Fill and Sign the Ex Parte Application for Wage Assignment 128565 Family Law 128565 Fl 430 Form

FL-430 ATTORNEY OR PARTY WITHOUT ATTORNEY OR GOVERNMENTAL AGENCY (pursuant TELEPHONE AND FAX NOS.:to Welf. & Inst. Code, §§ 11475.1, 11478.2) (Name, state bar number, and address): ATTORNEY FOR (Name): FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT: EX PARTE APPLICATION FOR WAGE ASSIGNMENT ASSIGNMENT ORDER MODIFICATION CASE NUMBER: APPLICANT DECLARES1. Child support was ordered as follows: a. Date of order: b. Payable by petitioner respondent other parent c.Payable to petitioner respondent other (specify) : d. Total amount unpaid is at least: $ as of (date) : 2. Spousal support family support was ordered as follows: a. Date of order: b. Payable by petitioner respondent other parentc.Payable to petitioner respondent other (specify) : d. Total amount unpaid is at least: $ as of (date) : 3. (Complete for support ordered before July 1, 1990 only) Payment of child support spousal support is overdue in the sum of at least one month's payment. Written notice of my intent to seek a wage assignment was a. given at least 15 days prior to the date of filing this application (1) by first class mail. (2) by personal service. (3) contained in the support order described in item 1 or 2. (4) other: b. waived (explain): 4. A Wage and Earnings Assignment Order has not been issued for support ordered after July 1, 1990.5. a.The amount of arrears stated in items 1d and 2d does does not include interest at the legal rate. If interest is not included, it is not waived.)b.The amount of arrears stated in items 1d and 2d does does not include interest at the legal rate. If penalties are not included, they are not waived.) (Continued on reverse) Form Adopted by for Manditory Use Judicial Council of CaliforniaFL-430 [Rev. January 1, 2003] EX PARTE APPLICATION FOR WAGE AND EARNINGS ASSIGNMENT ORDER Family Code, §§ 5230, 5252 ele ctr o n ic f o rm  2 002 WWW.LawCA.com La w P ublis h ers PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT: CASE NUMBER: 6. Modification of the existing Wage and Earnings Assignment Order is requested because a.th e f o llo w in g c h ild re n a re e m ancip ate d ( s u pport n o lo nger r e quir e d b y la w ) a s o f t h e f o llo w in g d ate s(specify name(s) and date(s)): b. custody of the following children has changed (specify): c. the support arrears in this case are paid in full. d. the Wage and Earnings Assignment Order must be conformed to the most recent support order asfollows (specify): e. the district attorney is no longer enforcing the current support obligation in this case but is required tocollect and enforce any arrears owing.f. the Wage and Earnings Assignment Order should be terminated as to spousal support because(1) the supported spouse remarried on (date): (2) the supported spouse died on (date): (3) by terms of the current order, spousal support was to terminate on (date): g. other (specify): 7. I request a Wage and Earnings Assignment Order issue for the following monthly deductions:a. $ per month current child support.b. $ per month current spousal support.c. $ per month current family support .c. $ per month child support arrears.e. $ per month spousal support arrears.f. $ per month family support arrears. g. Total deductions per month: $ I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.D ate : (TYPE OR PRINT NAME)(SIGNATURE Of APPLICANT) FL-430 [Rev. January 1, 2003] EX PARTE APPLICATION FOR WAGE AND EARNINGS ASSIGNMENT ORDERpage 2 of 2 e le ctr o n ic f o rm  2 002 WWW.LawCA.com La w P ublis h ers