1.
Total amount unpaid (arrears) is at least:
2.
Date of order:
Payable by
Payable to
Total amount unpaid (arrears) is at least:
Payment of
Written notice of my intent to seek an earnings assignment was
a.
(1)
(2)
(3)
(4)
(specify):
by first class mail.
by personal service.
contained in the support order described in item 1 or 2.
other
Payable by (party):
Date of birth Monthly amountChild’s name
Payable to (party):
The amount of arrears stated in items 1f and 2d
(If penalties are not included, they are not waived.)
3.
b.
FL-430
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
TELEPHONE NO.:
FAX NO. (Optional):
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
BRANCH NAME:
CITY AND ZIP CODE:
STREET ADDRESS:
MAILING ADDRESS:
PETITIONER/PLAINTIFF:
RESPONDENT/DEFENDANT:
OTHER PARTY/PARENT:
FOR COURT USE ONLY
CASE NUMBER:
TERMINATE AN EARNINGS ASSIGNMENT ORDER
EX PARTE APPLICATION TO
MODIFY, OR
ISSUE,
(date):
Spousal or domestic partner support
family support was ordered as follows:
$
as of (date):
$
as of (date):
petitioner
other parent
other
respondent
respondent
(specify):
Interest and penalties
does
does not include interest at the legal rate. (If interest
does does not include penalties at the legal rate.
4.
(Complete for support ordered before July 1, 1990, only)
petitioner
child support
given at least 15 days before the date of filing this application
5.
An earnings assignment order has not been issued for support ordered after July 1, 1990.
Page 1 of 3
Family Code, §§ 3901, 5230, 5240, 5252
www.courts.ca.gov
EX PARTE APPLICATION TO ISSUE, MODIFY, OR
TERMINATE AN EARNINGS ASSIGNMENT ORDER
Form Adopted for Mandatory Use
Judicial Council of California
FL-430 [Rev. January 1, 2014]
E-MAIL ADDRESS (Optional):
b. c.
f.
d.
a.
b.
c.
d.a.
e.
The amount of arrears stated in items 1f and 2d
is not included, it is not waived.)
a.
b.
APPLICANT DECLARES
is overdue in the sum of at least one month's payment.
spousal or partner support
Child support was ordered as follows on
waived (explain):