dates by

Cal. Form L-3052B

California Superior Local Rules

DATE: CASE NAME: CASE NUMBER: Form Approved for Optional Use L-3052B [New. 02/05/2026] STIPULATION - SETTLEMENT AGREEMENT PAGE ___ OF ___ CHILDREN AND PARENTAGE ORDERS: 24. The Petitioner and Respondent are the parents of each minor child listed here: Name: Birth Date: Any reference in this document to a minor child refers to any minor child listed above unless otherwise specified. JURISDICTION OVER CHILD CUSTODY (Family Code

section 3048, Mandatory) 25. This court’s basis for the exercise of jurisdiction over each minor child is that this is a proceeding under the California Family Code in which this court is authorized to make child custody orders, (Family Code

section 3021(a)-(

g) or Family Code

section 3104) AND; ☐ The country of habitual residence of each minor child for all purposes is the United States, (42 United States Code

section 11601 et seq.) AND; ☐ The home state for all purposes is the State of California, (Family Code

section 3421, 42 United States Code

section 11601 et seq.); OR ☐ Each minor child has a significant connection with this state and there is either no home state or no home state that has not already declined to exercise its jurisdiction (Family Code sections 3421, 3423) OR ☐ This state has temporary emergency jurisdiction under the UCCJEA (Family Code

section 3424) OR ☐ All necessary parties have acquiesced in this court’s exercise of jurisdiction over the custody of each child. CHILD CUSTODY ORDERS (Family Code sections 3000-3204): Unless otherwise provided herein, the agreements that are to be included in a judgment or modification of a prior judgment shall be considered as a final determination of the child custody and visitation litigation. Under Family Code

section 3025, access to records and information pertaining to a minor child, including health care and school records, shall not be denied to a parent because that parent is not a custodial parent. 26. ☐ Custody of each minor child is awarded pursuant to the Family Court Services agreement dated/filed: _______ 27. ☐ Existing child custody orders shall remain in full force and effect except as otherwise provided herein. LEGAL CUSTODY ORDERS Legal custody of each minor child is awarded as follows: 28. ☐ JOINT LEGAL CUSTODY. (Family Code

section 3003) Both parents shall share the right and responsibility to make decisions relating to the health, education and welfare of each minor child. Such decisions shall include, but are not limited to, those specified in item 48 herein, if any. Joint legal custody does not permit actions that are inconsistent with the physical custody unless the action is expressly authorized by the court. Either parent acting alone may exercise legal control of each minor child except under circumstances, if any, in which the consent of both parents is required by agreement or court order (Family Code

section 3083). 29. The consequences for failure to obtain mutual consent when required by court order are as follows (Family Code

section 3083): a. Willful disobedience of a lawful court order may be contempt of court (Code of Civil Procedure sections 1209-1222) and a misdemeanor (Penal Code

section 166). b. Such failure may be a lawful reason for the court to change the legal and physical custody of a minor child. c. Other consequences, if any, may be specified in this agreement or by court order.

DATE: CASE NAME: CASE NUMBER: Form Approved for Optional Use L-3052B [New. 02/05/2026] STIPULATION - SETTLEMENT AGREEMENT PAGE ___ OF ___ 30. ☐ SOLE LEGAL CUSTODY (Family Code

section 3006) is awarded to the ☐ Petitioner ☐ Respondent, who shall have the right and responsibility to make decisions relating to the health, education and welfare of each minor child. PHYSICAL CUSTODY ORDERS Physical custody of each minor child is awarded as follows (Select one of the following): 31. ☐ JOINT PHYSICAL CUSTODY. (Family Code

section 3004) Each parent shall have significant periods of physical custody. Joint physical custody shall be shared by the parents in such a way so as to ensure each minor child of frequent and continuing contact with both parents. (See item 33 for specific arrangements, if any) 32. ☐ SOLE PHYSICAL CUSTODY (Family Code

section 3007) is awarded to ☐ Petitioner ☐ Respondent. Each minor child shall reside with and be under the supervision of that parent subject to the power of the court to order visitation.

Reasonable visitation ☐ IS (OR) ☐ IS NOT, awarded to ☐ Petitioner ☐ Respondent. (See item 33 for specific arrangements, if any) PARENTING PLAN: 33. ☐ Petitioner ☐ Respondent shall have the custody of and responsibility for each minor child during the following times periods and the times not specified herein shall be for the other party: (ONLY CHECK BOXES THAT APPLY, COMPLETE BLANKS THAT APPLY, AND CIRCLE THE OPTIONS THAT APPLY) ☐ Alternate weeks or weekends from __________ (day) at __________ (time) to __________ (day) at __________ (time) starting __________ (date). ☐ Alternate weeks or weekends from __________ (day) at __________ (time) to __________ (day) at __________ (time) starting __________ (date). ☐ 1 st ☐ 2 nd ☐ 3 rd ☐ 4 th ☐ 5 th weekends of each month from __________ (day) at __________ (time) to __________ (day) at __________ (time) starting __________ (date). ☐ 1 st ☐ 2 nd ☐ 3 rd ☐ 4 th ☐ 5 th weekends of each month from __________ (day) at __________ (time) to __________ (day) at __________ (time) starting __________ (date). (1 st weekend is the weekend with the first Saturday of each month) ☐ Each week from __________ (day) at __________ (time) to __________ (day) at __________ (time) starting __________ (date). ☐ Each week from __________ (day) at __________ (time) to __________ (day) at __________ (time) starting __________ (date). ☐ Each week on __________ (day) from __________ (time) to __________ (time) starting __________ (date). ☐ Each week on __________ (day) from __________ (time) to __________ (time) starting __________ (date).

Vacation periods, holidays, and other non-school periods shall be shared by the parties as follows and the above

schedule shall not apply to the time periods specified below: all years with ☐ Thanksgiving break from __________ (day) at __________ (time) to __________ (day) at __________ (time) in odd even all years with PETITIONER and in odd even all years with RESPONDENT. ☐ Winter vacation, first part, from last day of school / __________ (date) at __________ (time) to Dec 24 25 26 / __________ (date) at __________ (time) in odd even PETITIONER and odd even all years with RESPONDENT. ☐ Winter vacation, second part, from Dec 24 25 26 / __________ (date) at __________ (time) to day before school resumes / __________ (date) at __________ (time) in odd even all years with PETITIONER and odd even all years with RESPONDENT.

DATE: CASE NAME: CASE NUMBER: Form Approved for Optional Use L-3052B [New. 02/05/2026] STIPULATION - SETTLEMENT AGREEMENT PAGE ___ OF ___ ☐ Spring vacation, all or first part, from last day of school / __________ (date) at __________ (time) to day before school resumes / __________ (date) at __________ (time) in odd even all years with PETITIONER and in odd even all years with RESPONDENT. ☐ ☐ Spring vacation, second part, from __________ (date) at __________ (time) to day before school resumes / __________ (date) at __________ (time) in odd even all years with PETITIONER and odd in even all years with RESPONDENT.

Summer (or other breaks, including year-round school breaks) shall be shared by alternating one two / __________ (number) week periods with ☐ PETITIONER ☐ RESPONDENT having the first period starting on years and the other party having the first even all the last school day at __________ (time) in o dd period in odd even all years. ☐ __________ (number) weeks each summer for PETITIONER who shall give written notice of dates by __________ (date).

Failure to give such notice results in the other party having priority if dates conflict. ☐ __________ (number) weeks each summer for RESPONDENT who shall give written notice of dates by __________ (date).

Failure to give such notice results in the other party having priority if dates conflict. ☐ Monday holidays to be with the party who has the weekend, extending such weekend 24 hours. (including Martin Luther King, Jr.’s Birthday, President’s Day, Cesar Chavez Day, Memorial Day, and Labor Day) ☐ If Mother’s Day or Father's Day occurs on a weekend otherwise scheduled for the other party, the parties shall exchange the entire weekend for that party's next scheduled weekend. ☐ All holidays not specified otherwise shall be ☐ SHARED OR ☐ ALTERNATED ANNUALLY by the parties. ☐ Other: _______________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ Other occasions not specified above such as New Year’s Day, President Lincoln’s Birthday, Passover, Easter, Mother's Day, Father's Day, Independence Day, Rosh Hashanah, Yom Kippur, Native American Day, Veteran’s Day, Halloween, Thanksgiving, Hanukkah, Christmas, and birthdays shall be shared as follows: other occasions times with Petitioner years times with Respondent years odd even all odd even all odd even all odd even all odd even all odd even all odd even all odd even all OTHER ORDERS RELATING TO THE LEGAL AND PHYSICAL CUSTODY OF MINOR CHILDREN (Optional): 34.

In the event of any dispute regarding custody, visitation, time sharing or other matters concerning a minor child, the parties shall attempt to mediate such dispute through Family Court Services. (Family Code sections 3160-3186) 35. ☐ Each party shall advise the other of his or her current address, place of employment and phone numbers and shall advise the other of any changes as soon as reasonably possible. (OR, within __________ days of any such change) 36. ☐ Each party shall advise all schools and health care providers of the name, address and phone numbers of the other party in any registration, enrollment, emergency notification or other forms in which family information is requested period. odd odd odd odd even even even even all all all all odd odd odd odd even even even even all all all all

DATE: CASE NAME: CASE NUMBER: Form Approved for Optional Use L-3052B [New. 02/05/2026] STIPULATION - SETTLEMENT AGREEMENT PAGE ___ OF ___ 37. ☐ Each party shall provide the other, within a reasonable period of time, with copies of all schedules of school and extracurricular activities, school report cards, progress and special reports, medical reports and health care instructions regarding any minor child. 38. ☐ Each party shall advise the other, within a reasonable period of time prior thereto, of all school and extracurricular activities of any minor child in which parents are invited or allowed to observe or participate. 39. ☐ Each party shall advise the other, within a reasonable period of time prior thereto, of any medical and mental health treatment or evaluation of any minor child, including the name and address of the provider of such services. 40. ☐ In emergency situations, either party may authorize necessary health care treatment and procedures for any minor child and such party shall notify the other thereof as soon as reasonably possible. 41. ☐ Neither party shall make derogatory nor disparaging remarks about the other to, or in the presence of, or within the hearing of, any minor child. 42. ☐ Neither party shall be under the influence of alcohol, nor other substance which substantially impairs that party's ability to care for a minor child, at any time such party is responsible for the health and safety of any minor child. 43. ☐ Neither party shall change the residence of any minor child from the state of California (AND ☐ from the counties of Orange and ___________) without the prior written consent of the other or prior order of court. 44. ☐ Neither party shall change the residence of any minor child for more than 30 days, without the written consent of the other or an order of this court, without giving written notice to the other party in the manner provided in Family Code

section 3024. 45. ☐ A party who is unable to assume responsibility for the care of any minor child during any scheduled period of custody for that party is responsible for making adequate alternative arrangements for the care of such child. 46. ☐ (For joint legal custody orders) The rights to make decisions, that the parties shall share, relating to the health, education and welfare of each minor child under item 29, include, but are not limited to: a) ☐ Enrollment or termination of attendance in any public or private school. b) ☐ Participation in regularly occurring extracurricular activities. c) ☐ Non-emergency medical, dental and orthodontic treatment other than routine checkups. d) ☐ Participation in mental health counseling, therapy or treatment. e) ☐ Change in area of child's residence. f) ☐ Issuance of driver’s license. g) ☐ Issuance of a passport. h) ☐ Other ORDERS FOR TRANSPORTATION AND EXCHANGE OF PHYSICAL CUSTODY/VISITATION (Optional): 47. ☐ Each party shall provide for the transportation of each minor child at the ☐ BEGINNING or ☐ ENDING of that party’s period of physical custody except as otherwise provided herein. 48. ☐ Petitioner ☐ Respondent shall provide for all transportation for exchanges of physical custody or visitation except as otherwise provided herein. 49. ☐ The parties shall exchange periods of physical custody through each child's school or childcare provider when such exchanges are to occur at times when that child is attending school or childcare.

If the child is absent from such location the receiving party shall pick up the child from the other party's residence unless agreed or specified herein.

DATE: CASE NAME: CASE NUMBER: Form Approved for Optional Use L-3052B [New. 02/05/2026] STIPULATION - SETTLEMENT AGREEMENT PAGE ___ OF ___ OTHER ORDERS: 50. CHILD SUPPORT ORDERS (Family Code

section 3500 et seq.): 51. ☐ Jurisdiction over child support is reserved. 52. ☐ A completed Stipulation to Establish or Modify Child Support and Order (form FL-350) is filed herewith or has been filed and remains in full force and effect.

OR 53. ☐ The Local Child Support Agency is currently enforcing child support orders in another case (provide case number):_________________________________________ 54. ☐ Petitioner ☐ Respondent shall pay the ☐ Petitioner ☐ Respondent for the support of each minor child, the amounts set forth below, ☐ through the California State Disbursement Unit (complete item 62 for such orders) ☐ payable one half on the 1 st and 15 th days of each month commencing: __________ (date) OR ☐ payable on the __________ day(

s) of each month commencing: __________ (date). Child’s name Birth date: Amount/mo. $ $ $ $ TOTAL CHILD SUPPORT AMOUNT PAYABLE EACH MONTH: $ The above payments shall continue for each child until such child reaches the age of 18 years, dies, marries or is otherwise emancipated or until further order of court, whichever first occurs. The above payments shall continue for an unmarried child who has attained the age of 18 years, is a full-time high school student, and who is not self-supporting, until the time the child completes the 12 th grade or attains the age of 19 years, whichever first occurs. (Family Code

section 3901) ☐ The person to whom payments are made, shall notify the person ordered to make the payments of the happening of any contingency terminating child support as provided by Family Code

section 4007. BASIS FOR CHILD, SPOUSAL, AND FAMILY SUPPORT CALCULATION (Optional, Family Code

section 4005) 55. ☐ A printout of a computer calculation of the parties’ financial circumstances is attached or on file herein. ☐ OR, the parties’ financial circumstances are as follows:

DATE: CASE NAME: CASE NUMBER: Form Approved for Optional Use L-3052B [New. 02/05/2026] STIPULATION - SETTLEMENT AGREEMENT PAGE ___ OF ___ Petitioner Respondent Federal tax filing status (Family Code

section 4059a): Approximate percentage of physical custody (Family Code

section 4055b1D): % % Gross monthly income or earning capacity (Family Code

section 4058): $ $ Net monthly disposable income (Family Code

section 4059- 60): $ $ Hardship expenses (Family Code

section 4071): $ $ Health insurance / plan premiums (Family Code

section 4059d) $ $ Other (Family Code

section 4059): $ $ Child care costs: $ $ ORDERS FOR CHILD CARE COSTS (Family Code

section 4062(a)(1)): 56.

The child care costs related to employment or to reasonably necessary education or training for employment skills shall be paid as follows: ☐ The above child support includes a contribution towards the child care expenses for one or more minor children. ☐ Each party shall pay one half of such child care costs in addition to any other support. ☐ Petitioner shall pay ($ or %) _______ and Respondent shall pay ($ or %) _______ of such child care costs. ☐ Each party shall be responsible for childcare expenses during that party's periods of physical custody. ☐ Other orders for child care costs: ___________________________________________________________ ________________________________________________________________________________________ STIPULATED CHILD SUPPORT DECLARATIONS (Family Code

section 4065) (Mandatory if amount differs from guideline formula): 57. Child support ☐ is ☐ is not based on the Statewide Uniform Guideline. ☐ The parties are fully informed of their rights concerning child support, this support order is agreed to without coercion or duress, is in the best interest of each minor child, and the needs of each minor child will be adequately met by the agreed amount of child support herein. ☐ 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. JOINDER IN STIPULATION LOCAL CHILD SUPPORT AGENCY (Family Code

section 4065(c)): (Mandatory where Local Child Support Agency (LCSA) providing services pursuant to

section 11477 of the Welfare and Institutions Code) (TYPE OR PRINT NAME) (SIGNATURE OF ATTORNEY FOR LOCAL CHILD SUPPORT AGENCY)

DATE: CASE NAME: CASE NUMBER: Form Approved for Optional Use L-3052B [New. 02/05/2026] STIPULATION - SETTLEMENT AGREEMENT PAGE ___ OF ___ MODIFICATION OF CHILD SUPPORT (Notice required by Family Code

section 4010): 58. Child support orders may be modified under the provisions of Family Code sections 3650-3680. Information on modification of child support is provided in Notice of Rights and Responsibilities Regarding Child Support (form FL-192), and assistance may be obtained through the Office of the Family Law Facilitator. WAGE AND EARNINGS ASSIGNMENT ORDER (Mandatory under Family Code

section 5230): 59. Income Withholding for Support (form FL-195), shall be filed ordering the employer of the obligor to pay the obligee that portion of the obligor’s earnings as will be sufficient to pay an amount to cover the support ordered in this case and any amount ordered by the court toward the liquidation of the following arrearages: ☐ a monthly payment of $ _________ toward arrearages of $ _________ in child support as of _________. ☐ a monthly payment of $ _________ toward arrearages of $ _________ in spousal support as of _________. ORDERS FOR HEALTH CARE COVERAGE AND COSTS FOR CHIDLREN (Mandatory under Family Code

section 3751(a)(2)): 60. ☐ Petitioner shall pay ($ or %) _______ and ☐ Respondent shall pay ($ or %) _______ of reasonable uninsured health care costs. ☐ Petitioner ☐ Respondent ☐ Both parents shall maintain health insurance coverage under Family Code sections 3750-3753 for the benefit of each supported child if that insurance is available at no cost or at reasonable cost to the parents as defined by Family Code

section 3751(a)(2), (presumed reasonable if does not exceed 5% of gross income). If such coverage is not available, such coverage shall be obtained if it becomes available at no cost or reasonable cost. Each parent shall provide the other with insurance coverage information, identification documents, claim forms and other documents and information necessary to utilize insurance coverage for each supported child and to obtain reimbursement for health care services costs incurred for each supported child. Any reimbursement due from one party to the other under this order or otherwise under Family Code

section 4063 shall be paid within 30 days of demand in the manner specified in Family Code

section 4063 unless a different period of time is specified here: _____________ (form FL-192 contains additional information on health care costs and reimbursement procedures) Reasonable and necessary health care costs of each supported child not covered by insurance, including medical, pharmaceutical, vision, dental, orthodontic and mental health costs, shall be shared as allocated above, and each parent shall reimburse the other for his or her share of such expenses paid by the other. ☐ The parties waive the right to written notice of an application for a health insurance coverage order under Family Code

section 3761. DEPENDENCY EXEMPTIONS (Optional): 61. In absence of any specific agreement the custodial parent is usually entitled to claim exemptions (see Internal Revenue Code

section 152(e)). ☐ Petitioner ☐ Respondent shall have the right to claim ☐ each minor child, OR ☐ each child listed ___________________________________, as a dependent and exemption for all state and federal income tax purposes ☐ every year, OR ☐ in each year listed ______________________, and each party shall execute and deliver, on demand, any documents necessary for such claim, including Release/Revocation of Release of Claim to Exemption for Child by Custodial Parent (IRS form 8332). ☐ A party required to pay child support to the other shall not make the above claims for any year for which the full amount of child support has not been paid.

INFORMATION REQUIRED FOR STATE DISBURSEMENT ORDERS (Mandatory for welfare recipients, Family Code

section 4200): 62. ☐ All support payments shall be paid to the office of the CA State Disbursement Unit, PO Box 989067, West Sacramento, CA 95798-9067 by check or money order including the number of this case.

DATE: CASE NAME: CASE NUMBER: Form Approved for Optional Use L-3052B [New. 02/05/2026] STIPULATION - SETTLEMENT AGREEMENT PAGE ___ OF ___ ☐ The Child Support Case Registry Form (form FL-191) shall be completed and submitted to the court. The Local Child Support Agency may appear on behalf of the public interest in any proceeding to enforce support. OTHER ORDERS: 63. SPOUSAL OR FAMILY SUPPORT ORDERS (Family Code sections 92, 142, 3590-3604, 3650-3654, 4300-4360): 64. Unless otherwise agreed in writing, the obligation of a party under an order for support of the other party terminates upon the death of either party or the remarriage of the other party (Family Code

section 4337). 65. ☐ The court reserves jurisdiction to award spousal support to ☐ both parties ☐ Petitioner ☐ Respondent until further order of court or until the date of __________, whichever first occurs. 66. ☐ Petitioner ☐ Respondent shall pay ☐ Petitioner ☐ Respondent, as ☐ spousal support ☐ family support: $ __________ per month beginning __________ (date), (If step down:) then $ __________ per month beginning __________ (date), then $ __________ per month beginning __________ (date), ☐ payable one half on the 1 st and 15 th days of each month, OR ☐ on the __________ day(

s) of each month. ☐ payable through the California State Disbursement Unit (complete item 62). ☐ payable by wage and earnings assignment order (Family Code

section 5230, using Earnings Assignment Order for Spousal or Partner Support (form FL-435) or form FL-195, if used in conjunction with child support). 67. These payments shall continue until further order of court, the date of __________ or until termination by law under Family Code

section 4337, whichever first occurs. 68. ☐ The duration of the court’s jurisdiction over spousal support ☐ MAY NOT BE, OR ☐ MAY BE extended if an application to extend jurisdiction is filed herein prior to the date that either the court's jurisdiction or any spousal support order otherwise expires. 69. THE FOLLOWING WAIVER TERMINATES THE PARTIES’ RIGHTS TO SPOUSAL SUPPORT. IN A PROCEEDING FOR DISSOLUTION OR LEGAL SEPARATION THE COURT WOULD OTHERWISE RETAIN JURISDICTION TO AWARD SPOUSAL SUPPORT TO EITHER PARTY INDEFINITELY WHERE THE MARRIAGE IS OF LONG DURATION. A MARRIAGE IS PRESUMED TO BE OF LONG DURATION IF OVER 10 YEARS BUT THIS MAY APPLY TO SHORT DURATIONS (Family Code

section 4336). ☐ Petitioner and Respondent both waive any and all rights to receive spousal support from the other at any time hereafter. No spousal support shall be paid by either party to the other and the court shall not retain jurisdiction to award spousal support so either party from the other at any time hereafter regardless of the needs or ability to pay of either party or any other circumstances. The right to receive spousal support or alimony from the other is terminated forever. The parties should initial here if they agree with, have read and understand this SPOUSAL SUPPORT WAIVER: Petitioner: _________ Respondent: _________

DATE: CASE NAME: CASE NUMBER: Form Approved for Optional Use L-3052B [New. 02/05/2026] STIPULATION - SETTLEMENT AGREEMENT PAGE ___ OF ___ HEALTH CARE COVERAGE AND COSTS FOR SPOUSE: 70. ☐ Petitioner ☐ Respondent shall maintain health insurance coverage for the benefit of the other, if eligible for such coverage under an existing insurance plan, to continue for so long as the other is eligible, and shall notify the other as soon as possible upon receiving notice of termination of such eligibility and of information necessary to convert such policy to any other available policy for which the other party would be eligible. (including COBRA rights, see California Health and Safety Code sections 1366.20-.28, 1373.621 and Internal Revenue Code

section 4980B). SPOUSAL SUPPORT ADMONITION (Family Code

section 4330): 71. The parties acknowledge, by signing this agreement, that it is the goal of this state that each party shall make reasonable, good faith efforts to become self-supporting as provided for in Family Code

section 4320. The failure to make good faith efforts may be one of the factors considered by the court as a basis for modifying or terminating support. OTHER ORDERS: 72.

Document details

Collection	California Superior Local Rules
Citation	Cal. Form L-3052B
Type	court_rule
Language	en
Format	pdf
Source	CA_LOCAL
Identifier	28f1d98164a8d98db6911af0c1d644dd7b6dbd32

Source file is stored in the law ingest library (pdf).