Superior Court Of California County Of San Diego Dissolution

Cal. Form PKT-003

California Superior Local Rules

PKT-003 (Rev. 7/26) SUPERIOR COURT OF CALIFORNIA COUNTY OF SAN DIEGO DISSOLUTION (JUDGMENT) PACKET FORMS INCLUDED IN THIS PACKET Judgment Checklist – Dissolution/Legal Separation Judicial Council Form #FL-182 Request to Enter Default (Family Law—Uniform Parentage) Judicial Council Form #FL-165 Declaration for Default or Uncontested Dissolution or Legal Separation (Family Law) Judicial Council Form #FL-170 Appearance, Stipulations, and Waivers (Family Law— Uniform Parentage— Custody and Support) Judicial Council Form #FL-130 Declaration of Disclosure (Family Law) Judicial Council Form #FL-140 Declaration Regarding Service of Declaration of Disclosure (Family Law) Judicial Council Form #FL-141 Stipulation and Waiver of Final Declaration of Disclosure Judicial Council Form #FL-144 Judgment (Family Law) Judicial Council Form #FL-180 Spousal, Partner, or Family Support Order Attachment (Family Law) Judicial Council Form #FL-343 Property Order Attachment to Judgment (Family Law) Judicial Council Form #FL-345 Notice of Entry of Judgment (Family Law— Uniform Parentage— Custody and Support) Judicial Council Form #FL-190 Information Sheet for Proof of Personal Service Judicial Council Form #FL-330-INFO Proof of Personal Service Judicial Council Form #FL-330 Information Sheet for Proof of Service by Mail Judicial Council Form #FL-335- INFO Proof of Service by Mail Judicial Council Form #FL-335 Notice of Change of Address or Other Contact Information Judicial Council Form #MC-040 WITH CHILDREN Child Support Case Registry Form Judicial Council Form #FL-191 Notice of Rights and Responsibilities Health-Care Costs and Reimbursement Procedures Judicial Council Form #FL-192 Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Judicial Council Form #FL-105 Child Custody and Visitation (Parenting Time) Order Attachment Judicial Council Form #FL-341 Supervised Visitation (Parenting Time) and Exchanges Order Judicial Council Form #FL-341(

A) Child Support Information and Order Attachment Judicial Council Form #FL-342 Income Withholding for Support Judicial Council Form #FL-195 Income Withholding for Support – Instructions Judicial Council Form #FL-196 Earning Assignment Order for Spousal or Partner Support (Family Law) Judicial Council Form #FL-435 Request for Hearing Regarding Earnings Assignment (Family Law— Governmental— UIFSA) Judicial Council Form #FL-450

FL-182 FOR COURT USE ONLY CASE NUMBER: JUDGMENT CHECKLIST— DISSOLUTION/LEGAL SEPARATION Page 1 of 3 Form Approved for Optional Use Judicial Council of California FL-182 [New July 1, 2012] www.courts.ca.gov ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): PETITIONER: RESPONDENT: FAX NO. (Optional): TELEPHONE NO.: EMAIL ADDRESS: ATTORNEY FOR (Name): This judgment checklist is a list of documents that a court may require to complete a default or uncontested judgment. The checklist may be filed along with your judgment, but is not required.

If the forms or other documents have already been filed, you should check the boxes indicating that they have been previously filed. Unless listed otherwise on this form, when you file a document with the court, you should submit an original and 2 copies. One copy is for you and one is for the other party.

There are three types of default and uncontested judgments: • Default With No Agreement (no response and no written agreement) • Default With Agreement (no response, but there is a written agreement) • Uncontested Case (response filed, or other appearance by respondent, and a written agreement) DEFAULT WITH NO AGREEMENT (no response and no written agreement) Proof of Service of Summons (form FL-115) or other proof of service Request to Enter Default (form FL-165), with a stamped envelope addressed to respondent and the court clerk's address as the return address Petitioner's Declaration Regarding Service of Declaration of Disclosure (form FL-141) Declaration for Default or Uncontested Dissolution or Legal Separation (form FL-170) Judgment (form FL-180) (5 copies) a. b. c. d. e. (Please check the box by each document being filed) If there are minor children of the marriage or domestic partnership: Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) (form FL-105). (A new form must be filed if there have been any changes since the one most recently filed.) Petitioner's Income and Expense Declaration (form FL-150) or Financial Statement (Simplified) (form FL-155). (Needed unless one has been filed within the past 90 days and there have been no changes since then.) Computer printout of guideline child support (optional) Notice of Rights and Responsibilities and Information Sheet on Changing a Child Support Order (form FL-192).

This may be attached by the petitioner or by the court. h. i. j. k. Previously Filed Notice of Entry of Judgment (form FL-190)f. 1. JUDGMENT CHECKLIST— DISSOLUTION/LEGAL SEPARATION Cal. Rules of Court, rule 5.405 2 stamped envelopes of sufficient size and with sufficient postage to return the Judgment and Notice of Entry of Judgment, one envelope addressed to petitioner and the other to respondent. g. SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S.

MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

CASE NUMBER: Page 2 of 3FL-182 [New July 1, 2012] FL-182 PETITIONER: RESPONDENT: Child Custody and Visitation (Parenting Time) Order Attachment (form FL-341) or other proposed written order containing the information required by Family Code 3048(a) (attach to Judgment) Income Withholding for Support (form FL-195/OMB No. 0970-0154) n. l. m. Previously Filed If spousal/partner support is requested, the marriage/partnership is over 10 years in duration, or termination of spousal/partner support for the respondent is requested: Spousal or Partnership Support Declaration Attachment (form FL-157)o.

Income and Expense Declaration (form FL-150) (Needed unless a current financial declaration has been filed within the past 90 days and there have been no changes since then.) p. Spousal, Partner, or Family Support Order Attachment (form FL-343) or other proposed written order (attach to Judgment) q. If assets or debts need to be divided or assigned: Property Declaration (form FL-160)r. Property Order Attachment to Judgment (form FL-345) or other proposed written order (attach to Judgment)s. If attorney fees and costs are requested: Request for Attorney Fees and Costs (form FL-319)t.

Attorney Fees and Costs Order Attachment (form FL-346) or other proposed written order (attach to Judgment) u. Proof of Service of Summons (form FL-115) or other proof of servicea. DEFAULT WITH AGREEMENT (no response and a written agreement)2. Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) (form FL-105). (A new form must be filed if there have been any changes since the one most recently filed.) j. Request to Enter Default (form FL-165), with a stamped envelope addressed to respondent and the court clerk's address as the return address b.

Petitioner's Declaration Regarding Service of Declaration of Disclosure (form FL-141) (preliminary)c. Declaration Regarding Service of Final Declaration of Disclosured. Declaration for Default or Uncontested Dissolution or Legal Separation (form FL-170)e. Written agreement of the parties. Respondent's signature on the agreement must be notarized. (attach to Judgment.) f. Judgment (form FL-180) (5 copies)g. h. If there are minor children of the marriage or domestic partnership: k.

Notice of Entry of Judgment (form FL-190) JUDGMENT CHECKLIST– DISSOLUTION/LEGAL SEPARATION Petitioner's Declaration Regarding Service of Declaration of Disclosure (form FL-141) (final) or Stipulation and Waiver of Final Declaration of Disclosure (form FL-144) or Separately filed waiver or waiver included in a written agreement under Family Code

section 2105(

d) Child Support Order Stipulation to Establish or Modify Child Support and Order (form FL-350) (attach to Judgment), or Child Support Information and Order Attachment (form FL-342) (attach to Judgment), or Written agreement containing declarations required by Family Code

section 4065(a) (attach to Judgment) 2 stamped envelopes of sufficient size and with sufficient postage to return the Judgment and Notice of Entry of Judgment, one envelope addressed to petitioner and the other to respondent i. Income and Expense Declaration (form FL-150) or Financial Statement (Simplified) (form FL-155). (Needed unless one has been filed within the past 90 days and there have been no changes since then.)

CASE NUMBER: Page 3 of 3FL-182 [New July 1, 2012] FL-182 PETITIONER: RESPONDENT: Previously Filed l. Appearance, Stipulations, and Waivers (form FL-130)b. UNCONTESTED CASE (Response filed, or other appearance by respondent, and a written agreement)3. Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) (form FL-105). (A new form must be filed if there have been any changes since the one most recently filed.) k. Respondent's filing fee, if first appearance, unless respondent has a fee waiver or is currently on active duty in the military c.

Declaration Regarding Service of Declaration of Disclosure (both petitioner's and respondent's preliminary) (form FL-141) d. e. Declaration for Default or Uncontested Dissolution or Legal Separation (form FL-170)f. Written agreement of the parties (attach to Judgment)g. Judgment (form FL-180) (5 copies)h. i.

If there are minor children of the marriage or domestic partnership: Stipulation to Establish or Modify Child Support and Order (form FL-350) (attach to Judgment) or Child Support Information and Order Attachment (form FL-342) (attach to Judgment), or Written agreement which includes declarations required by Family Code

section 4065(a) (attach to Judgment) Computer printout of guideline child support (optional). m. n. o. Child Custody and Visitation Order Attachment (form FL-341) or written agreement containing the information required by Family Code

section 3048(a) (attach to Judgment) p. Computer printout of guideline child support (optional)l. o. m. Child Custody and Visitation Order Attachment (form FL-341) or written agreement containing the information required by Family Code

section 3048(a) (attach to Judgment) p. Income Withholding for Support (form FL-195/OMB No. 0970-0154) Notice of Rights and Responsibilities and Information Sheet on Changing a Child Support Order (form FL-192). This may be attached by the petitioner or by the court. Notice of Rights and Responsibilities and Information Sheet on Changing a Child Support Order (form FL-192 ). This may be attached by either party or by the court.

Notice of Entry of Judgment (form FL-190) Income Withholding for Support (form FL-195/OMB No. 0970-0154) Declaration Regarding Service of Final Declaration of Disclosure Declaration Regarding Service of Declaration of Disclosure (both petitioner's and respondent's final) (form FL-141), or Stipulation and Waiver of Final Declaration of Disclosure (form FL-144), or Separately filed waiver or waiver included in a written agreement under Family Code

section 2105(

d) JUDGMENT CHECKLIST– DISSOLUTION/LEGAL SEPARATION 2 stamped envelopes of sufficient size and with sufficient postage to return the Judgment and Notice of Entry of Judgment, one envelope addressed to petitioner and the other to respondent j. Proof of Service of Summons (form FL-115) or other proof of service if you want to use the date of service as the beginning of the six-month waiting period. a. Child Support Order Stipulation to Establish or Modify Child Support and Order (form FL-350) (attach to Judgment), or Child Support Information and Order Attachment (form FL-342) (attach to Judgment), or Written agreement containing declarations required by Family Code

section 4065(a) (attach to Judgment) n. Child Support Order

Form Adopted for Mandatory Use Judicial Council of California FL-165 [Rev. July 1, 2025] Code of Civil Procedure, §§ 585, 587; Family Code, §§ 2330.5 and 2335.5 REQUEST TO ENTER DEFAULT (Family Law—Uniform Parentage) FL-165 FAX NO. (Optional): PARTY WITHOUT ATTORNEY OR ATTORNEY (Name, State Bar number, and address): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S.

MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910 PETITIONER: RESPONDENT: REQUEST TO ENTER DEFAULT FOR COURT USE ONLY CASE NUMBER: 1. To the clerk: Please enter the default of the respondent who has failed to respond to the petition. 2. A completed Income and Expense Declaration (form FL-150) or Financial Statement (Simplified) (form FL-155) is attached is not attached.

A completed Property Declaration (form FL-160) is attached is not attached If a completed Property Declaration (form FL-160) is not attached, check at least one of the following boxes to indicate the reason: a. There have been no changes since the previous filing. b. The issues subject to disposition by the court in this proceeding are the subject of a written agreement. c. There are no issues of child, spousal, or partner support or attorney fees and costs subject to determination by the court. d. The petition does not request money, property, costs, or attorney fees. e.

There are no issues of division of community property. f. This is an action to establish parental relationship. 3. Date: (TYPE OR PRINT NAME) (SIGNATURE OF [ATTORNEY FOR] PETITIONER) 4. Declaration a. No mailing is required because service was by publication or posting and the address of the respondent remains unknown. b.

A copy of this Request to Enter Default, including any attachments and an envelope with sufficient postage, was provided to the court clerk, with the envelope addressed as follows (address of the respondent’s attorney or, if none, the respondent’s last known address): I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME) (SIGNATURE OF DECLARANT) FOR COURT USE ONLY Request to Enter Default mailed to the respondent or the respondent’s attorney on (date): . Default entered as requested on (date): . Default not entered.Reason: .

Clerk, by ________________________________ , Deputy Page 1 of 2 courts.ca.gov TELEPHONE NO.: EMAIL ADDRESS: ATTORNEY FOR (Name):

FL-165 [Rev. July 1, 2025] REQUEST TO ENTER DEFAULT (Family Law—Uniform Parentage) Page 2 of 2 PETITIONER: RESPONDENT: CASE NUMBER: 5. Memorandum of costs a. Costs and disbursements are waived. b. Costs and disbursements are listed as follows:

(1) Clerk’s fees $

(2) Process server’s fees $

(3) Other (specify): $ $ $ $ TOTAL $ c. I am the attorney, agent, or party who claims these costs. To the best of my knowledge and belief, the foregoing items of cost are correct and have been necessarily incurred in this cause or proceeding. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME) (SIGNATURE OF DECLARANT) 6. Declaration of nonmilitary status (required for a judgment).

The respondent is not in the military service of the United States as defined by either the Servicemembers Civil Relief Act (see 50 U.S.C. § 3911(2)) or California Military and Veterans Code sections 400 and 402(f). I know that the respondent is not in the U.S. military service because (check all that apply): a. the search results that I received from say the respondent is not in the U.S. military service. b. I am in regular communication with the respondent and know that they are not in the U.S. military service. c.

I recently contacted the respondent, and they told me that they are not in the U.S. military service. d. I know that the respondent was discharged from U.S. military service on or about (date): . e. the respondent is not eligible to serve in the U.S. military because they are incarcerated (in jail or prison). f. other (specify): .

Note • U.S. military status can be checked online at . • If the respondent is in the military service, or their military status is unknown, the respondent is entitled to certain rights and protections under federal and state law before a default judgment can be entered. • For more information, see . I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME) (SIGNATURE OF DECLARANT) scra.dmdc.osd.mil/ scra.dmdc.osd.mil/ selfhelp.courts.ca.gov/military-defaults

Both the parties have filed, or are filing concurrently, a Declaration Regarding Service of Declaration of Disclosure (form FL-141) and an Income and Expense Declaration (form FL-150). This matter is proceeding by default. I am the petitioner in this action, and service of the summons on respondent was done by publication or posting under court order. Service of the preliminary Declaration of Disclosure (form FL-140) is not required. I hereby waive receipt of the final Declaration of Disclosure (form FL-140) from the respondent. a. c. Uncontested This matter is proceeding by default.

I am the petitioner in this action and have filed a proof of service of the preliminary Declaration of Disclosure (form FL-140) with the court. I hereby waive receipt of the final Declaration of Disclosure (form FL-140) from the respondent. Default with agreementb. Default without agreement There are no assets or debts to be disposed of by the court. The community and quasi-community assets and debts are listed on the completed current Property Declaration (form FL-160), which includes an estimate of the value of the assets and debts that I propose to be distributed to each party.

The division in the proposed Judgment (form FL-180) is a fair and equal division of the property and debts, or if there is a negative estate, the debts are assigned fairly and equitably. Form Approved for Mandatory Use Judicial Council of California FL-170 [Rev.

January 17, 2020] Family Code, § 2336 www.courts.ca.gov Page 1 of 3 LEGAL SEPARATION DECLARATION FOR DEFAULT OR UNCONTESTED DISSOLUTION FOR COURT USE ONLY FAX NO. (Optional): ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S.

MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910 RESPONDENT: PETITIONER: CASE NUMBER: FL-170 (NOTE: Items 1 through 12 apply to both dissolution and legal separation proceedings.) I declare that if I appeared in court and were sworn, I would testify to the truth of the facts in this declaration.

I agree that my case will be proven by this declaration and that I will not appear before the court unless I am ordered by the court to do so. is true and correct.All the information in the No response has been filed and there is no written agreement or stipulated judgment between the parties;

(2) The following statement is true (check one): 1. 2. 3. The default of the respondent was entered or is being requested, and I am not seeking any relief not requested in the petition; and Type of case (check a, b, or c):4. (1) (B) (3) (

A) Petition Responseamended No response has been filed and the parties have agreed that the matter may proceed as a default matter without notice; and The parties have entered into a written agreement regarding their property and their marriage or domestic partnership rights, including support, the original of which is being or has been submitted to the court. I request that the court approve the agreement. (2)

(1) Both parties have appeared in the case; and (2)

(1) The parties have entered into a written agreement regarding their property and their marriage or domestic partnership rights, including support, the original of which is being or has been submitted to the court. I request that the court approve the agreement. Declaration of disclosure (check a, b, c, or d): a. b. c. 5. DECLARATION FOR DEFAULT OR UNCONTESTED DISSOLUTION OR LEGAL SEPARATION (Family Law) TELEPHONE NO.: EMAIL ADDRESS: ATTORNEY FOR (Name):

The facts that support the requested judgment are (In a default case, state your reasons below): The current custody and visitation (parenting time) previously ordered in this case, or the current

schedule is (specify): Child support is being enforced in another case in I request that this order be based on the The information in the child support calculation attached to the proposed judgment is correct based on my personal knowledge. FL-170 [Rev. January 17, 2020] Page 2 of 3DECLARATION FOR DEFAULT OR UNCONTESTED DISSOLUTION OR LEGAL SEPARATION (Family Law) RESPONDENT: PETITIONER: CASE NUMBER: FL-170 d. This matter is proceeding as an uncontested action. Service of the final Declaration of Disclosure (form FL-140) is mutually waived by both parties.

A waiver provision executed by both parties under penalty of perjury is contained on the Stipulation and Waiver of Final Declaration of Disclosure (form FL-144), in the settlement agreement or proposed judgment, or in another, separate stipulation. has d. Contained on Attachment 6d. Contained on Attachment 6c. has not 6. a. Child support should be ordered as set forth in the proposed Judgment (form FL-180).7. changed since it was last filed with the court. (If changed, attach updated form.) (county): c.

The case number is (specify): Child custody and visitation (parenting time) should be ordered as set forth in the proposed Judgment (form FL-180). a. b. The information in Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) (form FL-105) There is an existing court order for custody/parenting time in another case in If there are minor children, check and complete item (1) if applicable and item (2) or (3): earning ability. The facts in(3) support of my estimate of earning ability are (specify):

(2) Complete items (1) and (2) regarding public assistance. (county): The case number is (specify):

(1) Petitioner's Respondent's Contained on Attachment 7a(3). b.

(1) I am receiving am not receiving intend to apply for To the best of my knowledge, the other party to the local child support agency at the address set forth in the proposed judgment. A representative of the local child support agency has signed the proposed judgment. listed in the proposed order.

(2) Spousal, Partner, and Family Support (If a support order or attomey fees are requested, submit a completed Income and Expense Declaration (form FL-150) unless a current form is on file. Include your best estimate of the other party’s income. Check at least one of the following.) a. b. c. Family support should be ordered as set forth in the proposed Judgment (form FL-180).e. f. d. 8. public assistance for the child or children is is not receiving public assistance.

Petitioner Respondent is presently receiving public assistance, and all support should be made payable I knowingly give up forever any right to receive spousal or partner support.

I ask the court to terminate forever spousal or partner support for: Spousal support or domestic partner support should be ordered as set forth in the proposed Judgment (form FL-180) based on the factors described in: I ask the court to reserve jurisdiction to award spousal or partner support in the future to: Petitioner Respondent Petitioner Respondent Spousal or Partner Support Declaration Attachment (form FL-157) attached declaration (Attachment 8d) written agreement Other (specify):

The facts in support of this request are on Request for Attorney's Fees and Costs Attachment (form FL-319). FL-170 [Rev.

January 17, 2020] Page 3 of 3DECLARATION FOR DEFAULT OR UNCONTESTED DISSOLUTION OR LEGAL SEPARATION (Family Law) Date: RESPONDENT: PETITIONER: CASE NUMBER: FL-170 (TYPE OR PRINT NAME) I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. 12. requests restoration of the former name as set forth in the proposed Judgment(form FL-180) Status only judgment: This declaration is only for the termination of marital or domestic partner status.

I ask the court to reserve jurisdiction over all other issues not requested in this declaration for later determination. Petitioner Respondent STATEMENTS IN THIS BOX APPLY ONLY TO DISSOLUTIONS If this is a dissolution of a marriage or domestic partnership created in another state, the petitioner or the respondent has been a resident of this county for at least three months and of the state of California for at least six months continuously and immediately preceding the date of the filing of the petition for dissolution of marriage or domestic partnership.

I ask that the court grant the request for a judgment of dissolution of marriage or domestic partnership based on irreconcilable differences and that the court make the orders set forth in the proposed Judgment(form FL-180) submitted with this declaration. 17. 15. 16. Irreconcilable differences have led to the irremediable breakdown of the marriage or domestic partnership, and there is no possibility of saving the marriage or domestic partnership through counseling or other means.

This declaration may be reviewed by a commissioner sitting as a temporary judge, who may determine whether to grant this request or require my appearance under Family Code

section 2336. 13. 14. (proceedings for dissolution or nullity of marriage only). THIS STATEMENT APPLIES ONLY TO LEGAL SEPARATIONS I ask that the court grant the request of a judgment for legal separation based on irreconcilable differences and that the court make the orders set forth in the proposed Judgment(form FL-180) submitted with this declaration. I understand that a judgment of legal separation does not terminate a marriage or domestic partnership, and that I am still married or a partner in a domestic partnership. 18. 19. Other (specify): (SIGNATURE OF DECLARANT) 9. 10.

The judgment should be entered nunc pro tunc for the following reasons (specify):11. (county): a. b. A voluntary declaration of parentage or paternity is attached. The written agreement of the parties regarding parentage is attached here (Attachment 9b) or to the proposed Judgment (form FL-180). Parentage was previously established by the court in The case number is (specify): Attorney fees should be ordered as set forth in the proposed Judgment(form FL-180).

Other(specify facts below): Parentage of the children of the petitioner and respondent born prior to their marriage or domestic partnership should be ordered as set forth in the proposed Judgment(form FL-180).

Form Approved for Optional Use Judicial Council of California FL-130 [Rev. January 1, 2023] APPEARANCE, STIPULATIONS, AND WAIVERS (Family Law—Uniform Parentage—Custody and Support) Government Code, § 70673 FL-130 FOR COURT USE ONLY CASE NUMBER: FAX NO. (Optional): PARTY WITHOUT ATTORNEY or ATTORNEY (Name, State Bar number, and address): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO PETITIONER: RESPONDENT: APPEARANCE, STIPULATIONS, AND WAIVERS 1. Appearance by respondent (you must choose one): a. By filing this form, I make a general appearance. b. I have previously made a general appearance. c.

I am a member of the military services of the United States of America. I have completed and attached to this form Declaration and Conditional Waiver of Rights Under the Servicemembers Civil Relief Act (form FL-130(A)). 2. Agreements, stipulations, and waivers (choose all that apply): a. The parties agree that this cause may be decided as an uncontested matter. b. The parties waive their rights to notice of trial, a statement of decision, a motion for new trial, and the right to appeal. c. This matter may be decided by a commissioner sitting as a temporary judge. d.

The parties have a written agreement that will be submitted to the court, or a stipulation for judgment will be submitted to the court and attached to Judgment (Family Law) (form FL-180). e. None of these agreements or waivers will apply unless the court approves the stipulation for judgment or incorporates the written settlement agreement into the judgment. f. This is a parentage case, and both parties have signed an Advisement and Waiver of Rights Re: Determination of Parental Relationship (form FL-235) or its equivalent. 3.

Other (specify): Date: (TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER) Date: (TYPE OR PRINT NAME) (SIGNATURE OF RESPONDENT) Date: (TYPE OR PRINT NAME) (SIGNATURE OF ATTORNEY FOR PETITIONER) Date: (TYPE OR PRINT NAME) (SIGNATURE OF ATTORNEY FOR RESPONDENT) Page 1 of 1 www.courts.ca.gov TELEPHONE NO.: EMAIL ADDRESS: ATTORNEY FOR (Name): CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FAX NO. (Optional):TELEPHONE NO.: EMAIL ADDRESS: ATTORNEY FOR (Name): PETITIONER: RESPONDENT: OTHER PARENT/PARTY: CASE NUMBER:DECLARATION OF DISCLOSURE Petitioner's Respondent's Preliminary Final DO NOT FILE DECLARATIONS OF DISCLOSURE OR FINANCIAL ATTACHMENTS WITH THE COURT FL-140 Page 1 of 1 Form Adopted for Mandatory Use Judicial Council of California FL-140 [Rev. July 1, 2013] DECLARATION OF DISCLOSURE (Family Law) Family Code, §§ 2102, 2104, 2105, 2106, 2112 www.courts.ca.gov A completed

Schedule of Assets and Debts (form FL-142) or A completed Income and Expense Declaration (form FL-150). A statement of all material facts and information regarding valuation of all assets that are community property or in which the community has an interest (not a form). A statement of all material facts and information regarding obligations for which the community is liable (not a form). All tax returns filed by the party in the two years before the date that the party served the disclosure documents. Community and Quasi-Community Property Separate Property.

A Property Declaration (form FL-160) for (specify):  SIGNATURE An accurate and complete written disclosure of any investment opportunity, business opportunity, or other income-producing opportunity presented since the date of separation that results from any investment, significant business, or other income- producing opportunity from the date of marriage to the date of separation (not a form). Attached are the following: 1. 2. 3. 4. 5. 6.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. (TYPE OR PRINT NAME) In a dissolution, legal separation, or nullity action, both a preliminary and a final declaration of disclosure must be served on the other party with certain exceptions. Neither disclosure is filed with the court. Instead, a declaration stating that service of disclosure documents was completed or waived must be filed with the court (see form FL-141).

The petitioner must serve a preliminary declaration of disclosure at the same time as the Petition or within 60 days of filing the Petition. The respondent must serve a preliminary declaration of disclosure at the same time as the Response or within 60 days of filing the Response. The time periods may be extended by written agreement of the parties or by court order (see Family Code

section 2104(f)). In

summary dissolution cases, each spouse or domestic partner must exchange preliminary disclosures as described in

Summary Dissolution Information (form FL-810). Final disclosures are not required (see Family Code

section 2109).   Parties who agree to waive final declarations of disclosure must file their written agreement with the court (see form FL-144).  Service of preliminary declarations of disclosure may not be waived by an agreement between the parties.  In a default judgment case that is not a stipulated judgment or a judgment based on a marital settlement agreement, only the petitioner is required to complete and serve a preliminary declaration of disclosure. A final disclosure is not required of either party (see Family Code

section 2110). Date: SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

FAX NO. (Optional):TELEPHONE NO.: EMAIL ADDRESS: ATTORNEY FOR (Name): ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): CASE NUMBER: PETITIONER: RESPONDENT: OTHER PARENT/PARTY: DECLARATION REGARDING SERVICE OF DECLARATION OF DISCLOSURE AND INCOME AND EXPENSE DECLARATION Final PreliminaryPetitioner's Respondent's FL-141 Page 1 of 1 Form Adopted for Mandatory Use Judicial Council of California FL-141 [Rev.

July 1, 2013] DECLARATION REGARDING SERVICE OF DECLARATION OF DISCLOSURE AND INCOME AND EXPENSE DECLARATION (Family Law) Family Code, §§ 2102, 2104, 2105, 2106, 2112 www.courts.ca.gov I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Preliminary Declaration of Disclosure (form FL-140), current* Income and Expense Declaration (form FL-150), completed

Schedule of Assets and Debts (form FL-142) or Community and Separate Property Declarations (form FL-160) with appropriate attachments, all tax returns filed by the party in the two years before service of the preliminary disclosures, and all other required information under Family Code

section 2104 were served on: I am the Petitioner's Respondent's the other party the other party's attorney by personal service mail Final Declaration of Disclosure (form FL-140), current* Income and Expense Declaration (form FL-150), completed

Schedule of Assets and Debts (form FL-142) or Community or Separate Property Declarations (form FL-160) with attachments, and the material facts and information required by Family Code

section 2105 were served on: 2. 3. Service of4. attorney for petitioner respondent in this matter. Petitioner's Respondent's the other party other party's attorney by personal service mail (specify):Other on (date): (specify):Other on (date): Petitioner's preliminary final declaration of disclosureRespondent's a. The parties agreed to waive final declaration of discl osure requirements under Family Code

section 2105(d.) current income and expense declaration has been waived as follows: The party has failed to comply with disclosure requirements, and the court has granted the request for voluntary waiver ofb. on (date):receipt under Family Code

section 2107 c. This is a default proceeding that does not include a stipulated judgment or settlement agreement. Petitioner waives final disclosure requirements under Family Code

section 2110. (date):was filed onThe waiver is being filed at the same time as this form. *Current is defined as completed within the past three months providing no facts have changed. (Cal. Rules of Court, rule 5.260.) NOTE: File this document with the court. Do not file a copy of the Preliminary or Final Declaration of Disclosure or any attachments to either declaration of disclosure with this document.  SIGNATURE(TYPE OR PRINT NAME) Date: (Form FL-144 may be used for this purpose.) 1.

SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., V ISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

FOR COURT USE ONLY CASE NUMBER: b. Date: Form Approved for Optional Use Judicial Council of California FL-144 [Rev. January 1, 2007] FL-144 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FAX NO. (Optional):TELEPHONE NO: EMAIL ADDRESS: ATTORNEY FOR (Name): Page 1 of 1 PLAINTIFF/ PETITIONER: DEFENDANT/ RESPONDENT: SUPERIOR COURT OF CALIFORNIA, COUNTY OF STIPULATION AND WAIVER OF FINAL DECLARATION OF DISCLOSURE STIPULATION AND WAIVER OF FINAL DECLARATION OF DISCLOSURE Under Family Code

section 2105(d), the parties agree to waive the requirements of Family Code

section 2105(

a) concerning the final declaration of disclosure. a. We have complied with Family Code

section 2104, and the preliminary declarations of disclosure have been completed and exchanged. We have completed and exchanged a current Income and Expense Declaration (form FL-150) that includes all material facts and information on each party's earnings, accumulations, and expenses. c. We have fully complied with Family Law

section 2102 and ha ve fully augmented the preliminary declarations of disclosure, including disclosure of all material facts and information on (1) the characterization of all assets and liabilities, (2) the valuation of all assets that are community property or in which the community has an interest, and (3) the amounts of all community debts and obligations. d. Each of the parties enters into this waiver knowingly, intelligently, and voluntarily. e.

Each party understands that this waiver does not limit the legal disclosure obligations of the parties but rather is a statement under penalty of perjury that those obligations have been fulfilled. f. The parties also understand that if they do not comply with these obligations, the court will set aside the judgment. The petitioner and respondent declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. (TYPE OR PRINT NAME) (SIGNATURE OF RESPONDENT) Family Code, §§ 2102, 2104, 2105(

d) www.courtinfo.ca.gov OTHER: (TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER) 1. The parties agree as follows:2. SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

Form Adopted for Mandatory Use Judicial Council of California FL-180 [Rev. July 1, 2012] CASE NUMBER:JUDGMENT NULLITYLEGAL SEPARATIONDISSOLUTION Status only Reserving jurisdiction over termination of marital or domestic partnership status Date marital or domestic partnership status ends: Default or uncontested By declara tion under Family Code

section 2336This proceeding was heard as follows: Contested Room:Dept.:Date: Temporary judgeJudicial officer (name): Attorney present in court (name): Claimant present in court (name): c. d. Attorney present in court (name):e. The court acquired jurisdiction of the respondent on (date): The respondent appeared. The respondent was served with process. THE COURT ORDERS, GOOD CAUSE APPEARING Judgment of dissolution is entered. Marital or domestic partnership status is terminated and the parties are restored to the status of single persons a. on (specify date):(1)

(2) Judgment of nullity is entered. The parties are declared to be single persons on the ground of (specify): b. c. petitioner's e. f. d. JUDGMENT (Family Law) Family Code, §§ 2024, 2340, 2343, 2346 www.courts.ca.gov FOR COURT USE ONLY STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PETITIONER: FL-180 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FAX NO. (Optional): RESPONDENT: 1. 2. 3. 4. a. b. Petitioner present in court Respondent present in court A ttorney present in court (name): on a date to be determined on noticed motion of either party or on stipulation.

Judgment of legal separation is entered. This judgment will be entered nunc pro tunc as of (date): Jurisdiction is reserved over all other issues, and all present orders remain in effect except as provided below. This judgment The restraining orders are contained on page(

s) of the attachment. They expire on (date): MARRIAGE OR PARTNERSHIP OF former name is restored to (specify):respondent's Judgment on reserved issues f. Other (specify name): g. Judgment on reserved issues. h. This judgment contains provisions for child support or family support. Each party must complete and file with the court a Child Support Case Registry Form (form FL-191) within 10 days of the date of this judgment. The parents must notify the court of any change in the information submitted within 10 days of the change, by filing an updated form.

The Notice of Rights and Responsibilities—Health-Care Costs and Reimbursement Procedures and Information Sheet on Changing a Child Support Order (form FL-192) is attached. Page 1 of 2 contains personal conduct restraining orders modifies existing restraining orders. a. b. TELEPHONE NO.: EMAIL ADDRESS: ATTORNEY FOR (Name): The Agreement in court SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S.

MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

FL-180 [Rev. July 1, 2012] JUDICIAL OFFICERDate: Number of pages attached: Parentage is established for children of this relationship born prior to the marriage or domestic partnership CASE NAME (Last name, first name of each party): CASE NUMBER: k. Child support is ordered as set forth in the attached Previously established in another case. Case number: Court: j. l. Child custody and visitation (parenting time) are ordered as set forth in the attached Spousal, domestic partner, or family support is ordered: As set forth in the attached Spousal, Partner, or Family Support Order Attachment (form FL-343).

Each attachment to this judgment is incorporated into this judgment, and the parties are ordered to comply with each attachment's provisions. Jurisdiction is reserved to make other orders necessary to carry out this judgment. 5. JUDGMENT (Family Law) Page 2 of 2 4. Stipulation to Establish or Modify Child Support and Order (form FL-350). SIGNATURE FOLLOWS LAST ATTACHMENT Stipulation and Order for Custody and/or Visitation of Children (form FL-355). Reserved for future determination as relates to petitioner respondent Other (specify):o. (2) (3) (2) (3) (4) (1) (3) 2)

(4) Property division is ordered as set forth in the attachedm. Settlement agreement, stipulation for judgment, or other written agreement. Other (specify): Property Order Attachment to Judgment (form FL-345). (1) (2)

(3) Dissolution or legal separation may automatically cancel the ri ghts of a sp ouse or domestic par tner under the other spouse's or domestic partner's will, trust, retirement plan, power of attorney, pay-on-dea th bank account, transfer-on-death vehicle regist ration, survivorship rights to any property owned in joint tenancy, and any other similar prop erty interest. It does not automatically cancel the rights of a spouse or domestic partner a s beneficiary of th e other spouse's or domest ic partner's life insurance policy.

You sh ould review these matters, as well as any credit cards, other credit accounts, insuranc e policies, retirement plans, and credit repo rts, to determine whether they should be changed or whether you should take any other actions. An earnings assignment may be issued without additional proof if child, family, partner, or spousal support is ordered. Any party required to pay support must pay interest on overdue amounts at the "legal rate," which is currently 10 percent.

A debt or obligation may be assigned to one party as part of the dissolution of property and debts, but if that party does not pay the debt or obligation, the creditor may be able to collect from the other party. NOTICE FL-180 i. Name Birthdate The children of this marriage or domestic partnership are: (2)

(1) Attorney fees and costs are ordered as set forth in the attachedn. Attorney Fees and Costs Order (form FL-346). Other (specify): (2)

(3) Other (specify): As set forth in the attached settlement agreement, stipulation for judgment, or other written agreement.

(5) Jurisdiction terminated to order spousal or partner support to petitioner respondent(2) Settlement agreement, stipulation for judgment, or other written agreement which contains the information required by Family Code

section 3048(a).

(1) Settlement agreement, stipulation for judgment, or other written agreement which contains the declarations required by Family Code

section 4065(a).

(1) Child Custody and Visitation Order Attachment (form FL-341). Child Support Information and Order Attachment (form FL-342). Previously established in another case. Case number: Court:

(4) Settlement agreement, stipulation for judgment, or other written agreement.

(1) THIS IS A COURT ORDER. Page 1 of 3 Form Approved for Optional Use Judicial Council of California FL-343 [Rev.

July 1, 2025] SPOUSAL, DOMESTIC PARTNER, OR FAMILY SUPPORT ORDER ATTACHMENT (Family Law) Family Code, §§ 150, 299, 3651, 3653, 3654, 4320, 4330, 4337 FL-343 PETITIONER: RESPONDENT: CASE NUMBER: SPOUSAL, DOMESTIC PARTNER, OR FAMILY SUPPORT ORDER ATTACHMENT TO Findings and Order After Hearing (form FL-340) Judgment (form FL-180) Restraining Order After Hearing (CLETS-OAH) (form DV-130) Other (specify): Parties' Stipulation (Written Agreement) dated THE COURT FINDS THE PARTIES STIPULATE (AGREE) (specify): Specify if this attachment is about an order for temporary support or a judgment for permanent support (check either 1 or 2 below). 1.

This attachment relates to temporary spousal or domestic partner support. a. This order attachment modifies an order or agreement for temporary support entered on (date): b. Net income. The parties' monthly income and deductions are as follows (complete (1), (2), or both):

(2) Respondent: receiving TANF/CaIWORKS $ $ $$ Total gross monthly income Total monthly deductions Total hardship deductions Net monthly disposable income

(1) Petitioner: receiving TANF/CaIWORKS $ $ $ $ c. A printout of a computer calculation of the parties' financial circumstances is attached for all required items not filled out above (for temporary support only). 2. This attachment relates to a judgment for permanent spousal or domestic partner support. a. This order attachment modifies a judgment entered on (date): b. The parties were married for (specify): years and months. c. The parties were registered as domestic partners or the equivalent for (specify): years and months. Family Code

section 4320 factors (check either (1) or (2) below, then complete (3)).d.

(1) The parties agreed to some or all of the factors as stated in Spousal or Domestic Partner Support Declaration Attachment (form FL-157) or in a similar written declaration filed with the court.

(2) The court considered the parties' declarations and supporting documents regarding each Family Code

section 4320 factor as stated in testimony, in Spousal or Domestic Partner Support Declaration Attachment (form FL-157), or in a similar written declaration filed with the court.

(3) The parties' agreement, or the court's findings, on Family Code

section 4320 factors are (specify): (

B) included in Spousal or Domestic Partner Support Factors Under Family Code

Section 4320—Attachment (form ). (

C) specified below: (

A) included in Attachment 2d(3)(A). courts.ca.gov FL-349

THIS IS A COURT ORDER. Page 2 of 3FL-343 [Rev. July 1, 2025] SPOUSAL, DOMESTIC PARTNER, OR FAMILY SUPPORT ORDER ATTACHMENT (Family Law) FL-343 PETITIONER: RESPONDENT: CASE NUMBER: f. The standard of living established during the marriage or domestic partnership was (describe): See Attachment 2f. g. The court finds that the parties have knowingly, intelligently, and voluntarily entered into a stipulation. 2. e. The parties are both self-supporting. 3. Jurisdiction a. The issue of support for the petitioner respondent is reserved for later determination. b.

The court terminates jurisdiction over the issue of support for the petitioner respondent. c. The court's jurisdiction over the issue of support will end on (specify date): 4. Support amount and payment terms a. The petitioner respondent must pay to the petitioner respondent as temporary permanent spousal support family support domestic partner support the following amount each month: $ b. Support payments will begin (date): c. Support payments are: (1) payable through (specify end date): (2) payable on the: day of each month.

(3) Other (specify): d. Support must be paid by check, money order, or cash other method (specify): a. An earnings assignment for the support will issue as requested by Note: The payor of spousal, family, or domestic partner support is responsible for the payment of support directly to the recipient until support payments are deducted from the earnings, and for any support not paid by the assignment. petitioner respondent. b. Service of the earnings assignment is stayed provided the payor is not more than (specify number): days late in paying spousal, family, or domestic partner support. 5.

Earnings assignment Termination (end) of support6. a. By law, unless the parties otherwise agree in writing, the support payor's obligation to pay support will end when either par ty dies or the support payee remarries or registers a new domestic partnership. b. Parties' agreement The parties agree that the support payor's obligation to pay support will not end as described in 6a. Instead, the support payor's obligation to pay support will continue until (specify below the terms of your agreement about when the support payee's obligation to pay support will end):

Page 3 of 3FL-343 [Rev. July 1, 2025] SPOUSAL, DOMESTIC PARTNER, OR FAMILY SUPPORT ORDER ATTACHMENT (Family Law) FL-343 PETITIONER: RESPONDENT: CASE NUMBER: 7. Family support orders. This order is for family support. a. Both parties must complete and file with the court a Child Support Case Registry Form (form ) within 10 days of the date of this order. b. The parents must notify the court of any change of information submitted within 10 days of the change by filing an updated form. A Notice of Rights and Responsibilities Regarding Child Support (form FL-192) must be attached to the court order.c. 8.

Notice of change of employment The parties must inform each other in writing within 10 days of any change of employment, and include the new employer’s name, address, and telephone number. 9. Duty to become self-supporting a. Notice: It is the goal of this state that each party must make reasonable good-faith efforts to become self-supporting as provided in Family Code

section 4320. 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. b. The petitioner respondent should make reasonable good-faith efforts to become self-supporting. c. Other (specify): 10. Attachment to Restraining Order After Hearing (form DV-130) a. This form is attached to Restraining Order After Hearing (CLETS-OAH) (Order of Protection) (form DV-130). b. The orders issued on this form (FL-343) do not expire on termination of the restraining orders issued on form DV-130. 11.

Other orders or agreements (specify): NOTICE: Any party required to pay support must pay interest on overdue amounts at the “legal” rate, which is currently 10 percent. THIS IS A COURT ORDER. FL-191

The petitioner PROPERTY ORDER ATTACHMENT TO JUDGMENT (Family Law) Form Approved for Optional Use Judicial Council of California FL-345 [Rev. January 1, 2021 Family Code, §§ 299, 2500–2660 www.courts.ca.gov Page 1 of 2 e. The FL-345 PETITIONER: RESPONDENT: CASE NUMBER: PROPERTY ORDER ATTACHMENT TO JUDGMENT 1. Division of community property assets a. There are no community property assets. The court finds that the net value of the community estate is less than $5,000 and that the c. The petitioner will receive the following assets: b. petitioner respondent cannot be found. Under Family Code

section 2604, the entire community estate is awarded to the petitioner respondent. See Attachment 1c. See Attachment 1d.The respondent will receive the following assets:d. petitioner respondent will be responsible for preparing and filing a Qualified Domestic Relations Order (QDRO) to divide the following plan or retirement account(s) (specify): The fee for preparation of the QDRO will be shared as follows: f. Other orders: g. Each spouse or domestic partner will receive the assets listed above as sole and separate property. The parties must execute any and all documents required to carry out this division. 2.

Division of community property debts a. There are no community property debts. All community debts have been paid by the c. b. petitioner respondent must reimburse the other party: $ petitioner respondent. The The payment plan is as follows: is assigned the debts listed below; is solely responsible for paying the debts listed below; and will not hold the respondent legally responsible for the debts listed below. (2) (1)

(3) See attachment 2c.

FL-345 [Rev. January 1, 2021] Page 2 of 2 FL-345 PETITIONER: RESPONDENT: CASE NUMBER: e. The court reserves jurisdiction to divide any community debts not listed here and to enforce the terms of this judgment. This enforcement may include ordering a defaulting party to reimburse the other party for failing to follow the terms of this judgment. 3. Equalization of division of property and debt orders. To equalize the division of the community property assets and debts, respondent must pay to the other the sum of: $ the , payable as follows: 4. Separate property a.

The court confirms the following assets or debts as the sole separate property, or sole responsibility, of the petitioner: The court confirms the following assets or debts as the sole separate property, or sole responsibility, of the respondent: b. 5. The settlement agreement between the parties dated: 6. Sale of property. The following property will be offered for sale and sold for the fair market value as soon as a willing buyer can be found, and the net proceeds from the sale will be divided equally other (specify): 7.

Other orders (specify): PROPERTY ORDER ATTACHMENT TO JUDGMENT (Family Law) is attached and made a part of this judgment. d. The respondent is assigned the debts listed below; is solely responsible for paying the debts listed below; and will not hold the petitioner legally responsible for the debts listed below. (2) (1)

(3) See attachment 2d. f. petitioner Notice regarding division of community property (items c. and d.): Creditors are not bound by this judgment. If a creditor seeks payment from the party who is not listed as responsible for the debt, that party can file a Request for Order (form FL-300) to seek reimbursement from the party who was assigned the debt. Other orders:g. 2.

Judicial Council of California, courts.ca.gov Rev. July 1, 2026, Mandatory Form Fam. Code, §§ 2338, 7636, 7637 Notice of Entry of Judgment (Family Law—Parentage—Custody and Support) FL-190, Page 1 of 1 FL-190 FAX NO. (Optional): ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): TELEPHONE NO.: EMAIL ADDRESS: ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO RESPONDENT: PETITIONER: FOR COURT USE ONLY NOTICE OF ENTRY OF JUDGMENT CASE NUMBER: You are notified that the following judgment was entered on (date): 1. Dissolution 2. Legal separation 3. Nullity 4.

Dissolution—status only 5. Parent-child relationship 6. Judgment on reserved issues 7. Dissolution—reserving jurisdiction over termination of marital status or domestic partnership 8. 2WKHU VSHFLI\ Date: Clerk, by , Deputy NOTICE TO ATTORNEY OR RECORD OR PARTY WITHOUT ATTORNEY Under Code of Civil Procedure

section 1952, if no appeal is filed, the court may order the exhibits destroyed or otherwise disposed of after 60 days from the expiration of the appeal time. STATEMENTS IN THIS BOX APPLY ONLY TO JUDGMENT OF DISSOLUTION Effective date of termination of marital status (specify): Effective date of termination of domestic partnership status (specify): WARNING: Neither party may remarry or enter into a new domestic partnership until the effective date of the termination of marital or domestic partnership status, as shown in this box.

CLERK'S CERTIFICATE OF MAILING I certify that I am not a party to this cause and that a true copy of Notice of Entry of Judgment was mailed first class, postage fully prepaid, in a sealed envelope addressed as shown below, and that the notice was mailed at (place): , California, on (date): Date: Clerk, by , Deputy Name and address of petitioner or attorney Name and address of petitioner or attorney Name and address of respondent or attorney Name and address of respondent or attorney CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E.

MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

INFORMATION SHEET FOR PROOF OF PERSONAL SERVICE Use these instructions to complete the Proof of Personal Service (form FL-330). A person at least 18 years of age or older must serve the documents. There are two ways to serve documents: (1) personal delivery and (2) by mail. See the Proof of Service by Mail (form FL-335) if the documents are being served by mail. The person who serves the documents must complete a proof of service form for the documents being served. You cannot serve documents if you are a party to the action.

INSTRUCTIONS FOR THE PERSON WHO SERVES THE DOCUMENTS (TYPE OR PRINT IN BLACK INK) You must complete a proof of service for each package of documents you serve. For example, if you serve the respondent and the other parent, you must complete two proofs of service; one for the respondent and one for the other parent. Complete the top

section of the proof of service forms as follows: First box, left side: In this box print the name, address, and phone number of the person for whom you are serving the documents. Second box, left side: Print the name of the county in which the legal action is filed and the court’s address in this box. Use the same address for the court that is on the documents you are serving. Third box, left side: Print the names of the petitioner/plaintiff, respondent/defendant, and other parent in this box. Use the same names listed on the documents you are serving.

First box, top of form, right side: Leave this box blank for the court’s use. Second box, right side: Print the case number in this box. This number is also stated on the documents you are serving. You are stating that you are over the age of 18 and that you are neither a party of this action nor a protected person listed in any of the orders. Print the name of the party to whom you handed the documents. List the name of each document that you delivered to the party. a. Write in the date that you delivered the documents to the party. b. Write in the time of day that you delivered the documents to the party. c.

Print the address where you delivered the documents. Check the box that applies to you. If you are a private person serving the documents for a party, check box “a.” Print your name, address, and telephone number. If applicable, include the county in which you are registered as a process server and your registration number. You must check this box if you are not a California sheriff or marshal. You are stating under penalty of perjury that the information you have provided is true and correct. Do not check this box unless you are a California sheriff or marshal.

Print your name, fill in the date, and sign the form. If you need additional assistance with this form, contact the family law facilitator in your county. FL-330-INFO [New January 1, 2012] Page 1 of 1 INFORMATION SHEET FOR PROOF OF PERSONAL SERVICE 1. 2. 3. 4. 5. 6. 8. 7. FL-330-INFO Third box, right side: Print the hearing date, time, and department. Use the same information that is on the documents you are serving. Code of Civil Procedure, § 1011 www.courts.ca.gov

FL-330 ATTORNEY OR PARTY WITHOUT ATTORNEY OR GOVERNMENTAL AGENCY (under Family Code, §§ 17400,17406) (Name, State Bar number, and address): PROOF OF PERSONAL SERVICE I am at least 18 years old, not a party to this action, and not a protected person listed in any of the orders. Person served (name): I served copies of the following documents (specify): By personally delivering copies to the person served, as follows: Date: b. Time: Address: I am registered California process server. exempt from registration under Business & Profession a. d. a California sheriff or marshal.e.

My name, address, and telephone number, and, if applicable, county of registration and number (specify): 7. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. 8. Date: (TYPE OR PRINT NAME OF PERSON WHO SERVED THE PAPERS) (SIGNATURE OF PERSON WHO SERVED THE PAPERS) Page 1 of 1 Code of Civil Procedure, § 1011 www.courts.ca.gov Form Approved for Optional Use Judicial Council of California FL-330 [Rev.

January 1, 2012] PROOF OF PERSONAL SERVICE FOR COURT USE ONLY CASE NUMBER: 1. 2. 3. 4. a. c. 5. not a registered California process server. a registered California process server. an employee or independent contractor of a b. c. Code

section 22350(b). 6. I am a California sheriff or marshal and I certify that the foregoing is true and correct. PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT/PARTY: TELEPHONE NO.: EMAIL ADDRESS: ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: FAX NO. (Optional): HEARING DATE: DEPT.: HEARING TIME: (If applicable, provide): CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 S OUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

INFORMATION SHEET FOR PROOF OF SERVICE BY MAIL Use these instructions to complete the Proof of Service by Mail (form FL-335). A person at least 18 years of age or older must serve the documents. There are two ways to serve documents: (1) personal delivery and (2) by mail. See the Proof of Personal Service (form FL-330) if the documents are being personally served. The person who serves the documents must complete a proof of service form for the documents being served. You cannot serve documents if you are a party to the action.

INSTRUCTIONS FOR THE PERSON WHO SERVES THE DOCUMENTS (TYPE OR PRINT IN BLACK INK) You must complete a proof of service for each package of documents you serve. For example, if you serve the respondent and the other parent, you must complete two proofs of service; one for the respondent and one for the other parent. Complete the top

section of the proof of service forms as follows: documents. Second box, left side: Print the name of the county in which the legal action is filed and the court’s address in this box. Third box, left side: Print the names of the petitioner/plaintiff, respondent/defendant, and other parent in this box. Use the same names listed on the documents you are serving. First box, top of form, right side: Leave this box blank for the court’s use. You cannot serve a temporary restraining order by mail. You must serve those documents by personal service.

You are stating that you are at least 18 years old and that you are not a party to this action. You are also stating that you either live in or are employed in the county where the mailing took place. Print your home or business address. List the name of each document that you mailed (the exact names are listed on the bottoms of the forms). Check this box if you put the documents in the regular U.S. mail. Check this box if you put the documents in the mail at your place of employment. Print the name you put on the envelope containing the documents.

Print the address you put on the envelope containing the documents. Print the date that you put the envelope containing the documents in the mail. Print the city and state you were in when you mailed the envelope containing the documents. You are stating under penalty of perjury that the information you have provided is true and correct. Print your name, fill in the date, and sign the form. If you need additional assistance with this form, contact the family law facilitator in your county.

INFORMATION SHEET FOR PROOF OF SERVICE BY MAIL FL-335-INFO [New January 1, 2012] Page 1 of 1 First box, left side: In this box print the name, address, and phone number of the person for whom you are serving the Second box, right side: Print the case number in this box. This number is also stated on the documents you are serving. 2. 1. 3. a. b. 4. a. b. c. d. 6. Check this box if you are serving an address verification form (required for service by mail of a postjudgment request to change a child custody, visitation, or child support order). 5. Third box, right side: Print the hearing date, time, and department.

Use the same information that is on the documents you are serving. FL-335-INFO Code of Civil Procedure, §§ 1013, 1013a www.courts.ca.gov Use the same address for the court that is on the documents you are serving.

FL-335 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY CASE NUMBER: PROOF OF SERVICE BY MAIL NOTICE: To serve temporary restraining orders you must use personal service (see form FL-330). I am at least 18 years of age, not a party to this action, and I am a resident of or employed in the county where the mailing took place. My residence or business address is: I served a copy of the following documents (specify): by enclosing them in an envelope AND a. depositing the sealed envelope with the United States Postal Service with the postage fully prepaid. b.

The envelope was addressed and mailed as follows: Name of person served: Date mailed: Place of mailing (city and state): I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME) (SIGNATURE OF PERSON COMPLETING THIS FORM) Page 1 of 1 Form Approved for Optional Use Judicial Council of California FL-335 [Rev.

January 1, 2012] PROOF OF SERVICE BY MAIL Code of Civil Procedure, §§ 1013, 1013a 1. 2. 3. placing the envelope for collection and mailing on the date and at the place shown in item 4 following our ordinary business practices. I am readily familiar with this business’s practice for collecting and processing correspondence for mailing. On the same day that correspondence is placed for collection and mailing, it is deposited in the ordinary course of business with the United States Postal Service in a sealed envelope with postage fully prepaid. 4.

Address:b. a. c. d. 6. www.courts.ca.gov PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT/PARTY: SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: I served a request to modify a child custody, visitation, or child support judgment or permanent order which included an5. address verification declaration. (Declaration Regarding Address Verification—Postjudgment Request to Modify a Child Custody, Visitation, or Child Support Order (form FL-334) may be used for this purpose.) HEARING DATE: DEPT.: HEARING TIME: FAX NO. (Optional): TELEPHONE NO.: EMAIL ADDRESS : ATTORNEY FOR (Name): (If applicable, provide): CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E.

MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

MC-040 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO TELEPHONE NO.: EMAIL ADDRESS: ATTORNEY FOR (Name): STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: Form Approved for Optional Use Judicial Council of California MC-040 [Rev. January 1, 2013] NOTICE OF CHANGE OF ADDRESS OR OTHER CONTACT INFORMATION Page 1 of 2 PLAINTIFF/PETITIONER: NOTICE OF CHANGE OF ADDRESS OR OTHER Please take notice that, as of (date): plaintiff (name): a.

The new address or other contact information for (name): All notices and documents regarding the action should be sent to the above address. Date: (SIGNATURE OF PARTY OR ATTORNEY)(TYPE OR PRINT NAME) b. d. f. g. Street: City: State and zip code: Fax number (if available): E-mail address (if available): e.

Telephone number : DEFENDANT/RESPONDENT: is as follows: FOR COURT USE ONLY CASE NUMBER: JUDICIAL OFFICER: DEPT.: has changed his or her address for service of notices and documents or other contact information in the above-captioned action. 1. 3. defendant (name): petitioner (name): respondent (name): other (describe): a. b. c. d. e. the following self-represented party or the attorney for: 2. A list of additional parties represented is provided in Attachment 1. c. Mailing address (if different from above): CONTACT INFORMATION Cal.

Rules of Court, rules 2.200 and 8.816 www.courts.ca.gov CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910

(NOTE: This page may be used for proof of service by first-class mail of the Notice of Change of Address or Other Contact Information. Please use a different proof of service, such as Proof of Service—Civil (form POS-040), if you serve this notice by a method other than first class-mail, such as by fax or electronic service. You cannot serve the Notice of Change of Address or Other Contact Information if you are a party in the action.

The person who served the notice must complete this proof of service.) CASE NUMBER: PROOF OF SERVICE BY FIRST-CLASS MAIL I served a copy of the Notice of Change of Address or Other Contact Information by enclosing it in a sealed envelope addressed to the persons at the addresses listed in item 5 and (check one): At the time of service, I was at least 18 years old and not a party to this action.

NOTICE OF CHANGE OF ADDRESS OR OTHER CONTACT INFORMATION The Notice of Change of Address or Other Contact Information was placed in the mail: I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME OF DECLARANT) (SIGNATURE OF DECLARANT) NOTICE OF CHANGE OF ADDRESS MC-040 [Rev. January 1, 2013] Page 2 of 2 4. a. b. 1. 3. deposited the sealed envelope with the United States Postal Service with postage fully prepaid. at (city and state):b. a. on (date): The envelope was addressed and mailed as follows:5. a.

Name of person served: Street address: City: State and zip code: c. Name of person served: Street address: City: State and zip code: b. Name of person served: Street address: City: State and zip code: d. Name of person served: Street address: City: State and zip code: Names and addresses of additional persons served are attached. (You may use form POS-030(P).) MC-040 OR OTHER CONTACT INFORMATION I am a resident of or employed in the county where the mailing took place.

My residence or business address is (specify):2. placed the sealed envelope for collection and for mailing, following our ordinary business practices. I am readily familiar with this business's practice for collecting and processing correspondence for mailing. On the same day correspondence is placed for collection and mailing, it is deposited in the ordinary course of business with the United States Postal Service in a sealed envelope with postage fully prepaid. PLAINTIFF/PETITIONER: DEFENDANT/RESPONDENT:

“WITH CHILDREN”

FL-191 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): COURT PERSONNEL: STAMP DATE RECEIVED HERE DO NOT FILE CHILD SUPPORT CASE REGISTRY FORM CASE NUMBER: Mother First form completed Father THIS FORM WILL NOT BE PLACED IN THE COURT FILE. IT WILL BE MAINTAINED IN A CONFIDENTIAL FILE WITH THE STATE OF CALIFORNIA. Notice: Pages 1 and 2 of this form must be completed and delivered to the court along with the court order for support. Pages 3 and 4 are instructional only and do not need to be delivered to the court.

If you did not file the court order, you must complete this form and deliver it to the court within 10 days of the date on which you received a copy of the support order. Any later change to the information on this form must be delivered to the court on another form within 10 days of the change. It is important that you keep the court informed in writing of any changes of your address and telephone number. ModificationInitial child support or family support orderb.

Total monthly base current child or family support amount ordered for children listed below, plus any monthly amount ordered payable on past-due support:

(1) Current base child support:

(2) Additional monthly support: Person required to pay child or family support (name): Relationship to child (if applicable): Person or agency to receive child or family support payments (name): TYPE OR PRINT IN INK Page 1 of 4 Family Code, § 4014Form Adopted for Mandatory Use Judicial Council of California FL-191 [Rev.

July 1, 2005] CHILD SUPPORT CASE REGISTRY FORM www.courtinfo.ca.gov Change to previous information Relationship to child (specify): FAX NO. (Optional):TELEPHONE NO.: EMAIL ADDRESS: ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S.

MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910 PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT: (5) ordered but stayed until (date):Wage withholding was Support order information (this information is on the court order you are filing or have received). ordered

(3) Total past-due support: $ $ $ Date order filed: 1. 3. 2. a. c. Child Support: Family Support: Spousal Support: $0 (zero) order Reserved order

(4) Payment on past- due support: $ Current base family support: Additional monthly support: Total past-due support: $ $ $ $0 (zero) order Reserved order Payment on past- due support: $ Current spousal support: Total past-due support: $ $ $0 (zero) order Reserved order Payment on past- due support: $

You are required to complete the following information about yourself. You are not required to provide information about the other person, but you are encouraged to provide as much as you can. This form is confidential and will not be filed in the court file. It will be maintained in a confidential file with the State of California. Father’s name: Date of birth: Social security number: Street address: City, state, zip code: Mailing address: Driver’s license number: State: Telephone number: Self-employedEmployed Not employedg. Employer’s name: Street address: City, state, zip code: Telephone number: 7.

A restraining order, protective order, or nondisclosure order due to domestic violence is in effect. Father Mother ChildrenThe order protects: Father MotherFrom: The restraining order expires on (date): I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME) (SIGNATURE OF PERSON COMPLETING THIS FORM) Page 2 of 4CHILD SUPPORT CASE REGISTRY FORM FL-191 [Rev. July 1, 2005] a. b. c. 5. a. b. c. d. e. f.

Mother’s name: Date of birth: Social security number: Street address: City, state, zip code: Mailing address: City, state, zip code: Driver’s license number: State: Telephone number: Self-employedEmployed Not employedg. Employer’s name: Street address: City, state, zip code: Telephone number: a. b. c. 6. d. e. f. City, state, zip code: PETITIONER/PLAINTIFF: CASE NUMBER: RESPONDENT/DEFENDANT: OTHER PARENT: The child support order is for the following children: Date of birth Social security number a. b. Additional children are listed on a page attached to this document. Child’s name 4. c.

INFORMATION SHEET FOR CHILD SUPPORT CASE REGISTRY FORM (Do NOT deliver this Information Sheet to the court clerk.) Please follow these instructions to complete the Child Support Case Registry Form (form FL-191) if you do not have an attorney to represent you. Your attorney, if you have one, should complete this form. Both parents must complete a Child Support Case Registry Form. The information on this form will be included in a national database that, among other things, is used to locate absent parents.

When you file a court order, you must deliver a completed form to the court clerk along with your court order. If you did not file a court order, you must deliver a completed form to the court clerk WITHIN 10 DAYS of the date you received a copy of your court order. If any of the information you provide on this form changes, you must complete a new form and deliver it to the court clerk within 10 days of the change. The address of the court clerk is the same as the one shown for the superior court on your order. This form is confidential and will not be filed in the court file.

It will be maintained in a confidential file with the State of California. INSTRUCTIONS FOR COMPLETING THE CHILD SUPPORT CASE REGISTRY FORM (TYPE OR PRINT IN INK): If the top

section of the form has already been filled out, skip down to number 1 below. If the top

section of the form is blank, you must provide this information. Page 1, first box, top of form, left side: Print your name, address, telephone number, fax number, and e-mail address, if any, in this box. Attorneys must include their State Bar identification numbers. Page 1, second box, top of form, left side: Print the name of the county and the court’s address in this box. Use the same address for the court that is on the court order you are filing or have received. Page 1, third box, top of form, left side: Print the names of the petitioner/plaintiff, respondent/defendant, and other parent in this box.

Use the same names listed on the court order you are filing or have received. Page 1, fourth box, top of form, left side: Check the box indicating whether you are the mother or the father. If you are the attorney for the mother, check the box for mother. If you are the attorney for the father, check the box for father.

Also, if this is the first time you have filled out this form, check the box by "First form completed.” If you have filled out form FL-191 before, and you are changing any of the information, check the box by “Change to previous information.” Page 1, first box, right side: Leave this box blank for the court’s use in stamping the date of receipt. Page 1, second box, right side: Print the court case number in this box. This number is also shown on the court papers. Instructions for numbered paragraphs: Enter the date the court order was filed.

This date is shown in the “COURT PERSONNEL: STAMP DATE RECEIVED HERE" box on page 1 at the top of the order on the right side. If the order has not been filed, leave this item blank for the court clerk to fill in. If the court order you filed or received is the first child or family support order for this case, check the box by “Initial child support or family support order." If this is a change to your order, check the box by “Modification.” Information regarding the amount and type of support ordered and wage withholding is on the court order you are filing or have received.

If your order provides for any type of current support, check all boxes that describe that support. For example, if your order provides for both child and spousal support, check both of those boxes. If there is an amount, put it in the blank provided. If the order says the amount is reserved, check the “Reserved order” box. If the order says the amount is zero, check the “$0 (zero) order" box. Do not include child care, special needs, uninsured medical expenses, or travel for visitation here These amounts will go in (2). Do NOT complete the Child Support Case Registry form if you receive spousal support only.

If your order provides for a set monthly amount to be paid as additional support for such needs as child care, special needs, uninsured medical expenses or travel for visitation check the box in Item 2 and enter the monthly amount. For example, if your order provides for base child support and in addition the paying parent is required to pay $300 per month, check the box in item 2 underneath the "Child Support" column and enter $300. Do NOT check this box if your order provides only for a payment of a percentage, such as 50% of the childcare. Page 3 of 4CHILD SUPPORT CASE REGISTRY FORMFL-191 [Rev.

July 1, 2005] 1. a. b. c. (1)

(2) Write the name of the person who is supposed to pay child or family support. Write the name of the person or agency supposed to receive child or family support payments. List the full name, date of birth, and social security number for each child included in the support order. If there are more than five children included in the support order, check the box below item 4e and list the remaining children with dates of birth and social security numbers on another sheet of paper. Attach the other sheet to this form. The local child support agency is required, under

section 466(a)(13) of the Social Security Act, to place in the records pertaining to child support the social security number of any individual who is subject to a divorce decree, support order, or paternity determination or acknowledgment. This information is mandatory and will be kept on file at the local child support agency. Top of page 2, box on left side: Print the names of the petitioner/plaintiff, respondent/defendant, and other parent in this box. Use the same names listed on page 1. Top of page 2, box on right side: Print your court case number in this box.

Use the same case number as on page 1, second box, right side. You are required to complete information about yourself. If you know information about the other person, you may also fill in what you know about him or her. If you are the father in this case, list your full name in this space. See instructions for a–g under item 6 below. If you are the mother in this case, list your full name in this space. List the street address, city, state, and zip code where you want your mail sent, if different from the address where you live.

Indicate whether you are employed, not employed, self-employed, or by checking the appropriate box. If you are employed, write the name, street address, city, state, zip code, and telephone number where you work. If there is a restraining order, protective order, or nondisclosure order, check this box. Check the box beside the parent who is restrained. Write the date the restraining order expires. See the restraining order, protective order, or nondisclosure order for this date.

If you are in fear of domestic violence, you may want to ask the court for a restraining order, protective order, or nondisclosure order. You must type or print your name, fill in the date, and sign the Child Support Case Registry Form under penalty of perjury. When you sign under penalty of perjury, you are stating that the information you have provided is true and correct. CHILD SUPPORT CASE REGISTRY FORMFL-191 [Rev.

July 1, 2005] Page 4 of 4 If your order provides for a specific dollar amount to be paid towards any past due support, check the box in Item 4 that states the type of past due support and enter the amount. For example, the court ordered $350 per month to be paid on the past due child support, you would check the box in Item 4 in the "Child Support" column and enter $350. If your order determined the amount of past due support, check the box in Item 3 that states the type of past due support and enter the amount.

For example, if the court determined that there was $5000 in past due child support and $1000 in past due spousal support, you would check the box in item 3 in the "Child Support" column and enter $5000 and you would also check the box in item 3 in the "Spousal Support" column and enter $1000. (3) (4) 2. a. b. 3. a. b. 4. Write the relationship of that person to the child. Write the relationship of that person to the child. 6. 5. Check the box beside each person who is protected by the restraining order. List your date of birth. Write your social security number.

List the street address, city, state, and zip code where you live. Write your driver's license number and the state where it was issued. List the telephone number where you live. 7. a. b. c. d. e. f. g. a. b. c. Check the "ordered" box if wage withholding was ordered with no conditions. Check the box "ordered but stayed until" if wage withholding was ordered but is not to be deducted until a later date. If the court delayed the effective date of the wage withholding, enter the specific date. Check only one box in this item.

(5) Page 1 of 3 Form Adopted for Mandatory Use Judicial Council of California FL-192 [Rev. September 1, 2024] NOTICE OF RIGHTS AND RESPONSIBILITIES REGARDING CHILD SUPPORT Childcare and Health Care Costs and Reimbursement Procedures Family Code, §§ 4007.5, 4010, 4062, 4063 FL-192 NOTICE OF RIGHTS AND RESPONSIBILITIES REGARDING CHILD SUPPORT Childcare and Health Care Costs and Reimbursement Procedures Your child support order may include a provision for payment of childcare or uninsured health care costs.

Childcare costs may be included as part of the monthly child support payment or reimbursable as a percentage of the costs. If the childcare costs are included as part of the monthly child support payment, you must pay that amount each month until the court changes (modifies) the child support order. If you need to change your child support order because there has been a change in the cost of childcare, see page 2.

If you have a child support order that includes a provision for the reimbursement of a percentage of childcare costs or a portion of the child's or children's health care costs and those costs are not paid by insurance, the law says: 1. Notice. You must give the other parent an itemized statement of the charges that have been billed for any childcare costs or health care costs not paid by insurance. You must give this statement to the other parent within a reasonable time, but no more than 90 days after those costs were given to you. 2. Proof of full payment.

If you have already paid all of the childcare costs or uninsured health care costs, you must (1) give the other parent proof that you paid them and (2) ask for reimbursement for the other parent's court- ordered share of those costs. 3. Proof of partial payment.

If you have paid only your share of the childcare costs or uninsured health care costs, you must (1) give the other parent proof that you paid your share, (2) ask that the other parent pay his or her share of the costs directly to the childcare or health care provider, and (3) give the other parent the information necessary for that parent to be able to pay the bill. 4. Payment by notified parent.

If you receive notice from a parent that a childcare or uninsured health care cost has been incurred, you must pay your share of that cost within the time the court orders; or if the court has not specified a period of time, you must make payment (1) within 30 days from the time you were given notice of the amount due, (2) according to any payment

schedule set by the health care provider, (3) according to a

schedule agreed to in writing by you and the other parent, or (4) according to a

schedule adopted by the court. 5. Going to court. Sometimes parents get into disagreements about childcare and health care costs. If you and the other parent cannot resolve the situation after talking about it, you can request that the court make a decision. a. Disputed requests for payment. If you dispute a request for payment made by the other parent, you may file a request for the court to resolve the dispute, but only if you pay the requested amount before filing your request. b. Nonpayment.

If you claim that the other parent has failed to pay you back for a payment, or they have failed to make a payment to the provider after proper notice, you may file a request for the court to resolve the dispute. c. Paid charges. The court will presume that if uninsured health care costs or childcare costs for employment or necessary training for job skills have been paid, those costs were reasonable. If you want to dispute paid charges, you will have to show the court that the costs were unreasonable. d. Attorney's fees.

If the court decides one parent has been unreasonable, it can order that parent to pay the other parent's attorney's fees and costs. e. Court forms. Use forms and to get a court date. See form for information about completing, filing, and serving your court papers. 6. Court-ordered insurance coverage. If a parent provides health care insurance as ordered by the court, that insurance must be used at all times to the extent that it is available for health care costs. a. Burden to prove. The parent claiming that the coverage is inadequate to meet the child's needs has the burden of proving that to the court. b.

Cost of additional coverage. If a parent purchases health care insurance in addition to that ordered by the court, that parent must pay all the costs of the additional coverage. In addition, if a parent uses alternative coverage that costs more than the coverage provided by court order, that parent must pay the difference. 7. Preferred health providers. If the court-ordered coverage designates a preferred health care provider, that provider must be used at all times consistent with the terms of the health insurance policy.

When any parent uses a health care provider other than the preferred provider, any health care costs that would have been paid by the preferred health provider if that provider had been used must be the sole responsibility of the parent incurring those costs. 8. Need help? Contact the in your county or call your county's bar association and ask for an experienced family lawyer. www.courts.ca.gov FL-300 FL-490 FL-300-INFO family law facilitator

FL-192 [Rev. September 1, 2024] NOTICE OF RIGHTS AND RESPONSIBILITIES REGARDING CHILD SUPPORT Information Sheet on Changing a Child Support Order Page 2 of 3 FL-192 Information Sheet on Changing a Child Support Order General Info The court has made a child support order in your case. This order will remain the same unless one of the parents requests that the support be changed (modified). An order for child support can be modified by filing a request to change child support and serving the other parent.

If both parents agree on a new child support amount, they can complete, sign, and file with the court a Stipulation to Establish or Modify Child Support and Order (form ). (Note: If the local child support agency is involved in your case, it must be served with any request to change child support and approve any agreement.) Online Self-Help Guide For more information about how child support works, visit: .

When a Child Support Order May Be Changed The court considers several things when ordering the payment of child support. z First, the number of children is considered, along with the percentage of time each parent has physical custody of the children. z Next, the net disposable incomes of both parents are determined (which is how much money is left each month after taxes and certain other items like health insurance, union dues, or other child support ordered and paid are subtracted from a parent's paycheck).

The court can also look at a parent's earning ability. z The court considers both parents’ tax filing status and may consider hardships, such as the cost of raising the parent's child from another relationship who lives with the parent. A parent can request to change an existing order for child support when circumstances change significantly. For example if the net disposable income of one of the parents changes, parenting time changes, or a new child is born. Examples z You have been ordered to pay $500 per month in child support. You lose your job.

You will continue to owe $500 per month, plus 10 percent interest on any unpaid support, unless you file a motion to modify your child support to a lower amount and the court orders a reduction. z You are currently receiving $300 per month in child support from the other parent, whose net income has just increased substantially. You will continue to receive $300 per month unless you file a motion to modify your child support to a higher amount and the court orders an increase. z You are paying child support based on having physical custody of your children 30 percent of the time.

After several months it turns out that you actually have physical custody of the children 50 percent of the time. You may file a motion to modify child support to a lower amount. How to Change a Child Support Order To change a child support order, you must file papers with the court. Remember: You must follow the order you have now. What forms do I need?

If you are asking to change a child support order, you must fill out one of these forms: z Form , Request for Order or z Form , Notice of Motion and Motion for Simplified Modification of Order for Child, Spousal, or Family Support You must also fill out one of these forms, and attach proof of income for the past two months (like your paycheck stubs): z Form , Income and Expense Declaration or z Form , Financial Statement (Simplified) What if I am not sure which forms to fill out? Contact the family law facilitator in your county. You can find them here: .

After you fill out the forms, file them with the court clerk and ask for a hearing date. Write the hearing date on the form. The clerk may ask you to pay a filing fee. If you cannot afford the fee, fill out these forms, too: z Form , Request to Waive Court Fees and z Form , Order on Court Fee Waiver (Superior Court) You must serve the other parent. If the local child support agency is involved, serve it too. z This means someone 18 or over—not you—must deliver copies of your filed court forms to the other parent, at least 16 court days before the hearing.

Add 5 calendar days if delivered by mail within California (see Code of Civil Procedure

section 1005 for other situations). z Court days are weekdays when the court is open for business (Monday through Friday except court holidays). Calendar days include all days of the month, including weekends and holidays. To find court holidays, go to: . Blank copies of both of these forms must also be served: z Form , Responsive Declaration to Request for Order z Form , Income and Expense Declaration Then the server fills out and signs a Proof of Service. Take this form, plus one copy, to the clerk and file it at least one week before your hearing. Go to your hearing and ask the judge to change the support.

Bring your tax returns from the last two years and your proof of income for the past two months (like your paycheck stubs). The judge will look at your information, listen to both parents, and make an order. After the hearing, fill out: z Form , Findings and Order After Hearing and z , Child Support Information and Order Attachment Form Need help? Contact the in your county or call your county's bar association and ask for an experienced family lawyer.

FL-350 https://selfhelp.courts.ca.gov/child-support FL-300 FL-390 FL-150 FL-155 www.courts.ca.gov/selfhelp-facilitators.htm FW-001 FW-003 www.courts.ca.gov/holidays.htm FL-320 FL-150 FL-340 FL-342 family law facilitator

FL-192 [Rev. September 1, 2024] NOTICE OF RIGHTS AND RESPONSIBILITIES REGARDING CHILD SUPPORT Information About Child Support for Incarcerated or Confined Parents Page 3 of 3 FL-192 Information About Child Support for Incarcerated or Confined Parents 1. Child support. As of September 27, 2022, child support automatically stops if the parent who has to pay is confined against their will for more than 90 days in a row in jail, prison, juvenile detention, a mental health facility, or other institution. Exception.

Child support does not automatically stop if the parent who has to pay has money available to pay child support. 2. Past confinement. Child support also automatically stops during past confinement if it was ordered from October 8, 2015, through December 31, 2019, or January 1, 2021, through September 26, 2022, and the parent who has to pay was confined for more than 90 days in a row during the same time frame. Exceptions for past confinement.

Child support does not automatically stop if the parent who has to pay was in jail or prison for failing to pay child support or for domestic violence against the other parent or the child, or if they had money available to pay support. 3. Timing. The date child support automatically restarts will depend on the parent's release date. If you need to change your child support order, see page 2. a. If released before January 1, 2024, child support automatically restarts the first day of the first full month after the parent is released. b.

If released after January 1, 2024, child support will automatically restart the first day of the 10th month after the parent is released. Employment before the 10-month period ends: If the parent who has to pay support starts working before the date child support is set to automatically restart, the person who is owed support or the local child support agency can request the court restart the child support order early. The court may order a different amount of child support if appropriate. 4. More info. For more information about child support and incarcerated parents, see or go to .

You can also contact the family law facilitator in your county and can find them here: . Famil y Code

section 4007.5 https://selfhelp.courts.ca.gov/child-support/incarcerated- parent www.courts.ca.gov/selfhelp-facilitators.htm

Form Adopted for Mandatory Use Judicial Council of California FL-105/GC-120 [Rev. January 1, 2025] DECLARATION UNDER UNIFORM CHILD CUSTODY JURISDICTION AND ENFORCEMENT ACT (UCCJEA) Family Code, § 3400 et seq.; Probate Code, §§ 1510(f), 1512 FL-105/GC-120 FAX NO. (Optional): ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910 (This

section applies to cases other than probate guardianships.) PETITIONER: OTHER PARTY: CHILD'S NAME (Juvenile cases only): RESPONDENT: (This

section applies only to probate guardianship cases.) GUARDIANSHIP OF (name): Minor DECLARATION UNDER UNIFORM CHILD CUSTODY JURISDICTION AND ENFORCEMENT ACT (UCCJEA) FOR COURT USE ONLY CASE NUMBER: 1. I am (check one): a party to this proceeding to determine custody of a child the authorized representative of the agency, which is a party to this proceeding to determine custody of a child. 2. There are (specify number): minor children who are subject to this proceeding, as follows (list oldest child first): Full Name Date of birth Place of birth (city and state) a. b. c. d.

Check this box if you need to list more children. (On form or a separate piece of paper, write "FL-105, Attachment 2, Additional Children" at the top, provide all requested information for each additional child, and attach to this form.) 3. a.

Dates of residence (Month/Year) Residence (City, State) Person child lived with and complete current address Relationship From: To present Confidential (list state only) Confidential (list state only) From: To: From: To: From: To: From: To: Additional addresses are listed on Attachment 3a. (Form may be used for this purpose.) (Provide the current address of the child listed in item 2a and their residence history for the past five years. If the current address is confidential under Family Code

section 3429, check the box and provide only the state of residence.) Check this box if there is only one child or if all of the children listed in item 2 have lived together for the past five years. b. Check this box if there is more than one child and all the children have not lived together for the past five years. (Attach form FL-105(A)/GC-120(

A) and list each other child's current address and their residence history for the past five years.) Page 1 of 2 www.courts.ca.gov MC-020 MC-020 TELEPHONE NO.: EMAIL ADDRESS: ATTORNEY FOR (Name):

FL-105/GC-120 [Rev. January 1, 2025] DECLARATION UNDER UNIFORM CHILD CUSTODY JURISDICTION AND ENFORCEMENT ACT (UCCJEA) Page 2 of 2 FL-105/GC-120 CASE NAME: CASE NUMBER: 4. Do you have information about, or have you participated as a party or as a witness or in some other capacity in, another cour t case or custody or visitation proceeding, in California or elsewhere, concerning a child subject to this proceeding?

Yes No (If yes, attach a copy of the orders if you have one and provide the following information): Proceeding Case number Court (name, state or tribe, location) Court order or judgment (date) Name of each child Your connection to the case Case status b. Probate Guardianship a. Family c. Other Proceeding Case Number Court (name, state or tribe, location) d. Juvenile e. Adoption 5.

One or more domestic violence restraining/protective orders are now in effect. (Attach a copy of the orders if you have one and provide the following information): Court County State or Tribe Case Number (if known) Orders expire (date) a. Criminal b. Family c. Juvenile d. Other 6. Do you know of any person who is not a party to this proceeding who has physical custody of or claims to have rights to custo dy of or visitation with any child in this case? Yes No (If yes, provide the following information): a.

Name and address of person: Has physical custody Claims custody rights Claims visitation rights Name of each child: b. Name and address of person: Has physical custody Claims custody rights Claims visitation rights Name of each child: c. Name and address of person: Has physical custody Claims custody rights Claims visitation rights Name of each child: 7. Number of pages attached: I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date: (NAME OF DECLARANT) (SIGNATURE OF DECLARANT) NOTICE TO DECLARANT: You have a continuing duty to inform this court if you obtain any information about a custody proceeding in a California court or any other court concerning a child subject to this proceeding.

Judicial Council of California, courts.ca.gov Rev. July 1, 2026, Optional Form Fam. Code, §§ 3011, 3020, 3022, 3025, 3040–3044, 3048, 3100, 6340, 7604 Child Custody and Visitation (Parenting Time) Order Attachment FL-341 CASE NUMBER:PETITIONER: RESPONDENT: OTHER PARENT/PARTY: CHILD CUSTODY AND VISITATION (PARENTING TIME) ORDER ATTACHMENT TO Findings and Order After Hearing (form FL-340) Judgment (form FL-180) Judgment (form FL-250) Stipulation and Order for Custody and/or Visitation (Parenting Time) (form FL-355) 2WKHU(specify): 1. Jurisdiction.

This court has jurisdiction to make child custody orders in this case under the Uniform Child Custody Jurisdiction and Enforcement Act (Fam. Code, §§ 3400–3465). 2. Notice and opportunity to be heard. The responding party was given notice and an opportunity to be heard, as provided by the laws of the State of California. 3. Country of habitual residence. The country of habitual residence of the child or children in this case is WKH8QLWHG6WDWHV2WKHU(specify): 4. Penalties for violating this order. If you violate this order, you may be subject to civil or criminal penalties, or both. 5.

Child abduction prevention. There is a risk that one of the parties will take the children out of California without the other party's permission. (Child Abduction Prevention Order Attachment (form is attached and must be obeyed.) 6. The court refers the parties to child custody mediation or child custody recommending counseling as follows: 7. Child custody. Custody of the minor children of the parties is awarded as follows: a. Child's Name Birth Date Legal custody to: (person who decides about the child's health, education, and welfare) Physical custody to: (person the child regularly lives with) b.

Joint legal custody of the child or children will be exercised as specified in the following order: Joint Legal Custody Attachment (form FL-341(E)) Attachment 7b (form MC-025 may be used for this purpose) 8. Child custody and visitation (parenting time) involving allegations of a history of abuse or substance abuse a. Allegations have been raised in form FL-311, other documents filed in the court, or in a court hearing that

(1) Petitioner Respondent Other parent/party is (or are) alleged to have a history of abuse against any of the following persons: a child, the other parent, their current spouse, or the person they live with or are dating or engaged to.

(2) Petitioner Respondent Other parent/party is (or are) alleged to have the habitual or continual illegal use of controlled substances, or the habitual or continual abuse of alcohol, or the habitual or continual abuse of prescribed controlled substances. b. The court does NOT grant sole or joint custody of the minor children to: Other parent/partyPetitioner Respondent c.

(1) Even though there are allegations of a history of abuse or substance abuse, the court GRANTS sole or joint custody of the minor child as set out in item 7.

(2) As required by Family Code

section 3011(a)(5)(A), the court's reasons for making the orders: (

B) Were recorded as follows: In a minute order By a court reporter 2WKHU(specify): (

A) Are in writing and filed separately (form FL-351 may be used for this purpose).

(3) The court finds that the order is in the best interests of the child, protects the safety of the parties and the child, and is specific as to time, day, place, and manner of transfer (exchange) of the child as Family Code sections 3011(a)(5)(

A) and 6323(

c) require. THIS IS A COURT ORDER. FL-341, Page 1 of 4 FL-341(B))

Rev. July 1, 2026 Child Custody and Visitation (Parenting Time) Order Attachment FL-341 CASE NUMBER:PETITIONER: RESPONDENT: OTHER PARENT/PARTY: 9. Visitation (parenting time) a. Reasonable right of visitation to the party without physical custody (not appropriate in cases involving domestic violence) b. 6HHWKHDWWDFKHG-page document c. No visitation (parenting time) d. The visitation (parenting time) will be supervised as specified in the attached Supervised Visitation (Parenting Time) and Exchanges Order (FL-341(A)). e. Visitation (parenting time) for the petitioner respondent other (name): will be in person, by virtual visitation (not in person), and/or other ways as specified below:

(1) In person, as follows (

a) Weekends starting (date): (Note: The first weekend of the month is the first weekend with a Saturday.) Weekend Day(

s) Times Start of (or After) School (if applicable) 1st from at a.m. p.m. start of after to at a.m. p.m. start of after 2nd from at a.m. p.m. start of after to at a.m. p.m. start of after 3rd from at a.m. p.m. start of after to at a.m. p.m. start of after 4th from at a.m. p.m. start of after to at a.m. p.m. start of after 5th from at a.m. p.m. start of after to at a.m. p.m. start of after (

i) The parties will alternate the fifth weekends, with the petitioner respondent other parent/party having the initial fifth weekend, starting (date): The petitioner respondent other parent/party odd evenwill have the fifth weekend in numbered months. (ii) (

b) Alternate weekends starting from at a.m. p.m. start of after to at a.m. p.m. start of after (date): (

c) Weekdays starting (date): from at a.m. p.m. start of after to at a.m. p.m. start of after (

d) Other visitation (parenting time) days and restrictions are listed in Attachment 9e(1)(

d) as follows:(form MC-025 may be used for this purpose)

(2) Virtual visitation, as follows: THIS IS A COURT ORDER. FL-341, Page 2 of 4

Rev. July 1, 2026 Child Custody and Visitation (Parenting Time) Order Attachment FL-341 CASE NUMBER:PETITIONER: RESPONDENT: OTHER PARENT/PARTY:

(3) Other ways visitation can happen that are in the best interests of the child are as follows: 10. Supervised visitation (parenting time) Until further order of the court other (specify): petitioner respondent other parent/party (name): will have supervised visitation (parenting time) with the minor children according to the attached Supervised Visitation (Parenting Time) and Exchanges Order (form FL-341(A)). 11. Transportation for visitation (parenting time) and place of exchange a. The children must be driven only by a licensed and insured driver.

The vehicle must be legally registered with the Department of Motor Vehicles, and must have child restraint devices properly installed, as required by law. b. Transportation to begin the visits will be provided by the petitioner respondent other (specify): c. Transportation from the visits will be provided by the petitioner respondent other (specify): d. The exchange point at the beginning of the visit will be at (address): e. The exchange point at the end of the visit will be at (address): f.

During the exchanges, the party driving the children will wait in the car and the other party will wait in the home (or exchange location) while the children go between the car and the home (or exchange location). g. Other (specify): 12. Travel with children. The petitioner respondent other parent/party (name): must have written permission from the other parent or a court order to take the children out of a. The state of California. b. The following counties(specify): c. Other places(specify): THIS IS A COURT ORDER. FL-341, Page 3 of 4 9. e.

Rev. July 1, 2026 Child Custody and Visitation (Parenting Time) Order Attachment FL-341 CASE NUMBER:PETITIONER: RESPONDENT: OTHER PARENT/PARTY: 13. Holiday schedule. The children will spend holiday time as listed EHORZ LQWKHDWWDFKHGVFKHGXOH (Children's Holiday

Schedule Attachment (form FL-341(C)) may be used for this purpose.) 14. Additional custody provisions. The parties will follow the additional custody provisions listed EHORZ LQWKH attached schedule. (Additional Provisions—Physical Custody Attachment (form FL-341(D)) may be used for this purpose.) 15. Access to children's records. Both the custodial and noncustodial parent have the right to access records and information about their minor children (including medical, dental, and school records) and consult with professionals who are providing services to the children. 16. Other (specify): THIS IS A COURT ORDER. FL-341, Page 4 of 4

Judicial Council of California, courts.ca.gov Rev. January 1, 2026; Mandatory Form Fam. Code, §§ 3100, 3031 Supervised Visitation (Parenting Time) and Exchanges Order FL-341(A), Page 1 of 2 FL-341(

A) CASE NUMBER:PETITIONER/PLAINTIFF: OTHER PARENT/PARTY: RESPONDENT/DEFENDANT: SUPERVISED VISITATION (PARENTING TIME) AND EXCHANGES ORDER ATTACHMENT TO: Child Custody and Visitation (Parenting Time) Order Attachment (form FL-341) (specify):Other 1. child abduction physical abuse drug abuse neglect sexual abuse domestic violence alcohol abuse RWKHU(specify): Evidence has been presented in support of a request that the contact of with the child or children be supervised based upon allegations of Petitioner Respondent Other Parent/Party Petitioner Respondent Other Parent/Party disputes these allegations and the court reserves the findings on these issues pending further investigation and hearing or trial. 2.

The court finds, under Family Code

section 3100, that the best interest of the child or children requires that visitation by Petitioner Respondent Other Parent/Party must, until further order of the court, be limited to contact supervised by the person or supervised visitation center set forth in this order pending further investigation and hearing or trial. THE COURT MAKES THE FOLLOWING ORDERS 3. CHILDREN a. Name: Date of birth: b. Name: Date of birth: c. Name: Date of birth: The names and birthdates of additional children are attached to the order. 4. PROFESSIONAL SUPERVISED VISITATION WITH CHILDREN a. Provider Information (check one):

(1) Chosen provider (name): Telephone: Address (if known): If the chosen provider cannot provide services, parties must use the alternate provider. Alternate provider (name): Telephone: Address (if known): Petitioner Respondent Other Parent/Party to contact the provider by (date):

(2) The parties have not yet chosen a provider. A list of professional providers (check all that apply): is attached to this order. was given in court to: Petitioner Respondent Other Parent/Party Petitioner Respondent Other Parent/Party must choose and contact a provider by (date): (4) (specify):Other

(3) The professional provider will be a mutually agreed-upon third party as arranged by the parties. b. Frequency of visits (check one): Once a week, for (1) (number of hours for each visit): Two times each week, for (2) (number of hours for each visit):

(3) According to the

schedule specified in: Form FL-341 Other (specify): c. Visits must be (check one): In person at a safe location.

(1) Virtual visitation (not in person). (2)

(3) Other (specify): d. Payment responsibility: Petitioner: % Respondent: % Other: % THIS IS A COURT ORDER.

Rev. January 1, 2026 FL-341(A), Page 2 of 2Supervised Visitation (Parenting Time) and Exchanges Order FL-341(

A) CASE NUMBER:PETITIONER/PLAINTIFF: OTHER PARENT/PARTY: RESPONDENT/DEFENDANT: Relationship to child:Name: Telephone (if known): Address (if known): a. Nonprofessional provider (person) to supervise visits: 5. NONPROFESSIONAL SUPERVISED VISITATION WITH CHILDREN b. Frequency of visits (check one): Once a week, for (1) (number of hours for each visit): Two times each week, for (2) (number of hours for each visit):

(3) According to the

schedule specified in: Form FL-341 Other (specify): c. Visits must be (check one): In person at a safe location.(1) (specify location): Virtual visitation (not in person). (Provider, child, and visiting parent may need to access the internet.)(2)

(3) Other (specify): d. Resources for nonprofessional providers: Find your Declaration (form FL-324(NP)) at: courts.ca.gov/sites/default/files/courts/default/2024-11/fl324np.pdf.

(1) For online information, go to: www2.courtinfo.ca.gov/accesstovisitation/story_html5.html.(2)

(3) For information about safe locations and virtual visits, go to: selfhelp.courts.ca.gov/guide-supervised-visitation. a.

(1) Professional provider Name: Relationship to child: Address (if known): Payment responsibility Petitioner: % Respondent: % Other: % Petitioner Respondent Other Parent/Party to contact the provider by (specify date) (date): Location of supervised exchanges to be decided by the professional provider. Safe location for exchanges: (For more information, see item 5d. Resources for nonprofessional providers.) Nonprofessional provider Relationship to child:Name: Telephone (if known): Address (if known):

(2) Type of provider: 6. SUPERVISED EXCHANGES (Drop-off and Pick-up of Children) b. Supervised exchanges will be according to the

schedule specified: In form FL-341(1)

(2) Other (specify):

(3) Below: 7. THE COURT FURTHER ORDERS THIS IS A COURT ORDER.

Page 1 of 3 Form Adopted for Mandatory Use Judicial Council of California FL-342 [Rev. September 1, 2024] CHILD SUPPORT INFORMATION AND ORDER ATTACHMENT Family Code, §§ 4055-4069 FL-342 PETITIONER: RESPONDENT: OTHER PARENT/PARTY: CASE NUMBER: CHILD SUPPORT INFORMATION AND ORDER ATTACHMENT Attachment to: Findings and Order After Hearing (form FL-340) Judgment (form FL-180) Judgment (form FL-250) Restraining Order After Hearing (form DV-130) Other (specify): THE COURT USED THE FOLLOWING INFORMATION IN DETERMINING THE AMOUNT OF CHILD SUPPORT: 1.

A printout of a computer calculation and findings is attached and incorporated in this order for all required items not filled out below. 2. Income a. Each parent’s monthly income is as follows: Gross monthly income Net monthly income Receiving TANF/CaIWORKs Petitioner: $ $ Respondent: $ $ Other Parent/Party: $ $ b. Earning capacity. The court finds that the (check all that apply): (1) petitioner has the ability to earn $ per month. (2) respondent has the ability to earn $ per month. (3) other parent/party has the ability to earn $ per month.

(4) The factors used to calculate earning capacity under Family Code

section 4058(

b) are stated (

a) in Earning Capacity Factors Attachment (form ). (

b) as follows (specify): 3. Children of this relationship a. Number of children who are the subjects of the support order (specify): b. Approximate percentage of time spent with petitioner: % respondent: % other parent/party: % 4. Hardships Hardships for the following have been allowed in calculating child support: Petitioner Respondent Other Parent/Party Approximate end date for the hardship a. Other minor children: $$$ b. Extraordinary medical expenses: $$$ c. Catastrophic losses: $$$ THE COURT ORDERS 5. Low-income adjustment a.

The low-income adjustment applies at the lowest amount of the range. b. 7KHORZHVWDPRXQWRIWKHORZLQFRPHDGMXVWPHQWKDVEHHQUHEXWWHGDQGGRHVQRWDSSO\EHFDXVH VSHFLI\UHDVRQV THIS IS A COURT ORDER. www.courts.ca.gov FL-302

FL-342 [Rev. September 1, 2024] CHILD SUPPORT INFORMATION AND ORDER ATTACHMENT Page 2 of 3 FL-342 PETITIONER: RESPONDENT: OTHER PARENT/PARTY: CASE NUMBER: 6. Child support a. Base child support Petitioner Respondent Other parent/party must pay child support beginning (date): and continuing until further order of the court, or until the child marries, dies, is emancipated, reaches age 19, or reaches age 18 and is not a full-time high school student, whichever occurs first, as follows: Child’s name Date of birth Monthly amount Payable to (name): $ $ $ $ Payable on the 1st of the month other (specify): b. Mandatory additional child support

(1) Childcare costs related to employment or reasonably necessary job training (

a) Petitioner must pay: % of total or $ per month child-care costs. (

b) Respondent must pay: % of total or $ per month child-care costs. (

c) Other parent/party must pay: % of total or $ per month child-care costs. (

d) Costs to be paid as follows (specify):

(2) Reasonable uninsured health care costs for the children (

a) Petitioner must pay: % of total or $ per month. (

b) Respondent must pay: % of total or $ per month. (

c) Other parent/party must pay: % of total or $ per month. (

d) Costs to be paid as follows (specify): c. Additional child support

(1) Costs related to the educational or other special needs of the children (

a) Petitioner must pay: % of total or $ per month. (

b) Respondent must pay: % of total or $ per month. (

c) Other parent/party must pay: % of total or $ per month. (

d) Costs to be paid as follows (specify):

(2) Travel expenses for visitation (

a) Petitioner must pay: % of total or $ per month. (

b) Respondent must pay: % of total or $ per month. (

c) Other parent/party must pay: % of total or $ per month. (

Document details

Collection	California Superior Local Rules
Citation	Cal. Form PKT-003
Type	court_rule
Language	en
Format	pdf
Source	CA_LOCAL
Identifier	4b439c296d81f9aca9b941c61641432d2f89bd15

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