Fill and Sign the Application for Notice of Support Arrearage Form

TELEPHONE NO.: ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address): FOR COURT USE ONLYJUDGMENT CREDITOR ATTORNEY FORPETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT:CASE NUMBER: 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):2. Attached to this application is anAbstract of Support Judgment OR certified copy of the judgment or order for supportThe judgment or order requires payment of child support as follows: 3. Date payableName of childThe judgment or order requires payment of spousal or family support as follows: 4. Amount payableThe child support arrearage delinquent more than 30 days is computed as follows (state each month separately): 5. Amount dueAmount paidAmount orderedDate dueThe spousal or family support arrearage delinquent more than 30 days is computed as follows: 6. Applicable interestAmount paidAmount orderedDate dueCheck 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. Date:See reverse for important instructionsAPPLICATION FOR NOTICE OF SUPPORT ARREARAGE (Support Arrearage)Code of Civil Procedure section 708.730(d) Form Adopted by Rule 1297.90 Judicial Council of California 1297.90 [Rev. January 1, 1990] SUPERIOR COURT OF CALIFORNIA, COUNTY OF CITY AND ZIP CODE: BRANCH NAME: STREET ADDRESS: MAILING ADDRESS: applies for issuance of a Notice of Support Arrearage. Amount payableDate payableApplicable interestAmount due(SIGNATURE OF DECLARANT) (TYPE OR PRINT NAME)......................................................................................WEST GROUP Official Publisher