Santa Clara — FM-1053*

Source: https://santaclara.courts.ca.gov/system/files/forms/fm-1053_rem.pdf

ATTACHMENT FM-1053 SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA FOR COURT USE ONLY STREET ADDRESS: 201 North First Street, San José, CA 95113 To keep other people from MAILING ADDRESS: 191 North First Street seeing what you have CITY AND ZIP CODE: San José, California 95113 entered, please press the BRANCH NAME: Family Justice Center Reset Form button at the end of this form when finished. PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

CASE NUMBER:
FAMILY LAW PARENTAGE JUDGMENT CHECKLIST
PETITION TO ESTABLISH PARENTAL RELATIONSHIP

Attorney/Mediator Self-Represented Party

INSTRUCTIONS:

Use this checklist to show the Court that you have turned in all the forms needed to get a Judgment in your case. There are four types of cases:

1. True Default - no Response filed, no written agreement
2. Default case with written agreement - no Response filed
3. Uncontested - appearance by both parties and a written agreement.

Check the box below for your type of case (one of the three listed above). Then complete all the items in that checklist. You only need to complete the checklist for your case type. All items must be completed either by checking each line to indicate you have filed that form or by marking “N/A” to say that an item is not applicable.

So that we can get your forms back to you, please turn in an envelope that is addressed to you, is large enough and has enough postage. If you do not want your forms mailed, give us other instructions.

TRUE DEFAULT CASE (no Response filed and NO WRITTEN AGREEMENT between the parties)

1. Proof of Service of Summons [FL-115] (check one of the following):

   Personal Service [FL-115]

   Notice and Acknowledgment of Receipt attached [FL-117]

   Service out-of-state by certified mail with receipt attached [FL-115 or out-of-state form]

   Other, (please describe)

2. Request to Enter Default [FL-165] with one (1) self-addressed envelope with postage prepaid

   Income and Expense Declaration [FL-150]

   (if you are requesting attorney fee/costs)

   Financial Statement (simplified) [FL-155] (if you are not requesting attorney fees/costs, and you qualify for this form according to the instructions

   on page 2 of the form; if you do not qualify, you must complete an Income and Expense Declaration)

3. Declaration for Default or Uncontested Judgment [FL-230]

4. Advisement and Waiver of Rights Regarding Parentage [FL-235]

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ATTACHMENT FM-1053

5. Judgment [FL-250]

   Child Custody and Visitation Attachment [FL-341]

   Child Support order Attachment [FL-342]

   Guideline child support calculation (Judicial Council approved software)

   Non-Guideline Child Support Findings attachment [FL-342(A)]

   Notice of Rights and Responsibilities/Information Sheet on Changing a Child Support Order [FL-192]

   Child Support Case Registry Form [FL-191]

   Order/Notice to Withhold Income [FL-195]

6. Notice of Entry of Judgment [FL-190] and two (2) self-addressed stamped envelopes (one for each party)

7. Other (Identify any optional forms included):

   DEFAULT CASE WITH WRITTEN AGREEMENT (no Response filed)

8. Proof of Service of Summons [FL-115] (check one of the following):

   Personal Service [FL-115]

   Notice and Acknowledgment of Receipt attached [FL-117]

   Service out-of-state by certified mail with receipt attached [FL-115 or out-of-state form]

   Other (please describe)

9. Request to Enter Default [FL-165] with one (1) self-addressed envelope with postage prepaid

   Income and Expense Declaration [FL-150] (If you are requesting attorney fees/costs)

   Financial Statement (simplified) [FL-155] (if you have a minor child, you are not requesting attorney fees/costs, and you qualify for this form according to the instructions on page 2 of the form; if you have a minor child and you do not qualify,

   you must complete an Income and Expense Declaration)

   Or Written Agreement

10. Declaration for Default or Uncontested Judgment [FL-230]

11. Advisement and Waiver of Rights Regarding Parentage [FL-235] (from both parties)

12. Stipulation for Entry of Judgment Regarding Establishing Parental Relationship [FL-240]

13. Judgment [FL-250] with written agreement

    Child custody/visitation and Family Code §3048 issues addressed

    Child Support – State whether child support is at guideline amount or not and include language required in Family Code §4065 If below guideline, attach guideline support calculation (Judicial Council approved software)

    Medical insurance and uninsured health care costs addressed

    Notice of Rights and Responsibilities/Information Sheet on Changing a Child Support Order [FL-192]

    Child Support Case Registry Form [FL-191]

    Order/Notice to Withhold Income [FL-195]

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ATTACHMENT FM-1053 Signature(s) are notarized for self-represented parties

Attorney has signed and approved Judgment for represented party

7. Notice of Entry of Judgment [FL-190] and two (2) self-addressed stamped envelopes (one for each party)

   UNCONTESTED CASE (Appearance by both parties and written agreement)

8. Appearance, Stipulations, and Waivers [FL-130] (along with Respondent’s first appearance fee if not already paid)

9. Declaration for Default or Uncontested Judgment [FL-230]

10. Advisement and Waiver of Rights Regarding Parentage [FL-235] (from both parties)

11. Stipulation for Entry of Judgment Regarding Establishing Parental Relationship [FL-240]

12. Judgment [FL-250] with written agreement

    Child custody/visitation and Family Code §3048 issues are addressed

    Child Support - State whether child support is at guideline amount or not and include language required in Family Code §4065 If below guideline, attach guideline support calculation (Judicial Council approved software)

    Medical insurance and uninsured health care costs addressed

    Notice of Rights and Responsibilities/Information Sheet on Changing a Child Support Order [FL-192]

    Child Support Case Registry Form [FL-191]

    Order/Notice to Withhold Income [FL-195]

    Signature(s) are notarized for self-represented parties

    Attorney has signed and approved Judgment for represented party

13. Notice of Entry of Judgment [FL-190] and two (2) self-addressed stamped envelopes (one for each party)

I certify that all of the information indicated in this checklist has been provided to the court.

Date: Submitting party’s signature

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