FL­230 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: ATTORNEY FOR (Name): FAX NO.: SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PETITIONER: RESPONDENT: CASE NUMBER: DECLARATION FOR DEFAULT OR UNCONTESTED JUDGMENT 1. I declare that if I appeared in court and were sworn, I would testify to the truth of the facts in this declaration. 2. I request that proof will be by this declaration and that I will not appear before the court unless I am ordered by the court to appear. 3. All the information in the Petition or Complaint to Establish Parental Relationship Response or Answer Petition to Establish Custody and Support Response is true and correct. 4. Respondent and/or Petitioner is/are the parent(s) of the minor child(ren). 5. A Voluntary Declaration of Paternity form has has not been signed regarding this child (attach a copy if available). 6. DEFAULT OR UNCONTESTED (Check a or b) a. The default of the respondent was entered or is being requested, and I am not seeking any relief not requested in the petition. OR b. The parties have stipulated that the matter may proceed as an uncontested matter without notice, and the stipulation is attached. 7. CHILD SUPPORT should be ordered as set forth in the proposed Judgment (form FL-250). Petitioner Respondent is presently receiving public assistance (TANF); thus all support should be made a. payable to the local child support agency at (specify address): b. NOTE: If a support order is requested, submit a completed Income and Expense Declaration (form FL-150), or Financial Statement (Simplified) (form FL-155), unless a current form is on file. Include your best estimate of the other party's gross monthly income. 8. 9. 10. 11. 12. ATTORNEY FEES should be ordered as set forth in the proposed Judgment (form FL-250). CHILD CUSTODY should be ordered as set forth in the proposed Judgment (form FL-250). CHILD VISITATION should be ordered as set forth in the proposed Judgment (form FL-250). REASONABLE EXPENSES OF PREGNANCY AND BIRTH should be ordered as set forth in the proposed Judgment (form FL-250). NAMES OF THE CHILDREN should be changed as set forth in the proposed Judgment (form FL-250). 13. This declaration may be reviewed by a commissioner sitting as a temporary judge who may determine whether to grant this request or require my appearance. 14. I have read and understand the Advisement and Waiver of Rights Re: Establishment of Parental Relationship (form FL-235), which is signed and attached to this declaration. 15. Other (specify): 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) Form Adopted for Mandatory Use Judicial Council of California FL-230 [Rev. January 1, 2003] (SIGNATURE OF DECLARANT) Page 1 of 1 Family Code, §§ 7600, 3120, 3900 et seq www.courtinfo.ca.gov. DECLARATION FOR DEFAULT OR UNCONTESTED JUDGMENT (Uniform Parentage, Custody and Support) 2003 © American LegalNet, Inc.