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The FL-420 form plays a critical role in the family law landscape of California, serving as a Declaration of Payment History for various support obligations. This form is primarily utilized in cases involving child support, spousal support, and other related financial responsibilities connected to family law matters. It must be completed to provide an accurate record of payments made and received, thereby ensuring transparency in financial dealings between parties. It includes sections where users declare the amounts owed and received, as well as a summary of any support arrears. The user must also confirm their identity and provide contact information, with particular emphasis on maintaining privacy. Furthermore, the form requires a declaration under penalty of perjury, which underscores the importance of accuracy in reporting financial obligations. Understanding the FL-420 form is essential for individuals engaged in family court processes, as it not only helps track compliance with court orders but also protects the rights of all involved parties.

Fl 420 Example

FL-420

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state Bar number, and address) or

FOR COURT USE ONLY

GOVERNMENTAL AGENCY (under Family Code, §§ 17400, 17406):

To keep other people from

 

 

 

 

seeing what you entered on

 

 

your form, please press the

 

 

Clear This Form button at the

TELEPHONE NO.:

FAX NO. (Optional):

end of the form when finished.

E–MAIL ADDRESS (Optional):

 

 

ATTORNEY FOR (Name):

 

 

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

OTHER PARENT:

DECLARATION OF PAYMENT HISTORY

CASE NUMBER:

1.Declaration of (name):

2.Based on my records or my recollection, I declare that the information on the attached pages showing the amounts ordered and the amounts paid are true and correct for the following obligations (check all that apply):

 

 

 

a.

 

Child support

 

 

d.

 

 

 

Medical support

 

 

 

 

g.

 

Other (specify):

 

 

 

 

 

 

 

 

 

 

 

 

 

b.

 

Spousal support

 

 

e.

 

 

 

Unreimbursed medical expenses

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

c.

 

Family support

 

 

f.

 

 

 

Unreimbursed child care expenses

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. Number of pages attached:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

 

 

 

 

Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(TYPE OR PRINT NAME)

 

 

 

 

 

 

 

 

 

 

 

(SIGNATURE OF DECLARANT)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SUPPORT ARREARAGE SUMMARY

 

 

 

 

 

 

 

 

 

 

This summary is for arrearage for the periods specified in the attached pages.

 

 

 

 

 

 

 

 

 

 

Interest is calculated through (specify date):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Principal:

 

 

 

 

Interest (optional):

 

 

Total Arrearage:

 

 

 

 

CHILD SUPPORT:

$

 

 

 

 

$

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

SPOUSAL SUPPORT:

$

 

 

 

 

$

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

FAMILY SUPPORT:

$

 

 

 

 

$

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

MEDICAL SUPPORT:

$

 

 

 

 

$

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

UNREIMBURSED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEDICAL EXPENSES:

$

 

 

 

 

$

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

UNREIMBURSED

 

 

 

 

 

 

$

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

CHILD CARE EXPENSES: $

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER (specify):

$

 

 

 

 

$

 

 

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOTICE: Interest that is not calculated is not waived

 

 

 

 

 

 

 

 

Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

Submitted by:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(TYPE OR PRINT NAME)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(SIGNATURE)

 

 

 

 

 

Details of the arrearage statement, consisting of (specify number)

pages, are attached.

 

 

 

 

 

 

Page 1 of 1

 

 

 

Form Adopted for Mandatory Use

 

 

DECLARATION OF PAYMENT HISTORY

 

 

 

 

 

 

Family Code, §§ 5230.5,

 

 

 

 

Judicial Council of California

 

 

 

 

 

 

 

 

17524(a), 17526(c)

 

 

 

 

 

(Family Law—Governmental—Uniform Parentage Act)

 

 

 

 

FL-420 [Rev. January 1, 2003]

 

www.courtinfo.ca.gov

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For your protection and privacy, please press the Clear This Form

button after you have printed the form.

Save This Form

Print This Form

Clear This Form

Get Fl 420 PDF Form

Form Characteristics

Fact Name Description
Form Name FL-420 is known as the Declaration of Payment History.
Purpose This form tracks amounts ordered and amounts paid for child support, spousal support, and other financial obligations.
Governing Laws The FL-420 form is governed by California Family Code §§ 17400, 17406, and 5230.5.
Mandatory Use This form is adopted for mandatory use in appropriate cases related to family law.
Submission The form must be signed and submitted to the Superior Court of California.
Privacy Notice There is a notice to clear the form for privacy protection after completing it.
Interest Calculation Interest may be calculated on arrears and must be specified on the form.
Attachments Multiple pages can be attached to the form detailing payment history.
Last Revision The form was last revised on January 1, 2003.

Guidelines on Utilizing Fl 420

Once you have gathered the necessary information, filling out the FL-420 form is straightforward. This form is essential for declaring payment history related to various support obligations. Make sure to provide accurate information to avoid any complications. Follow these steps to successfully complete the form.

  1. At the top of the form, enter your name, state bar number (if applicable), and address. If you're a governmental agency or without an attorney, indicate that in the designated areas.
  2. Provide your telephone number and, if you choose, your fax number and email address.
  3. Identify the attorney for the case (if you have one) by entering their name.
  4. Fill in the court's information, including the street address, mailing address, city, zip code, and branch name.
  5. List the names of the petitioner/plaintiff, respondent/defendant, and the other parent if applicable.
  6. In the section labeled "Declaration of Payment History," state your name for the declaration.
  7. Check all applicable support obligations from the given options, including child support, spousal support, and others as needed.
  8. Indicate the number of attached pages that provide further detail about your payment history.
  9. Sign and date the declaration to affirm its accuracy under penalty of perjury.
  10. For the Support Arrearage Summary, fill out the amounts for principal, interest (if applicable), and total arrearage for each type of support indicated.
  11. Note the date and provide your signature to confirm submission along with a printed name.
  12. Make sure to confirm that the attached pages outline the arrearage statement and specify the total number of pages.

When you're finished, it’s important to ensure your privacy. You can press the "Clear This Form" button, which will erase all entries to prevent unauthorized viewing. Once printed, save a copy for your records.

What You Should Know About This Form

What is the purpose of the FL-420 form?

The FL-420 form, known as the Declaration of Payment History, serves as a critical document in family law cases. It is designed to provide a clear record of payments made or owed relating to support obligations. These can include child support, spousal support, medical support, and other related financial responsibilities. A party uses this form to declare all amounts ordered by the court and to clarify their payment history, helping to ensure both parties are aware of their obligations.

Who is required to file the FL-420 form?

How do I complete the FL-420 form?

Completing the FL-420 form requires attention to detail. Start by filling in your name, contact information, and the details of the other parties involved. You will need to indicate the specific types of support obligations relevant to your case. By checking the appropriate boxes, you will list the amounts ordered and the amounts you have actually paid for each obligation. Ensure you attach any additional pages needed to substantiate your claims and provide a total summary of arrearages. Finally, you must sign and date the form to affirm the truthfulness of the information provided.

What should I do if I have questions or need help with the FL-420 form?

If you have questions about the FL-420 form or how to fill it out, it is advisable to seek assistance. You can consult with a family law attorney who can provide guidance specific to your situation. Alternatively, you may also contact the court where you are filing for clarification. Many courts have self-help resources available, including workshops and informational materials that can help address common concerns.

What happens after I submit the FL-420 form?

Once the FL-420 form is submitted to the court, the information contained within it becomes part of the official court record. The court will review the completed form, especially if there is a dispute regarding support payments. The information may be considered during hearings or proceedings related to modifications of support orders or enforcement actions. It is essential to retain copies of your submitted forms and keep track of any follow-up actions required by the court.

Common mistakes

When filling out the FL-420 form, one common mistake is not providing complete contact information. This includes the attorney or party's name, state bar number, and full address. Without thorough details, the court may struggle to communicate properly, which could delay your case.

Another mistake is neglecting to clearly indicate the amounts for each category. The form asks for specific amounts for child support, spousal support, and others. If these amounts are left blank or are unclear, it can lead to confusion and further complications in the process.

Many people also forget to attach all necessary pages. The FL-420 form requires an accurate count of the attached documents, and failing to do this can result in the court rejecting your submission. Always double-check that you have all the pages ready to go before handing in your form.

A common oversight is the date. Some individuals write the wrong date or forget to sign the form altogether. The declaration under penalty of perjury must be dated and signed to affirm the truthfulness of the information provided. An unsigned document may be considered invalid.

It’s important to be precise when indicating the purpose of the payments. For example, if you check "Other," be sure to specify what that means. Vague descriptions can lead to misunderstandings about what obligations are being addressed.

People often underestimate the importance of calculating interest. If applicable, always complete the interest section. If you exclude it or calculate it incorrectly, you risk underreporting your arrearages, which can create distrust in your claims.

Some make the mistake of not reviewing the instructions carefully. Each section of the FL-420 form has specific requirements. Skimming through these can lead to overlooking essential details, which can hinder your filing process.

Lastly, many forget to safeguard their information. After filling out the form, it’s crucial to press the “Clear This Form” button to keep your personal information private. This is not just a suggestion, but a necessary step to ensure confidentiality.

Documents used along the form

The FL-420 form is commonly used in family law cases in California, particularly for those involving support payments. It helps parties declare their payment history, which can be critical for enforcing legal obligations. Alongside this form, several other documents may also be necessary to ensure comprehensive compliance with court requirements regarding family support. Here’s a list of five related forms you might encounter.

  • FL-421: Declaration of Support Payments - This form accompanies the FL-420 and provides a detailed declaration of all support payments made or received. It helps clarify any discrepancies that may exist in payment history.
  • FL-430: Notice of Motion to Modify Support - This is used when a party seeks to change an existing support order. It outlines the reasons for the requested modification and initiates the court process.
  • FL-480: Request for Order - This form enables a party to formally request the court to enforce or modify support orders. The request included in this form can directly impact payment obligations.
  • FL-300: Petition for Custody and Support - When establishing custody and support arrangements, this form is essential. It initiates the legal process regarding custodial rights and financial support for children.
  • FL-110: Summons - This document is essential for notifying the other party about the court case. It includes important details and instructions regarding the proceedings and support obligations.

Utilizing the appropriate forms in addition to FL-420 can streamline your case and ensure compliance with legal requirements. Always consult with a legal professional if you're unsure about what forms you need for your situation.

Similar forms

  • FL-430 - Child Support Case Summary: This document outlines the financial details related to child support, including the original support order and any modifications that have been made over time.
  • FL-150 - Income and Expense Declaration: Similar to FL-420, FL-150 offers a comprehensive look at an individual's finances to assess their ability to pay support or receive support, ensuring fair calculations in family law cases.
  • FL-395 - Application for Order and Supporting Declaration: This form supports requests for various family law orders, similar to FL-420, in that it requires a declaration detailing the necessary financial history related to support obligations.
  • FL-485 - Spousal Support Request for Order: Like FL-420, FL-485 helps individuals substantiate their claims for spousal support, including a detailed account of payment histories and amounts owed.
  • FL-427 - Notice of Motion to Modify Child Support: This document assists in requests to modify child support amounts, much like FL-420, by demanding detailed information regarding past payments and obligations.
  • FL-430 - Support Enforcement Report: This form is used by agencies to report on the enforcement of support orders, similar to FL-420 as it analyzes payment history and the status of obligations.
  • FL-430 - Governmental Case Summary: This document provides a summary from a governmental perspective concerning support obligations, closely related to FL-420 in focusing on declarations of payment histories.
  • FL-028 - Request for Child Support Order: FL-028 allows you to request child support orders while requiring similar supporting documents to demonstrate prior payments, just like FL-420 provides a declaration of payment history.

Dos and Don'ts

When completing the FL-420 form, it is crucial to follow specific guidelines to ensure accuracy and compliance. Below is a list of actions that should and should not be taken while filling out this form.

  • Do double-check all personal information for accuracy.
  • Do ensure that the declaration of payment history is complete and truthful.
  • Do provide all required attachments to support your payment history.
  • Do press the Clear This Form button after printing to protect your privacy.
  • Don't leave any sections blank unless specified.
  • Don't submit the form without verifying that all calculations are correct.
  • Don't forget to include your signature, as it is a necessary component of your declaration.
  • Don't ignore any instructions or notices provided within the form itself.

Misconceptions

Misconceptions often arise around legal forms, and the FL-420 is no exception. This form, officially named the Declaration of Payment History, serves an important function in family law matters, especially concerning child and spousal support. Here are four common misconceptions about the FL-420 form:

  • It only pertains to child support. While child support is indeed one component, the FL-420 also encompasses spousal support, medical support, family support, and unreimbursed expenses. Claimants often overlook these crucial elements, which can lead to incomplete information.
  • Filing the FL-420 is optional. Many believe that this form is just a suggestion, but this is far from the truth. In many cases, submitting the FL-420 is essential for the court to have a full understanding of payment history, especially during disputes over arrears.
  • The information on the form is automatically verified by the court. There is a common belief that the court will check the figures listed on the FL-420 before any decisions are made. However, it is the responsibility of the person submitting the form to provide accurate and truthful information. Errors or omissions can have significant consequences and may not be rectified without action from the filer.
  • The FL-420 requires legal representation to file. While having a lawyer can be beneficial, it is not a requirement to file the FL-420. Individuals can complete and submit the form on their own. Resources are often available to assist those who choose to represent themselves in court matters.

Understanding these misconceptions can lead to a smoother process when dealing with family law issues. Knowledge is a powerful tool when it comes to navigating the complexities of legal forms.

Key takeaways

When completing and utilizing the FL-420 form, it’s important to keep several key points in mind. Understanding these takeaways can help streamline the process and ensure your information is accurate and protected.

  • Provide Accurate Information: Ensure that all details entered on the form, such as names, case numbers, and payment amounts, are correct. This information must reflect true and accurate records.
  • Check All Applicable Obligations: Mark all applicable obligations related to child support, spousal support, or other expenses. It’s crucial to include everything that applies to your situation.
  • Include Documentation: Attach any necessary pages that detail the payment history and arrears. A clear record will support your declarations and claims made on the form.
  • Sign and Date: Remember to sign and date the declaration. This step confirms your acknowledgment that the information provided is true, under penalty of perjury.
  • Protect Your Privacy: After completing the form, press the "Clear This Form" button to safeguard your information from being viewed by others. Your privacy is a priority.

These guidelines can help you navigate filling out the FL-420 form with confidence. By taking the time to follow each step carefully, you can ensure that your submission is thorough and compliant with legal requirements.

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