Application for Notice of Support Arrearage

APPLICATION FOR NOTICE OF SUPPORT ARREARAGE

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

RESPONDENT/DEFENDANT:

APPLICATION FOR NOTICE OF SUPPORT ARREARAGE

NOTE: Instead of using these forms, you may ask the district attorney to collect your support arrearages through the tax intercept program.

1. Judgment creditor (name): applies for issuance of a Notice of Support Arrearage.

2. Attached to this application is an Abstract of Support Judgment OR certified copy of the judgment or order for support

3. The judgment or order requires payment of child support as follows:

4. The judgment or order requires payment of spousal or family support as follows:

5. The child support arrearage delinquent more than 30 days is computed as follows (state each month separately):

6. The spousal or family support arrearage delinquent more than 30 days is computed as follows:

Check this box and use an additional sheet if more space is required.

7. The exact amount now required to satisfy the judgment or order is: $

8. No child receives or received Aid to Families with Dependent Children (AFDC) during the period computed above. There is no assign- ment to a government agency of any child's right to support. I certify on information and belief there is no action pending by a district attorney to enforce any child's right to support.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.