JV-134 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: CHILD(REN)'S NAME(S): CASE NUMBER: RESPONSE TO RECOMMENDATION REGARDING ABILITY TO REPAY COST OF LEGAL SERVICES I, (name): 1. 2. am a person responsible for the support of the child(ren) named above. I agree to repay the court for the cost of my legal services in the amount of $ , as recommended by the financial evaluation officer on the accompanying Recommendation Regarding Ability to Repay Cost of Legal Services. I agree to repay the court for the cost of legal services provided to the child(ren) in this case in the amount of $ , as recommended by the financial evaluation officer on the attached Recommendation Regarding Ability to Repay Cost of Legal Services (form JV-133). I promise to pay $ on the (1st, 2nd, etc.): the agreed amount is paid in full. a. b. day of every month, beginning on (date): until 3. I waive my right to a hearing on the recommendation and understand that the court will order me to pay the agreed amount under the terms above. I understand that if I default on these payment terms, the entire balance will become immediately due and payable on demand. 4. I dispute the recommendation of the financial evaluation officer regarding my ability to pay, and I have requested a hearing before the court to review that recommendation. a. I understand that a hearing has been scheduled on: Hearing date: at the Court address above Time: other (address): Dept./Room: b. I also understand that if I do not appear at this hearing and do not pay in full the assessed costs for legal services, the court may enter a judgment against me based on the financial evaluation officer's recommendation without further notice or order. I understand that I am entitled to the following at the hearing: c. · · · · · · 5. The opportunity to be heard in person; The opportunity to present witnesses and written evidence; The opportunity to confront and cross-examine witnesses brought against me; Disclosure of the evidence against me; A written statement of the findings of the court; and To be represented by a lawyer and, if I cannot afford a lawyer, to have a lawyer appointed to represent me. I understand that at any time before I complete payment of the full amount ordered by the court, I may petition the court to change its judgment if a change in circumstances affects my ability to pay the judgment. I declare under penalty of perjury under the laws of the State of California that the above information is true and correct. Date: Form Approved for Alternative Optional Use Instead of Form JV-136 Judicial Council of California JV-134 [New January 1, 2013] ( SIGNATURE OF RESPONSIBLE PERSON) Page 1 of 1 RESPONSE TO RECOMMENDATION REGARDING ABILITY TO REPAY COST OF LEGAL SERVICES Welfare and Institutions Code, §§ 903.1, 903.45(b), 903.47 www.courts.ca.gov American LegalNet, Inc. www.FormsWorkFlow.com