FL-688 GOVERNMENTAL AGENCY (under Family Code, §§ 17400, 17406): 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: SHORT FORM ORDER AFTER HEARING 1. This matter proceeded as follows: a. b. c. d. e. f. Date: Dept: Petitioner/plaintiff present Respondent/defendant present Other parent/party present Uncontested Judicial Officer: Attorney present (name): Attorney present (name): Attorney present (name): CASE NUMBER: By stipulation Contested Attorney for local child support agency present under Family Code sections 17400 and 17406 by (name): Other (specify): 2. THE COURT FINDS, based upon the moving papers: a. (Name): is the parent ordered to pay support in this proceeding. b. The parent ordered to pay support has no ability to pay support because (specify): c. Health insurance coverage at no or reasonable cost is currently not available to the parent ordered to pay support to cover the minor children in this action. 3. THE COURT ORDERS b. c. d. e. a. All orders previously made in this action will remain in full force and effect except as specifically modified below. for the following purposes only: This matter is continued to: in Dept.: The parent ordered to pay support is ordered to appear on the continuance date. Current child support is modified to: $ per month beginning (date): The court retains jurisdiction to order support retroactive to: (1) (Specify date): (2) The date the parent ordered to pay support becomes employed or otherwise has the ability to pay support. (3) The date the parent ordered to pay support abandons or separates from the children at issue in this case. Any order to liquidate the support arrearage is suspended until further order of this court. f. g. 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. h. 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. Page 1 of 2 Form Adopted for Mandatory Use Judicial Council of California FL-688 [Rev. January 1, 2017] SHORT FORM ORDER AFTER HEARING (Governmental) American LegalNet, Inc. www.FormsWorkFlow.com Family Code, §§ 17400, 17402, 1740, 17406 www.courts.ca.gov FL-688 PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT/PARTY: CASE NUMBER: 3. i. j. The parents must notify the local child support agency in writing within 10 days of any change in residence or employment. The parent ordered to pay support is ordered to obtain health insurance coverage for the children in this action if it becomes available at no or reasonable cost. The party 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. Other (specify): k. 4. Number of pages attached: Approved as conforming to court order. Date: (SIGNATURE OF ATTORNEY FOR THE PARENT ORDERED TO PAY SUPPORT) Date: JUDICIAL OFFICER FL-688 [Rev. January 1, 2017] SHORT FORM ORDER AFTER HEARING (Governmental) American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2