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13-19117-360StipulationForEntryOfJudgment - approved Agreement for Judgment 120109 no msc

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Stipulation for Entry of Judgment
Re: Establishment of Parentage
Use Black Ink!
SUPERIOR COURT OF CALIFORNIA
COUNTY OF SAN BERNARDINO
Fill out each section in black ink, initial the bottom of each page, and sign & date the last page.
Section 1: Fill-in the names of each party and mark the
boxes to indicate who is the mother and
who is the father of the child(ren). Fill-in the name and birthdate of each child.
Section 3: Fill-in details regarding your agreement for child support, arrears, and child care costs.
You may reserve jurisdiction for one of the reasons provided. (Reserving jurisdiction means that
you do not want the Court to order child support payments right now. You may apply for it later.)
Section 4: Read the statements and mark the boxes that you agree with. You
may write any additional orders you want included as part of your judgment.
Next Step—Creation of Complete Judgment Package
For y
our judgment, you will need to have ad
ditional forms attached to your agreement before
filing it with the clerk’s office for submission to the judge for signature. The Resource Center
can fill out the additional forms that are needed for your judgment.
If you wish the Resource Center staff to prepare the judgment package for you,
then both parties need to take this paperwork to the Resource Center.
Section 2: Mark the boxes and fill-in the details about your agreement regarding custody and
visitation. You may fill out and attach form FL-341(C) if your agreement includes a specific
schedule for holidays.
PROTECT YOUR PRIVACY --- The party filing a document is responsible for excluding or redacting
(removing) personal identifying information such as social security and financial account numbers
from documents filed with the court. When filing a document with the court, use only the last four
digits of the social security and financial account numbers.
Page - 1 of 5
Petitioner Initials:
Respondent Initials:
Form No. 13-19117-360 rev. 040418
Stipulation for Entry of Judgment Re:
Establishment of Parental Relationship


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STIPULATION FOR ENTRY OF JUDGMENT
THE PARTIES STIPULATE THAT
1.
The parties have read and understand the Advisement and Waiver of Rights Re:
Establishment of Parental Relationship (form FL-235), which is submitted with this Stipulation
for Entry of Judgment. The parties give up those rights and freely agree that a judgment may
be entered in accordance with this stipulation.
Name:
Mother
Father
Name:
are the parents of the following children:
Mother Father
Date of Birth:
Check here if there are additional children.
2.
CHILD CUSTODY AND VISITATION (“Parenting Time”)
CUSTODY SHALL BE AWARDED AS FOLLOWS: Custody of the minor child/ren shall
be ordered as follows, and such arrangements are in the best interests of the minor child/ren:
LEGAL CUSTODY:
SOLE LEGAL CUSTODY of the minor child/ren shall be awarded to .
JOINT LEGAL CUSTODY of the minor child/ren shall be awarded to both parties.
Additional Joint Legal Custody Provisions as stated in the Attached Form FL-341(E)
PHYSICAL CUSTODY:
SOLE PHYSICAL CUSTODY of the minor child/ren shall be awarded to
JOINT PHYSICAL CUSTODY shall be shared between both parties.
Additional Physical Custody Provisions as stated in the Attached Form FL-341(D)
Petitioner:
Respondent:
Case Number:
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Petitioner:
Case Number:
Respondent:
Form No. 13-19117-360 rev. 040418
Stipulation for Entry of Judgment Re:
Establishment of Parental Relationship
Petitioner Initials:
Respondent Initials:




VISITATION (“Parenting Time”) AS FOLLOWS:
PRIMARY PHYSICAL CUSTODY to , with the right of
REASONABLE visitation to as follows:
OR
As contained in the attached Family Court Services report, consisting of
pages (Mediation date: / / ).
OR
SPECIFIC VISITATION to as follows:
Holiday Schedule as stated in the Attached Form FL-341(C)
PURSUANT TO FAMILY CODE SECTION 3048 (A)
This Court exercises jurisdiction under the Uniform Child Custody and Jurisdiction
Enforcement Act (part 3 of the California Family code, commencing with section 3400)
Notice and opportunity to be heard were given under Family Code Section 3425.
Violation of the order may subject the party in violation to civil or criminal penalties, or both.
The habitual residence of the child/ren is the United States unless marked
ADDITIONAL ORDERS RE: MINOR CHILDREN
Neither party shall remove the child/ren from the following geographic area
without prior written consent of the other party or prior order
of the Court first having been obtained except for vacation periods.
Page - 2 of 5
Petitioner:
Case Number:
Respondent:
Form No. 13-19117-360 rev. 040418
Stipulation for Entry of Judgment Re:
Establishment Parental Relationship
Petitioner Initials:
Respondent Initials:




___
___
Neither party shall use or make, nor allow any other persons to use or make, any
disparaging, or derogatory remarks about the absent parent in the presence of said
child/ren.
Each party shall keep the other party informed of his or her current address and telephone
number and those of the child/ren and shall notify the other within days of any change
of address or telephone number.
shall not consume any alcoholic beverages, narcotic, or restricted
dangerous drug (except upon prescription) prior to hours of visitation or during the
visitation with the minor children.
Transportation for visitation shall be as follows:
Transport TO visit provided by .
Transport FROM visit provided by .
Drop Off & Pickup will be at .
Other:
3.
CHILD SUPPORT
_ _ Petitioner _ _ Respondent shall pay to the other party as and for child support the
sum of $ per month, commencing and continuing until each child
dies, marries, becomes emancipated, reaches the age of 18 or reaches the age of 19 and is
a full-time high school student, or until further order of the Court, whichever first occurs,
Payable one-half on the and one-half on the day of each month
Payable once a month on the of each month
The allocation of support per child is as stated in the attached Child Support Calculation.
GUIDELINE: A printout of a computer calculation and findings is attached and incorporated in this
order. The amount of support per the guideline formula is $ .
The amount of child support is set forth as calculated under the guideline.
OR
Page - 3 - of
11
Petitioner:
Case Number:
Respondent:
Form No. 13-19117-360 rev. 040418
Stipulation for Entry of Judgment Re:
Establishment Parental Relationship
Petitioner Initials:
Respondent Initials:


___
___

WE AGREE TO NON-GUIDELINE CHILD SUPPORT. The child support agreed to by the
parties is below or above guideline. Pursuant to Family Code Section 4065(a), the parties declare
that they have been fully informed of their rights concerning child support. Neither party is acting
out of duress or coercion. Neither party is receiving public assistance and no application for public
assistance is pending. The needs of the children will be adequately met by this agreed-upon
amount of child support; the agreement is in the best interests of the children involved. Application
of the guideline amount would be unjust or inappropriate in this case. If the order is below the
guideline, no change of circumstances will be required to modify this order. If the order is above the
guideline, a change of circumstances will be required to modify this order.
Health insurance coverage for the minor children of the parties shall be maintained by the
petitioner respondent if available at no or reasonable cost through their respective places of
employment or self-employment. Both parties are ordered to cooperate in the presentation,
collection and reimbursement of any health-care claims. Any health expenses not paid by
insurance shall be shared: % Petitioner % Respondent
CHILD CARE COSTS
_ Petitioner _ Respondent shall pay reasonable child care costs related to
employment or necessary job training in the amount of $ , per month:
Each party shall pay one-half.
% Petitioner % Respondent
$ Petitioner $ Respondent
NO CHILD SUPPORT ORDER because child support has been previously established in
another case. Case Number:
RESERVED. The court’s jurisdiction to award child support is reserved for the following
reason:
Petitioner and Respondent have equal time with the children and equal income.
Supporting party has no income at this time.
Other: .
Page - 4 of 5
Petitioner:
Case Number:
Respondent:

4.
OTHER ORDERS
Change the last names of the children as follows:
from to
from to
from to
from to
The birth certificates must be amended to conform to this court order by
(1)
adding the father's name.
(2)
changing the last name of the children.
Each of the parties shall pay his/her own fees, expenses of litigation and court costs,
excepting those previously ordered.
Both parties waive Statement of Decision and any right to appeal.
Restraining orders have already been issued in this case and a copy of the personal conduct
restraining order is attached to this Judgment.
Additional orders
NOTICE AND OPPORTUNITY TO BE HEARD
The responding party was given notice and an opportunity to be heard as provided by the laws of
the State of California.
PENALTIES FOR VIOLATION OF ORDERS
If either party violates orders contained herein, party may be subject to civil or criminal penalties, or
both.
The foregoing is agreed to by:
x
Petitioner Date
x
Respondent Date
IT IS SO ORDERED:
Dated:
JUDGE OF THE SUPERIOR COURT
Petitioner Initials:
Form No. 13-19117-360 rev. 040418
Stipulation For Entry of Judgment Re:
Establishment of Parental Relationship
Page - 5 of 5
Respondent Initials:
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13-19117-360StipulationForEntryOfJudgment - approved Agreement for Judgment 120109 no msc

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Completed 3 July 2020

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