FL-665 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS: ATTORNEY FOR (name): FAX NO.: SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT/PARTY: FINDINGS AND RECOMMENDATION OF COMMISSIONER 1. Name (specify): hearing this matter as a temporary judge. 2. THIS MATTER PROCEEDED AS FOLLOWS a. By court hearing, appearances as follows: Dept.: (1) Date: Petitioner/plaintiff present (2) (3) CASE NUMBER: objected to Commissioner (name): Judicial officer: Attorney present (name): Respondent/defendant present Attorney present (name): Attorney present (name): Other parent/party present (4) (5) Local child support agency attorney (Family Code, §§ 17400, 17406) by (name): (6) Other (specify): b. The parent ordered to pay support is the 3. 4. petitioner/plaintiff respondent/defendant other parent/party. 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 is based on the attached documents (specify): 5. THE COMMISSIONER RECOMMENDS THE FOLLOWING a. All orders previously made in this action remain in full force and effect except as modified below. b. (Name of parent): mother father (Name of parent): mother father are the parents of the children listed below. c. The parent ordered to pay support must pay current child support as follows: Date of birth Name of child Monthly support amount (1) Mandatory additional child support. (a) The parent ordered to pay support must pay additional monthly support for reasonable child-care costs, as follows: one-half or % or (specify amount): $ per month of the costs. Payments must be made to the other parent State Disbursement Unit child-care provider. (b) The parent ordered to pay support must pay reasonable uninsured health-care costs for the children, as follows: (specify amount): $ per month of the costs. one-half or % or Payments must be made to the other parent State Disbursement Unit health-care provider. 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 3 Form Adopted for Alternative Mandatory Use Instead of Form FL-692 Judicial Council of California FL-665 [Rev. January 1, 2017] FINDINGS AND RECOMMENDATION OF COMMISSIONER (Governmental) Family Code, § 4251 www.courts.ca.gov American LegalNet, Inc. www.FormsWorkFlow.com FL-665 PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT/PARTY: CASE NUMBER: 5. c. (2) Other (specify): (3) (4) For a total of: $ beginning (date): payable on the: day of each month The low-income adjustment applies. The low-income adjustment does not apply because (specify reasons): (5) Any support ordered will continue until further order of court, unless terminated by operation of law. (6) When a person who has been ordered to pay child support is in jail or prison or is involuntarily institutionalized for any period of more than 90 days in a row, the child support order is temporarily stopped. However, the child support order will not be stopped if the person who owes support has the financial ability to pay that support while in jail, prison, or an institution. It will also not be stopped if the reason the person is in jail, prison, or an institution is because the person didn't pay court ordered child support or committed domestic violence against the supported person or child. The child support order starts again on the first day of the month after the person is released from jail, prison, or an institution. d. The parent receiving support must (1) provide and maintain health insurance The parent ordered to pay support 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 percent 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 must pay child support for the past periods and in the amounts set forth below: Date of birth Period of support Amount Name of child e. (1) Other (specify): (2) (3) f. (1) (2) (3) (4) For a total of: $ beginning (date): payable: $ on the: day of each month 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): Child support: $ Spousal support: $ Family support: $ Interest is not included and is not waived. Payable: $ on the: day of each month beginning (date): Interest accrues on the entire principal balance owing and not on each installment as it becomes due. FL-665 [Rev. January 1, 2017] FINDINGS AND RECOMMENDATION OF COMMISSIONER (Governmental) Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com FL-665 PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT/PARTY: CASE NUMBER: 5. g. 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. h. All payments, unless specified in it