Fillable RI-FL03 SUPERIOR COURT OF CALIFORNIA, COUNTY OF RIVERSIDE (California)

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RI-FL03 SUPERIOR COURT OF CALIFORNIA, COUNTY OF RIVERSIDE (California)

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SUPERIOR COURT OF CALIFORNIA, COUNTY OF RIVERSIDE
BLYTHE 265 N. Broadway, Blythe, CA 92225
INDIO 46-200 Oasis St., Indio, CA 92201
HEMET 880 N. State St., Hemet, CA 92543
RIVERSIDE 4175 Main St., Riverside, CA 92501
RI-FL03
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number and Address)
FOR COURT USE ONLY
TELEPHONE NO.:
FAX NO. (Optional):
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
PETITIONER:
RESPONDENT:
OTHER:
CASE NUMBER:
STIPULATION AND ORDER ON REQUEST FOR ORDER
THE PARTIES STIPULATE AND AGREE AS FOLLOWS:
1.
Child Custody and Visitation
This court has jurisdiction over the minor children under Family Code §§ 3421 – 3424.
Notice and an opportunity to be heard were given as provided by the laws of the State of California.
The habitual residence of the children is the United States of America.
The parties acknowledge that they were advised that any violation of this order may result in civil or criminal penalties, or both.
a.
Legal and physical custody of the children shall be as follows:
Child’s Name Birth Date Legal Custody to Physical Custody to
b.
Petitioner Respondent shall have the following visitation:
(1) Supervised visitation as stated in FL-341(A), which is attached.
(2) As stated in the Order Pursuant to Referral to Child Custody Recommending Counseling Services, consisting of
pages, which was filed on , and is attached.
(3) Other:
2.
Child Support
a.
Petitioner Respondent shall pay child support of $ per month due ½ on the 1
st
day and ½ on the 15
th
day
of each month commencing , and continuing until further order of the court or until each child marries,
dies, is emancipated, reaches age 19, or reaches age 18 and is not a full-time high school student, which ever first occurs.
b.
Support is allocated between minor children as follows:
Child’s name: Monthly Amount: Child’s Name Monthly Amount
$ $
$ $
$ $
Page 1 of 3
Approved for Optional Use
Riverside Superior Court
RI-FL03 [Rev, 05/27/14]
STIPULATION AND ORDER ON REQUEST FOR ORDER
riverside.courts.ca.gov/localfrms/localfrms.shmtl
PETITIONER:
RESPONDENT:
CASE NUMBER:
c.
A printout of a computer calculation and finding is attached.
d.
Non-Guideline Child Support: The parties agree that: (1) they are fully informed of their rights concerning guideline child
support; (2) they have agreed to the child support provisions of this Stipulation without coercion or duress; (3) this Stipulatio
n
in the best interests of the children involved; (4) the needs of the children will be adequately met by this agreed-upon child
support; and (5) they have not assigned the right to support to the county and no public assistance application is pending.
3.
Child Support Arrears
Petitioner Respondent owes to the other parent child support arrears in the principal amount of $ for the
from to Arrears shall at $ Per month due of each
month commencing until paid in full.
4.
Additional Child Support Orders:
a.
An Income Withholding Order for the above child support shall issue.
b.
Child Care.
Petitioner
Respondent shall pay to the other parent for child care costs related to employment:
(1) The sum of $ per month commencing .
(2) A sum equal to ½ of the verifiable daycare expenses.
c.
Health Care
(1)
Petitioner
Respondent shall obtain and/or maintain for the minor children medical, dental and visual insurance,

Lf available at reasonable cost through employment, self-employment, or union affiliation. The cost is presumed
reasonable if it does not exceed 5% of the responsible parent’s gross income.
(2) Any health expenses not paid by insurance shall be shared Petitioner 50% and Respondent 50%.
5.
If the person who receives child support enters into a contract with a private child support collector, the party ordered to pay support
must pay the fee charged by the private support collector. The fee must not exceed 33⅓ % of the total amount of arrears nor may it
exceed 50% 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.
6.
Spousal/Partner Support
Petitioner Respondent shall pay spousal/partner support of $ per month, due ½ on the 1
st
, and ½ on the
15
th
day of each month commencing and continuing until the death of either party, remarriage or
Uegistration of a new domestic partnership by the party receiving support, further order of the court or termination date of
7.
Spousal/Partner Support Arrears
Petitioner Respondent owes to the other party spousal/partner support arrears in the principal amount of $
period from to Arrears shall be paid at $ per month due
of each month commencing until paid in full.
Page 2 of 3
Approved for Optional Use
Riverside Superior Court
RI-FL03 [Rev. 05/27/14]
STIPULATION AND ORDER ON REQUEST FOR ORDER
riverside.courts.ca.gov/localfrms/localfrms.shmtl
PETITIONER:
RESPONDENT:
CASE NUMBER:
8.
Attorney’s Fees
a. Petitioner Respondent will directly pay the attorney for Petitioner Respondent $
contribution towards fees and $ costs payable in full by .
b. Petitioner Respondent will directly pay the attorney’s fees for Petitioner Respondent
payable in installments of $ on the of each month commencing on
until paid in full.
If any payment is more than 30 days overdue the entire unpaid balance will immediately become due with interest at the legal
rate from the date of default. The legal rate is currently 10 percent per year.
c. Neither party shall be responsible for attorney’s fees and costs except as otherwise ordered by the court.
9.
Exclusive Use
a. Petitioner Respondent will have exclusive use, possession and control of the family residence motor
vehicle described as:
10.
Other Orders:
11.
Based on this stipulation the parties agree to vacate the hearing on the Request for Order set for .
Dated:
(TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER OR SIGNATURE OF ATTORNEY FOR PETITIONER)
(TYPE OR PRINT NAME) (SIGNATURE OF RESPONDENT OR SIGNATURE OF ATTORNEY FOR RESPONDENT)
IT IS SO ORDERED
Dated:
(JUDICIAL OFFICER)
Number of pages attached:
Each attachment to this stipulation and order is incorporated into this order, and the parties are ordered to comply with each
attachment’s provisions.
Page 3 of 3
Approved for Optional Use
Riverside Superior Court
RI-FL03 [Rev. 05/27/14]
STIPULATION AND ORDER ON REQUEST FOR ORDER
riverside.courts.ca.gov/localfrms/localfrms.shmtl
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RI-FL03 SUPERIOR COURT OF CALIFORNIA, COUNTY OF RIVERSIDE (California)

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Completed 19 April 2021

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