Santa Clara — FM-1068*

Source: https://santaclara.courts.ca.gov/system/files/forms/fm-1068.pdf

ATTACHMENT FM-1068 ATTORNEY OR PARTY WITHOUT AN ATTORNEY (Name and Address): TELEPHONE NUMBER: FOR COURT USE ONLY aasdasd

ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA STREET ADDRESS: 201 North First Street, San José, CA 95113

MAILING ADDRESS: 191 North First Street

CITY AND ZIP CODE: San José, California 95113

BRANCH NAME: Family Justice Center

PETITIONER:

RESPONDENT:

CLAIMANT: CASE NUMBER:

APPLICATION #:

PETITIONER’S RESPONDENT’S APJ:

RESPONSE TO CHILDREN’S COUNSEL APPLICATION FOR PAYMENT OF ATTORNEY FEES AND COSTS DEPARTMENT:

1. I, , declare the following:

   I am the attorney for the Petitioner/Respondent.

   I am the Petitioner/Respondent. I am self-represented.

   A new Income and Expense Declaration is attached.

   I am attaching a copy of the Income and Expense Declaration I have filed previously because I declare

   that the information in it has not changed.

   REQUEST FOR ALLOCATION OF FEES FOR CHILD(REN)’S COUNSEL

2. I propose the following allocation of payment:

   Petitioner to pay % and Respondent to pay % of the ordered fees and costs. My reasons for

   proposing that allocation are the following:

3. I ask that the Court pay my part of the fees and costs for the following reason(s):

4. I request monthly payments, I believe I can pay $ per month.

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

Date: Signature

FM-1068 REV 01/01/2022 RESPONSE TO CHILDREN’S COUNSEL’S APPLICATION Page 1 of 2 For Mandatory Use FOR PAYMENT OF ATTORNEY FEES

ATTACHMENT FM-1068 NOTICE TO PARTIES

YOU MUST SUBMIT THIS FORM AND A CURRENT INCOME AND EXPENSE DECLARATION, JUDICIAL COUNCIL FORM FL-150 (OR A PREVIOUSLY-FILED INCOME AND EXPENSE DECLARATION IF YOU DECLARE THAT THE INFORMATION HAS NOT CHANGED)

YOU MUST FILE THIS FORM AND ANY ATTACHMENTS WITHIN 21 CALENDAR DAYS OF THE DATE ON THE APPLICATION FOR FEES. DO NOT ADD AN ADDITIONAL FIVE DAYS FOR SERVICE BY MAIL.

FAILURE TO SUBMIT A RESPONSE MAY RESULT IN AN ORDER DIRECTING YOU TO PAY UP TO 100% OF THE FEES AND COSTS REQUESTED.

You must also mail or give a copy of this Response and the Income and Expense Declaration to the other party or his/her attorney, and file a Proof of Service with the Court.

FM-1068 REV 01/01/2022 RESPONSE TO CHILDREN’S COUNSEL’S APPLICATION Page 2 of 2 For Mandatory Use FOR PAYMENT OF ATTORNEY FEES