arrearages). I have not been subject to a support order for the last 12 months, but I have posted cash a cash bond with the 2. clerk of the court in the amount of $ , which is equal to three months' support, and I do not owe any back support (arrearages). Service of the earnings assignment would cause extraordinary hardship on me as follows (state reasons): 3. (Note: You must prove these reasons at any hearing on this application by clear and convincing evidence.) 4. 5. I have a written agreement with the party receiving support that provides a stay of service of the earnings assignment order. A copy of the agreement is attached. (Note: This agreement must be signed by the local child support agency if support is payable to a county officer designated for that purpose.) My employer or the local child support agency has been unable to deliver the support payments to the recipient for at least six months because the recipient has not notified my employer or the local child support agency of a change of address. (Attach a statement made under oath by employer or local child support agency.) I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME) (SIGNATURE OF APPLICANT) NOTICE OF HEARING A hearing on this application will be held as follows: a. Date: b. The address of the court Time: is shown above is: Dept.: Room: Page 1 of 2 Form Adopted for Mandatory Use Judicial Council of California FL-455 [Rev. January 1, 2003] STAY OF SERVICE OF EARNINGS ASSIGNMENT ORDER Family Code, §§ 5260, 5261 www.courtinfo.ca.gov 2003 © American LegalNet, Inc. PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT: CASE NUMBER: APPLICATION FOR TERMINATION OF STAY I request that the court terminate the stay of service of the earnings assignment previously issued in this case because (check one or more applicable reasons): on (date): The person required to make payments has missed at least one payment of support, which continues unpaid. (Note: A false 1. statement about missed payments is punishable as contempt.) the person required to make the payments I am the local child support agency, 2. and I wish the stay terminated. 3. 3 The reasons for granting the stay no longer exist. (A hearing is required. See page 1 for notice of hearing.) (State facts showing that the previous reasons for granting the stay no longer exist.) I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME) (SIGNATURE OF APPLICANT) PROOF OF SERVICE BY MAIL 1. I am at least 18 years of age and not a party to this cause. I am a resident of or employed in the county where the mailing took place, and my residence or business address is (specify): 2. I served a copy of this Stay of Service of Earnings Assignment Order by enclosing it in a sealed envelope with first-class postage fully prepaid and depositing it in the United States Postal Service as follows: a. Date of deposit: b. Place of deposit (city, state): c. Addressed as follows: I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME) (SIGNATURE OF DECLARANT) ORDER GOOD CAUSE APPEARING: Service of the earnings assignment order issued in this action is stayed. 1. The stay of service granted above will terminate without further order on (date): 2. The previous stay of service of the earnings assignment order made on (date): 3. and the earnings assignment order previously issued in this case may be served. is terminated, Date: (JUDICIAL OFFICER) FL-455 [Rev. January 1, 2003] STAY OF SERVICE OF EARNINGS ASSIGNMENT ORDER Page 2 of 2 2003 © American LegalNet, Inc.