PETITIONER: RESPONDENT: ADDENDUM TO JUDGMENT CUSTODY/VISITATION Legal and physical custody of the minor child/ren shall be as follows: Child's Name Birth Date CASE NUMBER: Legal Custody to: Physical Custody to: The other parent shall have the following secondary visitation rights: Reasonable right of visitation as agreed between the parties. As set forth in the order pursuant to Referral to the Child Custody Recommending Counseling Services, consisting of pages, which was filed on , and is attached and incorporated. Other: Pursuant to Family Code § 3048(a): (1) (2) (3) (4) (5) This court exercises jurisdiction under Family Codes § 3421-3424. Notice and opportunity to be heard were given under Family Code § 3425. A clear description of the custody and visitation rights of each party is set forth herein. Violation of the order may subject the party in violation to civil or criminal; penalties, or both. The habitual residence of the child/ren is the United States of America. CHILD SUPPORT A printout of the computer calculation and findings is attached and incorporated. Child support is allocated per child as shown on the printout. Guideline Child Support Findings: Federal Tax Filing Status: Petitioner: Single Head of Household Respondent: Single Head of Household Gross monthly incomes are as follows: Petitioner's $ Petitioner: Petitioner pays: Respondent pays: Married Filing Jointly Married Filing Separately Married Filing Jointly Married Filing Separately : Respondent's $ . % Respondent: per month. Mandatory Pension: $ Mandatory Pension: $ % Approximate percentage of time child/ren spend with each parent: Petitioner: Respondent is experiencing a statutory hardship of $ Medical Insurance: $ Medical Insurance: $ Union Dues:$ Union Dues: $ Based on the above, the amount of child support payable by Petitioner Respondent as calculated under the statutory guideline is $ per month. Support shall be allocated between minor children as follows: $ $ for support of the first (oldest) child; for support of the third child; $ $ for support of the second child; for support of the fourth child. Approved for Optional Use Riverside Superior Court RI-FL017 [Rev. 10/11/16] ADDENDUM TO JUDGMENT Page _____ of _____ Family Code § 3048(a) riverside.courts.ca.gov/localfrms.shtml American LegalNet, Inc. www.FormsWorkFlow.com PETITIONER: RESPONDENT: CASE NUMBER: ADDENDUM TO JUDGMENT Petitioner Respondent shall pay to the other party as and for Child Support Payments: child support the sum of $ per month due one-half on the first and one-half on the fifteenth day of each month commencing , and continues until further order of the court, or until each child has married, dies, is emancipated, reaches the age of 19, or reaches the age of 18 and is not a full-time student, which ever first occurs. Petitioner Respondent owes to the other parent child support arrears in the Arrears. principle sum of $ for the period of to . These arrears shall be paid as follows: $ per month due each month commencing , until paid in full. Non-Guideline Child Support: The parties acknowledge that : (1) they are fully informed of their rights concerning guideline child support; (2) they have agreed to the child support provisions of this Agreement without coercion or duress; (3) this Agreement is in the best interests of the child involved; (4) the needs of the child/ren will be adequately met by this agreed-upon child support; and (5) they have not assigned the right to support to the county and no public assistance application is pending, except as set forth below. Additional Child Support Orders: An Income Withholding Order for the above child support shall issue. Child Care. Respondent shall pay to the other parent for child care costs related to employment: per month commencing . The sum of $ A sum equal to one-half (1/2) of the verifiable daycare expenses. Petitioner Petitioner Health Care. Respondent shall obtain and/or maintain for the minor child/ren medical, dental, and visual insurance, if available at reasonable costs through employment, self-employment or union affiliation. The cost is presumed reasonable if it does not exceed 5% of the responsible parent's gross income. Any health expenses not paid by insurance shall be shared: Petitioner 50% and Respondent 50% If the person who receives child support enters into a contract with a private child support collector, the party ordered to pay support must pay the fee charged by the private support collector. The fee must not exceed 33 1/3 percent of the total amount of arrears 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. The Department of Child Support Services Reserved. The issue of child support is reserved. is collecting support for these children and this case shall be consolidated with case number . The Department of Child Support Services (DCSS) approves of the foregoing support order. Is no longer collecting. Has closed the (DCSS) case. Date: Approved for Optional Use Riverside Superior Court RI-FL017 [Rev. 10/11/16] (Signature of DCSS Attorney: ) (SIGNATURE) ADDENDUM TO JUDGMENT Page _____ of _____ Family Code § 3048(a) riverside.courts.ca.gov/localfrms.shtml American LegalNet, Inc. www.FormsWorkFlow.com PETITIONER: RESPONDENT: CASE NUMBER: ADDENDUM TO JUDGMENT STATISTICAL INFORMATION The parties were married or registered as domestic partners on There is/are no minor child/ren of the marriage/domestic partnership. SPOUSAL/PARTNER SUPPORT and separated on . Waiver: Petitioner Respondent knowingly and intelligently waive(s) spousal/partner support forever. Jurisdiction shall be terminated over spousal/partner support. When a court has no jurisdiction over support, no support can be ordered regardless of the hardship that this might cause. Termination. The court's jurisdiction to award spousal/partner support to the Respondent is terminated. Reserved. The court reserves jurisdiction over spousal/partner support as to Petitioner Respondent. Notwithstanding this reservation, the existing temporary spousal support order ordering to pay $ to the other party, shall remain Petitioner Respondent in effect until further order of the court, death of either party, or remarriage or registration of a new domestic partnership of the party receiving support. Petitioner Respondent shall pay to the othe