Fill and Sign the California Short Form

ATTORNE Y F OR (N a me): SUPERIOR COUR T OF CA L IFORNIA, COUNT Y OF O T HER PARENT: SHORT FORM ORDER AFTER HEARING 3 . THE COUR T ORDERS: a . All orders previously ma de in thi s act i on will rem a in in fu ll force and effec t exce pt as sp e c i fica l ly modifie d b e low. Obl i go r is ordered t o a ppea r on th e contin u ance date. Curren t ch i ld s u ppor t is m o dified to $ per m o nt h b egin n in g (date): e . T he c o ur t r e ta i ns j u r i s d ict i on t o orde r s u pport retroact i v e to: (1 ) (Specify d at e ): (2 ) T h e d at e th e obl i gor b ecom es employe d o r otherwise ha s the ab i li ty to p ay sup p ort. (3 ) T h e d at e th e obl i gor a b ando ns o r s e parate s from the c h ildre n at i s su e i n thi s c a s e . ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– – – – ––––– ––––– ––––– – – ––––– – – ––––– – – ––––– ––––– ––––– – ––––– ––––– ––––– – ––––– – – ––––– ––––– ––––– ––––– – ––––– – ––––– ––––– – – ––––– – – – – – ––––– ––––– ––––– –––––GO V ERNM E NTA L AGENCY ( u n d e r Fa mil y Co d e , § § 1 7 4 0 0 , 1 7 4 0 6 ) : FOR COUR T US E ONLY F L - 688 T E L E P HON E N O. ( O p t i on a l): FA X NO. ( O p t i o na l ): E -M A I L ADDR E S S ( O p t i on a l): S TRE E T A DDR E S S : MAILING A DDR E S S : CIT Y A ND ZI P CODE: BR A NCH NAM E : P E T I TI ON E R /PL A I N TI F F : RESP O NDENT/DEFENDAN T: C A S E NU M B E R: 1 . T h i s matte r p r oce e de d a s fo l l o ws: a . Dat e : Dept .: Unconteste d By stipul a ti o n Judic i al officer: Conteste d b . c . d . Petit i oner/ p laintiff present Respon d ent/defen d ant prese n t Other paren t p r e s e nt Attorney presen t (na m e): Attorney presen t (na m e): Attorney presen t (na m e):e . Attorn ey for l o c a l ch i l d s u pport a g ency pre s e n t und e r F a mi l y Cod e sections 174 00 a nd 1 7406 b y ( n am e ) : f . O t her (specify): 2 . THE COUR T FINDS , base d u p on the moving pa p ers: a. (Name): is th e obl i gor (th e paren t o r d ered to pay support) in thi s p r o c e edin g . b . T h e o blig or is an d b a s e d there o n h as n o ab i lity to p ay sup p ort. c . He a lt h i n s u r a nce c o v e r a g e a t n o or re a s o nabl e cost i s curr e nt l y not availa b le to the obli g o r t o cover t he min o r chil d r en i n this action. b . This m a tte r i s continu ed t o in De p t. : for th e fo l lowi n g p urposes o nly: c . d . f . A n y order t o l i quid a te t he su p port arrearag e i s suspend e d u nt i l furthe r ord e r o f this court. g . T he p arents must notify the local chil d supp o rt agency in wr i ti ng w i th in 10 d ay s o f a n y cha n ge in r e s i dence o r e m p l oyme n t. h . i . The ob l igor i s ord e r ed to obtain hea l th insura n c e coverag e fo r t h e chil d r e n i n thi s acti o n if it b e c o me s avail a bl e at n o or r e asonab l e cost. Othe r ( s pecify): 4 . N um b er of p age s attache d : Date: Approved as c o nf o r min g to c o urt order: ( S I G N A TURE OF A T T O RN E Y FOR OB L IGO R) JUDICIA L OFFICER Fo rm A d op te d f o r Ma n d a t o r y U se P a ge 1 of 1 Fa m il y C od e, §§ 1 7 4 0 0 , 1 7 40 2 ,Ju d icia l C o u n c i l of C a lifor n ia FL -6 8 8 [R ev . July 1 , 2 0 0 5 ] SHORT FORM ORDER AFTER HEA R ING ( G ov e rnme n tal) 1 74 0, 1 7 4 0 6elec troni c form ã 2005 WWW.LawCA.co m L a w P u b l i s h e r s