EXPEDITED PROCESSING ATTACHMENT TO DISSOLUTION OR SEPARATION JUDGMENT (Children) CASE NUMBER: WARNING: The Expedited Processing Attachment is only intended to include the minimum statutory requirements at the time of entry of judgment. It is not intended to replace the stipulated judgment or other required documents. I. DISCLOSURE (Family Code 2104, 2105) The parties have fully complied with the Disclosure requirements of FC 2102, 2104 and 2105 Preliminary Declaration of Disclosures (FC 2104) Petitioner filed the Declaration of Service (FL-141) on: or Submitted with Judgment Respondent filed the Declaration of Service (FL-141) on: ____________ or Submitted with Judgment Final Declaration of Disclosures (FC 2105) Petitioner filed the Declaration of Service (FL-141) on: or Submitted with Judgment Respondent filed the Declaration of Service (FL-141) on: ____________ or Submitted with Judgment Mutually Waived by: use of Stipulation and Waiver of Final Declaration of Disclosure Form (FL-144) Filed on: ________________ Submitted with Judgment use of the statutory language in a separate stipulation signed under penalty of perjury Stipulation submitted with Judgment See page _________ of Judgment II. CHILD CUSTODY/VISITATION (FC 3048) (1) This court has jurisdiction to make child custody orders in this case under the Uniform Child Custody Jurisdiction and Enforcement Act (part 3 of the California Family Code commencing with section 3400). (2) The responding party was given notice and an opportunity to be heard as provided by the laws of the State of California. (3) The country of habitual residence of the child(ren) is: The United States Other (specify country): (4) If you violate this order you may be subject to civil or criminal penalties, or both. (5) The judgment contains a clear description of the custody and visitation rights of each party. Expedited Attachment (Children) L-1300 (rev. 07/10) Page 1 American LegalNet, Inc. www.FormsWorkFlow.com III. CHILD SUPPORT (FC 3901/4065) (1) The parties are fully informed of their rights concerning child support. (2) The order is being agreed to without coercion or duress. (3) The agreement is in the best interests of the child(ren) involved. (4) The needs of the child(ren) will be adequately met by the stipulated amount. (5) The right to support has not been assigned to the county pursuant to Section 11477 of the Welfare and Institutions Code and no public assistance application is pending. Please check all appropriate boxes. At least one (1) box must be checked: AGREED UPON CHILD SUPPORT Father Mother shall pay to Father Mother child support of $ ______________ per week month, payable $_________________ on_____________________ and week month commencing $__________________ on ______________ of each ______________________ and continuing until the child for whom support is payable marries, dies, is emancipated, until further order of the court or, as to an unmarried child who has attained the age of 18 years old, is a full-time high school student, and who is not selfsupporting, until the time the child completes the 12th grade or attains the age of 19 years old, whichever first occurs. MONEY JUDGMENT IN COURT ORDER (FC 5616) 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. CHILD SUPPORT IS RESERVED DEPARTMENT OF CHILD SUPPORT SERVICES INVOLVED The parties currently have an open case with the Department of Child Support Services (DCSS) and a DCSS representative has signed the proposed judgment The parties currently have an open case with DCSS, no child support orders are contained in this judgment and the court reserves jurisdiction over the issue of child support, health insurance coverage, and mandatory additional child support. If checked, skip items IV and V. Expedited Attachment (Children) L-1300 (rev. 07/10) Page 2 American LegalNet, Inc. www.FormsWorkFlow.com IV. HEALTH INSURANCE COVERAGE (FC 3751) At least one (1) box must be checked: Health insurance coverage for the minor child(ren) must be maintained by Father Mother if that insurance is available at no cost or at reasonable cost to the parent through their respective places of employment or self-employment. Both parties are ordered to cooperate in the presentation, collection, and reimbursement of any health care claims. Father Mother shall maintain the existing health insurance coverage for the minor child(ren). Health insurance is not available to Father Mother at a reasonable cost at this time. Upon health insurance coverage at no or reasonable cost becoming available to a parent, that parent shall apply for that coverage. V. MANDATORY ADDITIONAL CHILD SUPPORT (FC 4062) Father Mother shall pay child care costs related to employment or reasonably necessary education/job training: in the amount of $_______________ per week month or ________% of total. no child care costs orders are contained in this judgment, and court reserves jurisdiction over the issue of child care costs Father VI. Mother shall pay the reasonable uninsured health care costs for the child(ren): in the amount of $_______________ per week month or _________% of total. REQUIRED ATTACHMENTS (FC 4063/7600) The parties have attached the following form: x Notice of Rights and Responsibilities: Health Care Costs and Reimbursement Procedures and Information Sheet on Changing a Child Support Order (Form FL-192) VII. ORDER/NOTICE TO WITHHOLD INCOME FOR CHILD SUPPORT (FC 5230) An Order/Notice to Withhold Income for Child Support (form FL-195) must issue. The payor of child support is responsible for the payment of support directly to the recipient until support payments are deducted from the payor’s wages, and for any support not paid by the assignment. VIII. EMPLOYER INFORMATION (FC 4014) The parties shall notify the other parent of the name and address of his or her current employer. IX. SPOUSAL SUPPORT (FC 4336) The parties had a marriage of 10 years or more, from the date of marriage to the date of separation, and spousal support has been addressed in the Marital Settlement Agreement/Stipulated Judgment. The parties agree to terminate the court’s jurisdiction (ability) to award spousal support. Expedited Attachment (Children) L-1300 (rev. 07/10) Page 3 American LegalNet, Inc. www.FormsWorkFlow.com X. MISCELLANEOUS PROVISIONS The Marital Settlement Agreement/Stipulated Judgment contains further orders. All provisions are deemed incorporated into the Judgment. As to the provisions that contain a checkbox ( ), only those provisions that are checked become part of the Judgment. If there is any express conflict between the Marital Settlement Agreement/Stipulated Judgment and this Expedited Processing Attachment, the Expedited Processing Attachment shall prevail. However, this Expedited Processing Attachment is not intended to be all inclusive. The fact that this Expedited Processing Attachment is less detailed is not a conflict. The Expedited Processing Attachment is only intended to include the minimum statutory requirements at the time of entry of judgment. It is not intended to replace the stipulated judgment or other required documents. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and agreed to by: ________________________________________ __________________________________________ Petitioner Date Respondent Date Approved as to form and content: ________________________________________ __________________________________________ Attorney for Petitioner Date Attorney for Respondent Date Expedited Attachment (Children) L-1300 (rev. 07/10) Page 4 American LegalNet, Inc. www.FormsWorkFlow.com