California > Judicial Council > Family Law - Enforcement
Application To Determine Arrearages FL-490 - California
| Application To Determine Arrearages Form. This is a California form and can be used in Family Law - Enforcement Judicial Council . |
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FL-490 PETITIONER: RESPONDENT: OTHER: CASE NUMBER: APPLICATION TO DETERMINE ARREARAGES Child support Unreimbursed expenses Other (specify): Attachment to Spousal support Family support Medical support Unreimbursed medical expenses Order to Show Cause (form FL-300) Notice of Motion (form FL-301) 1. I ask that arrearages be determined in this case. 2. I have attached (check all that apply): a. a Declaration of Payment History (FL-420) a Payment History Attachment (FL-421) b. c. Other (specify): 3. a. b. c. I ask that the support arrearage be changed as follows: I have already paid some all of the support ordered. Proof of payment is attached. The children for whom support is to be paid were living with me full time for the period from to . I provided all of their support during that period. I am attaching a detailed declaration explaining these facts and supporting documentation, including any proof that the children were living with me. Other (specify): 4. I have previously asked the other parent for payment and provided the other parent with an itemized statement of the unreimbursed childcare expense medical expense (Attach copies of all bills being claimed and proof of any payments that you have made on these bills.) Attorney fees and costs a. Fees b. Costs Income and Expense Declaration (form FL-150) is attached. 5. 6. Facts in support of the relief requested are (specify): contained in the attached declaration. 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) Petitioner/Plaintiff Attorney Respondent/Defendant Other (specify): NOTICE: This form must be attached to an Order to Show Cause (FL-300) or a Notice of Motion (FL-301). NOT A COURT ORDER Form Adopted for Mandatory Use Judicial Council of California FL-490 [Rev. July 1, 2003] Page ___ of ___ American LegalNet, Inc. www.USCourtForms.com APPLICATION TO DETERMINE ARREARAGES Family Code, §§ 47204732 www.courtinfo.ca.gov
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