ATTACHMENT FM-1083
FM -1083 NEW 07/01/11 STIPULATION AND ORDER Page 1 of 2
ATTORNEY OR PARTY WITHOUT ATTORNEY (NAME AND ADDRESS) TELEPHONE NUMBER:
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
PETITIONER:
RESPONDENT:
OTHER PARENT/CLAIMANT:
FOR COURT USE ONLY
STIPULATION AND ORDER
Modification
CASE NUMBER:
DEPARTMENT:
1. Not based on a hearing
Today’s Hearing (date)
2. Judge: Temporary
3. The parties agree that the Court will make orders about the following items:
Custody/Visitation Arrears
Child Support Attorney’s Fees and Costs
Spousal or Family Support Other:
All other issues are reserved until further Court order
4. Parties/Attorneys:
Petitioner present in court Petitioner’s attorney present:
Respondent present in court Respondent’s attorney present:
Claimant present in court Claimant’s attorney present:
Child’s Attorney/Other (specify): present:
5.
Continued Hearing: This hearing is continued to (dept) on (date) at (time)
about the following issues:
6. Number of attached pages:
Do not use this form for domestic violence restraining orders.
Those orders must be made on a Restraining Order after Hearing (CLETS), form DV-130.
We have read this entire Stipulation and Order, including all Attachments. We understand it fully and ask that
the Court make our stipulation into court orders.
201 North First Street, San José, CA 95113
191 North First Street
San José, California 95113
Family Justice Center
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PETITIONER:
RESPONDENT:
CASE NUMBER:
FM-1083 NEW 07/01/11 STIPULATION AND ORDER Page 2 of 2
Date:
Petitioner
Date:
Attorney for Petitioner
Date:
Respondent
Date:
Attorney for Respondent
Date:
Child’s Attorney
Date:
Other:
Date:
Other:
Interpreter Witness Declaration
Interpreter: The Petitioner Respondent is unable to read or understand this Stipulation and Order
and its attachments because:
a.
his/her primary language is (specify):
b.
other (specify):
I certify under penalty of perjury under the laws of the State of Calif
ornia that I have, to the best of my ability, read or
translated for the
Petitioner Respondent this Stipulation and Order including all attachments. He or she
said they understood this Stipulation and Order and its attachments before signing them.
Date Interpreter’
s printed name Interpreter’s signature
ORDER
The Court approves the terms stipulated and agreed to in this document by the parties and makes them court
orders. All prev
ious orders that are not inconsistent with these orders remain in full force and effect.
Date:
Judi
cial Officer of the Superior Court
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