ATTACHMENT FM-1083 ATTORNEY OR PARTY WITHOUT 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: RESPONDENT: OTHER PARENT/CLAIMANT: STIPULATION AND ORDER Modification 1. Not based on a hearing Today's Hearing (date) 2. Judge: CASE NUMBER: DEPARTMENT: Temporary 3. The parties agree that the Court will make orders about the following items: Custody/Visitation Child Support Spousal or Family Support Arrears Attorney's Fees and Costs Other: All other issues are reserved until further Court order 4. Parties/Attorneys: Petitioner present in court Respondent present in court Claimant present in court Child's Attorney/Other (specify): 5. Petitioner's attorney present: Respondent's attorney present: Claimant's attorney present: present: on (date) at (time) Continued Hearing: This hearing is continued to (dept) about the following issues: 6. Number of attached pages: Do not use this form for domestic violence restraining orders. Those orders must be made on a Restraining Order after Hearing (CLETS), form DV-130. We have read this entire Stipulation and Order, including all Attachments. We understand it fully and ask that the Court make our stipulation into court orders. FM -1083 NEW 07/01/11 STIPULATION AND ORDER Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com PETITIONER: RESPONDENT: CASE NUMBER: Date: Petitioner Date: Attorney for Petitioner Date: Respondent Date: Attorney for Respondent Date: Child's Attorney Date: Other: Date: Other: Interpreter Witness Declaration Interpreter: The Petitioner and its attachments because: a. b. other (specify): Respondent is unable to read or understand this Stipulation and Order his/her primary language is (specify): I certify under penalty of perjury under the laws of the State of California that I have, to the best of my ability, read or Petitioner Respondent this Stipulation and Order including all attachments. He or she translated for the said they understood this Stipulation and Order and its attachments before signing them. Date Interpreter's printed name Interpreter's signature ORDER The Court approves the terms stipulated and agreed to in this document by the parties and makes them court orders. All previous orders that are not inconsistent with these orders remain in full force and effect. Date: Judicial Officer of the Superior Court FM-1083 NEW 07/01/11 STIPULATION AND ORDER American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2