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I. DISCLOSURE PURSUANT TO FC 2104, 2105 The (The Superior Court of California - County of Orange)

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L-1300 (Rev. 08/27/15)
Approved for Optional Use
Expedited Processing Attachment and Stipulation to Dissolution or Separation Judgment
Page 1 of 5
EXPEDITED PROCESSING ATTACHMENT AND STIPULATION TO
DISSOLUTION OR SEPARATION JUDGMENT
CASE NUMBER:
WARNING: This Attachment only includes the minimum statutory requirements at the time of entry of judgment.
It does not replace the stipulated judgment or other required documents.
I. DISCLOSURE PURSUANT TO FC §§ 2104, 2105
The parties have fully complied with the disclosure requirements of FC §§2102, 2104 and 2105
a. Preliminary Declaration of Disclosures Pursuant to FC §2104
Petitioner filed the Preliminary Declaration of Service (FL-141) on: _____________________
Submitted with Judgment
Respondent filed the Preliminary Declaration of Service (FL-141) on: ____________________
Submitted with Judgment
b. Final Declaration of Disclosures Pursuant to FC §2105
Petitioner filed the Final Declaration of Service (FL-141) on: _______________________
Submitted with Judgment
Respondent filed the Final Declaration of Service (FL-141) on: _____________________
Submitted with Judgment
Mutually Waived by:
use of Stipulation and Waiver of Final Declaration of Disclosure Form (FL-144)
Filed on: _________________
Submitted with Judgment
use of the statutory language in a separate stipulation, signed under penalty of perjury
Stipulation submitted with Judgment
See page _____ of Judgment
II. SPOUSAL SUPPORT PURSUANT TO FC §4336
The parties had a marriage of 10 years or more, from the date of marriage to the date of
separation, and spousal support has been addressed in the Marital Settlement Agreement/Stipulated
Judgment.
The parties had a marriage of less than 10 years, from the date of marriage to the date of
separation, and spousal support has been addressed in the Marital Settlement Agreement/Stipulated
Judgment.
The Parties agree to terminate the court’s jurisdiction (ability) to award spousal support.
Both parties knowingly give up forever any right to receive spousal or partner support.
L-1300 (Rev. 08/27/15)
Approved for Optional Use
Expedited Processing Attachment and Stipulation to Dissolution or Separation Judgment
Page 2 of 5
IF THERE ARE MINOR OR DEPENDENT CHILDREN OF THE MARRIAGE,
COMPLETE SECTIONS III AND IV, OTHERWISE PROCEED DIRECTLY TO
SECTION V, ON PAGE 5 OF THIS FORM
THERE ARE NO MINOR OR DEPENDENT CHILDREN OF THIS MARRIAGE.
III. CHILD CUSTODY/VISITATION PURSUANT TO FC §3048
(1) This court has jurisdiction to make child custody orders in this case under the Uniform Child
Custody Jurisdiction and Enforcement Act (part 3 of the California Family Code
commencing with section 3400).
(2) The responding party was given notice and an opportunity to be heard as provided by the
laws of the State of California.
(3) The country of habitual residence of the child(ren) is:
The United States
Other (specify country): _____________________________________
(4) If you violate this order you may be subject to civil or criminal penalties, or both.
(5) The judgment contains a clear description of the custody and visitation rights of each party.
IV. CHILD SUPPORT
a. FINDINGS PURSANT TO FC §3901 and §4065
(1) The Parties are fully informed of their rights concerning child support.
(2) The order is being agreed to without coercion or duress.
(3) The agreement is in the best interests of the child(ren) involved
(4) The needs of the child(ren) will be adequately met by the stipulated amount
(5) Unless otherwise indicated, the right to support has not been assigned to the county pursuant
to Section 11477 of the Welfare and Institutions Code and no public assistance application is
pending.
b. MONEY JUDGMENT IN COURT ORDER PURSUANT TO FC §5616
In the event that there is a contract between a party receiving support and a private child support
collector, the party ordered to pay support must pay the fee charged by the private child support
collector. This fee must not exceed 33 1/3 percent of the total amount of past due support nor
may it exceed 50 percent of any fee charged by the private child support collector. The money
judgment created by this provision is in favor of the private child support collector and the party
receiving support, jointly.
L-1300 (Rev. 08/27/15)
Approved for Optional Use
Expedited Processing Attachment and Stipulation to Dissolution or Separation Judgment
Page 3 of 5
_________
c. BASE CHILD SUPPORT
Please check all appropriate boxes. At least one (1) box must be checked:
CHILD SUPPORT IS RESERVED (If checked, skip directly to section V)
CHILD SUPPORT SERVICES INVOLVED
The parties currently have an open case with the Child Support Services (CSS)
and a CSS representative has signed the proposed judgment.
The parties currently have an open case with CSS, no child support orders are
contained in this judgment, and the court reserves jurisdiction over the issue of
child support, health insurance coverage, and additional child support.
If checked, skip directly to section V.
AGREED UPON SUPPORT
Petitioner
Respondent shall pay to Petitioner
Respondent base child support
of $
_________________ per
week
month, payable $ __________________
on_______________ and $ __________________ on ____________
of
each
week
month, commencing _______________
and continuing until
the child(ren) for whom support is payable: marries, dies, is emancipated, until
further order of the court or, as to an unmarried child who has attained the age of
18 years old, is a full-time high school student, and who is not self-supporting,
until the time the child completes the 12th grade or attains the age of 19 years old,
whichever first occurs.
d. MANDATORY ADDITIONAL CHILD SUPPORT PURSUANT TO FC §4062
Petitioner Respondent shall pay child care costs related to employment or reasonably
necessary education/job training:
________ % of total.
in the amount of $___________________
per week
month or
No child care costs orders are contained in this judgment and the court
reserves jurisdiction over the issue of child care costs.
Petitioner
Respondent shall pay the reasonable uninsured health care costs for the
child(ren):
% of total.
in the amount of $________________
per
week month or
e. DISCRETIONARY ADDITIONAL CHILD SUPPORT PURSUANT TO FC §4062
Petitioner
Respondent shall pay costs related to ___________________________
______________________________________________________________________:
in the amount of $ ___________
per
week
month or
_____ % of total.
L-1300 (Rev. 08/27/15)
Approved for Optional Use
Expedited Processing Attachment and Stipulation to Dissolution or Separation Judgment
Page 4 of 5
f. TOTAL CHILD SUPPORT
Petitioner Respondent shall pay to Petitioner Respondent base child support
of $ __________
per
week
month, plus additional child support as specified in
sections (d) and/or (e) on the previous page, for a total of $___________ per
week month,
payable $
______________per
week
month, $__________ on the_________
and $ ___________
on the ______________of each
week
month, commencing on_____________
and continuing
until the child(ren) for whom support is payable: marries, dies, is emancipated, until further order of
the court or, as to an unmarried child has attained the age of 18
years old, is a full-time high school
student, and who is not self-supporting, until the time the child completes the 12th grade or attains the
age of 19 years old, whichever first occurs.
g. REQUIRED ATTACHMENT PURSUANT TO FC §4063 and §7600
The parties have attached the following form: “Notice of Rights and Responsibilities: Health
Care Costs and Reimbursement Procedures and Information sheet on Changing a Child Support
Order” (Form FL-192)
h. HEALTH INSURANCE COVERAGE PURSUANT TO FC §3751
If child support is not reserved, at least one (1) of the following boxes must be checked.
Health insurance coverage for the minor child(ren) must be maintained by Petitioner
Respondent if that insurance is available at no cost or at reasonable cost to the parent(s) 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. The parent ordered to provide
health insurance must seek continuation of coverage for the child after the child attains the age when the
child is no longer considered eligible for coverage as a dependent under the insurance contract, if the
child is incapable of self-sustaining employment because of a physically or mentally disabling injury,
illness, or condition and is chiefly dependent upon the parent providing health insurance for support and
maintenance.
Health Insurance is not available to the
Petitioner
Respondent at a reasonable cost at this time.
Should health insurance coverage become available to a parent for no or for reasonable cost, that parent
must apply for that coverage.
i. INCOME WITHHOLDING FOR CHILD SUPPORT PURSUANT TO FC §5230
An Income Withholding for Child Support (form FL-195) must issue. Note: The payor of child
support is responsible for the payment of support directly to the recipient until support payments
are deducted from the payor's wages, and for any support not paid by the assignment.
j. EMPLOYER INFORMATION PURSUANT TO FC §4014
The parties must notify the other parent of the name and address of his or her current employer.
L-1300 (Rev. 08/27/15)
Approved for Optional Use
Expedited Processing Attachment and Stipulation to Dissolution or Separation Judgment
Page 5 of 5
V. MISCELLANEOUS PROVISIONS
The Marital Settlement Agreement/Stipulated Judgment that is also attached to the Judgment (form FL-180)
contains further orders.
All provisions are deemed incorporated into the Judgment. As to the provisions that contain a checkbox (
✔
),
only those provisions that are checked become part of the Judgment.
If there is any express conflict between the Marital Settlement Agreement/Stipulated Judgment and this
Expedited Processing Attachment, the Expedited Processing Attachment prevails. However, this Expedited
Processing Attachment is not all inclusive. The fact that this Expedited Processing Attachment is less
detailed is not a conflict. The Expedited Processing Attachment only includes the minimum statutory
requirements at the time of entry of judgment. It does not replace the stipulated judgment or other required
documents.
VI. STIPULATION FOR JUDGMENT
The parties agree that the Judgment (form FL-180) and all attachments, including this Expedited
Processing Attachment, contain the exact terms of the Judgment to be entered in this case.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true
and correct and agreed to by:
Petitioner:
Date
Date
Approved as confirming to the agreement of the parties:
Date
Date
Each attachment to this judgment is incorporated into this judgment, and the parties are ordered to comply
with each attachment’s provisions. Jurisdiction is reserved to make other orders necessary to carry out this
judgment.
Date Judge / Commissioner of the Superior Court
*: If Judgment is being submitted by way of a Stipulated Default (no Response [form FL-120] or Appearance,
Stipulations and Waivers [form FL-130] has been filed), then the Respondent's signature must be notarized and
must comply with Civil Code §1189.
Attorney for Petitioner:
Attorney for Respondent:
Respondent:
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I. DISCLOSURE PURSUANT TO FC 2104, 2105 The (The Superior Court of California - County of Orange)

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Completed 8 February 2021

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