ATTACHMENT F CASE NAME: CASE NUMBER: SPOUSAL/FAMILY SUPPORT ATTACHMENT THE FACTS ARE: 1. INCOME: A. A COMPUTER PRINTOUT OF THE PARTIES’ FINANCIAL CIRCUMSTANCES IS ATTACHED. OR B. The parties’ incomes and deductions are: Gross Monthly Income Mother: on AFDC/TANF Father: Net Monthly Income on AFDC/TANF 2. HARDSHIPS: Not Applicable Hardships for the following have been allowed in calculating child support and the approximate ending time for the hardship is listed below: 3. OTHER FACTORS: THE COURT ORDERS: 1. a. Petitioner as and for Respondent shall pay the sum of $ temporary spousal support per month to Petitioner Respondent, family support, commencing on b. Said support shall terminate on: 2. A wage assignment shall issue for the payment of spousal/family support. NOTE: THE PAYOR OF SPOUSAL/FAMILY SUPPORT IS RESPONSIBLE FOR THE PAYMENT OF SUCH SUPPORT DIRECTLY TO THE RECEIPIENT OR THE FAMILY SUPPORT TRUSTEE UNTIL ANY WAGE ASSIGNMENT IS IN PLACE. 3. Service of the Wage Assignment is stayed provided the payor is not more than payment of spousal/family support. days late in the 4. FAMILY SUPPORT TRUSTEE: All support payments shall be made to the FAMILY SUPPORT TRUSTEE. The District Attorney FSB number is: . A copy of this order shall be served on the Santa Clara County Family Support Division of the District Attorney’s Office, 2645 Zanker Road, San Jose, CA 95134. 5 CHANGE OF EMPLOYMENT: Each party shall inform the other party in writing 15 days of any change in employment, including the employer’s name, address, and telephone number. 6. FAMILY CODE SECTION 4330 ADMONITION: It is the goal of this state that each party shall make reasonable good faith efforts to become self-supporting as provided for in Section 4320. The failure to make reasonable good faith efforts may be one of the factors considered by the court as a basis for modifying or terminating support. SPOUSAL/FAMILY SUPPORT ATTACHMENT Rev. 01/01/02 Petitioner Respondent FM-1005 2002 © American LegalNet, Inc.