ATTACHMENT FM-1068 ATTORNEY OR PARTY WITHOUT AN ATTORNEY (Name and Address): TELEPHONE NUMBER: FOR COURT USE ONLY ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PETITIONER: 201 North First Street, San José, CA 95113 191 North First Street San José, California 95113 Family Justice Center RESPONDENT: CLAIMANT: CASE NUMBER: FCS NUMBER: PETITIONER'S RESPONDENT'S RESPONSE TO CHILDREN'S COUNSEL'S APPLICATION FOR PAYMENT OF ATTORNEY FEES AND COSTS 1. I, APJ: DEPARTMENT: , declare the following: I am the attorney for the Father/Mother of the minor children in this case. I am the Father/Mother of the minor children in this case. I am self-represented. A new Income and Expense Declaration is attached. I am attaching a copy of the Income and Expense Declaration I have filed previously because I declare that the information in it has not changed. REQUEST FOR ALLOCATION OF FEES FOR CHILD(REN)'S COUNSEL 2. I propose the following allocation of payment: Father to pay % and Mother to pay % of the ordered fees and costs. My reasons for proposing that allocation are the following: 3. I ask that the Court pay my part of the fees and costs for the following reason(s): 4. I request monthly payments, I believe I can pay $ per month. I declare under penalty of perjury under the laws of California that the foregoing is true and correct. Date: Signature FM-1068 REV 08/01/16 RESPONSE TO CHILDREN'S COUNSEL'S APPLICATION FOR PAYMENT OF ATTORNEY FEES Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com ATTACHMENT FM-1068 PETITIONER: RESPONDENT: CASE NUMBER: NOTICE TO PARTIES YOU MUST SUBMIT THIS FORM AND A CURRENT INCOME AND EXPENSE DECLARATION, JUDICIAL COUNCIL FORM FL-150 (OR A PREVIOUSLY-FILED INCOME AND EXPENSE DECLARATION IF YOU DECLARE THAT THE INFORMATION HAS NOT CHANGED) THE CLERK MUST RECEIVE THE APPLICATION WITHIN 21 CALENDAR DAYS OF THE DATE ON THE APPLICATION FOR FEES. DO NOT ADD AN ADDITIONAL FIVE DAYS FOR SERVICE BY MAIL. (*OR mail to Santa Clara County Superior Court, 191 North First St., San José, CA 95113). FAILURE TO SUBMIT A RESPONSE MAY RESULT IN AN ORDER DIRECTING YOU TO PAY UP TO 100% OF THE FEES AND COSTS REQUESTED. You must also mail or give a copy of this Response and the Income and Expense Declaration to the other party or his/her attorney, and file the attached Proof of Service with the Court. FM-1068 REV 08/01/16 RESPONSE TO CHILDREN'S COUNSEL'S APPLICATION FOR PAYMENT OF ATTORNEY FEES Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com