Double Elimination 20 PDF Details

In the heart of California's efforts to ensure the well-being of families, particularly children, lies the crucial tool known as the Double Elimination 20 form, officially designated as the Declaration of Support Payment History (DCSS 0569) by the Department of Child Support Services. This document serves a vital function in outlining the history of support payments, encompassing child support, spousal support, family support, medical support, unreimbursed medical expenses, and more. Individuals are guided to meticulously provide both the court-ordered amounts and the actual payments made on a monthly basis, thereby painting a clear picture of any outstanding dues. Additionally, it includes a section for documenting any period of incarceration or institutionalization of the parent obliged to pay support, which could influence the support calculations. By mandating detailed record-keeping, the form plays a pivotal role in resolving disputes, ensuring fairness, and facilitating the legal process in support cases. Moreover, it emphasizes transparency and accountability by making the declaration available for review by both parties involved, where discrepancies might be challenged through the submission of proof like cancelled checks or receipts. The state also offers resources for assistance and clarification through the Family Law Facilitator Office, ensuring that every individual can navigate their obligations with informed support. Essentially, this document is a cornerstone in the structure of child and spousal support, reinforcing the legal framework that seeks to maintain the financial stability and welfare of families within California.

QuestionAnswer
Form NameDouble Elimination 20
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesdouble elimination bracket generator, 12 team double elimination bracket, double elimination bracket maker, fillable double elimination bracket

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

DEPARTMENT OF CHILD SUPPORT SERVICES

DECLARATION OF SUPPORT PAYMENT HISTORY

DCSS 0569 (06/17/2018)

INSTRUCTIONS FOR COMPLETING THE DECLARATION

OF SUPPORT PAYMENT HISTORY

On the back of this page is the Declaration of the Support Payment History for your case. Please provide the amount of support that was ordered by the court and the amount that was paid for each month. These figures will help determine the amount of the past due support owed, if any.

Within the boxes on the bottom half of the page, please complete the:

"Amount Ordered" column for each year

Fill in the amount of support that was ordered by the court each month since your order began. If there has been a change in your order, make sure each month reflects the correct amount of support due.

"Amount Paid" column for each year

Fill in the dollar amount of support paid in that month. If more than one payment was made in a given month, put the total dollar amount of support paid. Put the dollar amount next to the month in which the payment was actually paid, and not the month the payments were intended to cover. If needed, you may attach more sheets.

Within the boxes on the bottom half on the page, only if it applies to your case, please complete the:

“Incarceration/Institutionalization History"

Fill in the details of any time periods during which the other parent of your child was involuntarily confined in a state prison, county jail, juvenile facility, mental health facility, or other facility. If needed, you may attach additional sheets.

Please complete a separate page(s) for child support, spousal support, family support, medical support, unreimbursed medical expenses, and other types of support not listed. DO NOT combine child support and spousal support unless your court order combines the two support payments into a "family" support order.

Be aware that this Declaration is not confidential and may be given to the other parent or party in your case for review. If there is a disagreement regarding the payment history, the parties may be required to present proof of payments, for example, cancelled checks, or receipts.

If you have questions and/or need assistance with child support forms, you can get free help from your local court's Family Law Facilitator Office. Information for the Family Law Facilitator can be found at the California Courts website at http://www.courts.ca.gov/selfhelp-facilitators.htm.

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

DEPARTMENT OF CHILD SUPPORT SERVICES

DECLARATION OF SUPPORT PAYMENT HISTORY

DCSS 0569 (06/17/2018)

Person completing this form (name):

 

 

 

I am the:

 

 

 

 

 

Support Payment History for (check one):

Child

Spousal

Family

Unreimbursed medical expenses

Medical

Other (specify):

 

 

Custodial Party Noncustodial Parent

 

YEAR

 

 

YEAR

 

 

YEAR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AMOUNT

 

AMOUNT

AMOUNT

AMOUNT

AMOUNT

AMOUNT

 

ORDERED

 

PAID

ORDERED

 

PAID

ORDERED

 

PAID

January

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

February

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

March

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

April

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

May

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

June

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

July

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

August

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

September

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

October

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

November

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

December

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Incarceration/Institutionalization History

BEGIN DATE

(MM/DD/YYYY)

RELEASE DATE (MM/DD/YYYY)

FACILITY/INSTITUTION NAME AND LOCATION

OTHER DETAILS, SUCH AS CHARGING

OFFENSE(S), CONVICTION(S),

VICTIM NAME(S), COURT WHERE

SENTENCED, ETC.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. I am aware that this may be provided to the other parent for their verification and that either party may be required to provide documentation.

Signature:

 

Date:

 

CSE Case Number:

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How to Edit Double Elimination 20 Online for Free

Quite a few things are quicker than preparing documentation through the PDF editor. There isn't much you have to do to update the 12 team double elimination bracket form - just follow these steps in the following order:

Step 1: Press the orange "Get Form Now" button on this web page.

Step 2: Once you've accessed the 12 team double elimination bracket edit page, you will notice all functions you may take concerning your document within the upper menu.

To be able to fill in the document, type in the details the application will require you to for each of the following sections:

filling out double elimination bracket template part 1

Put down the data in the DCSS, Person completing this form name, I am the, Custodial Party, Noncustodial Parent, Support Payment History for check, Child, Spousal, Family, Unreimbursed medical expenses, Medical, Other specify, YEAR, AMOUNT ORDERED, and YEAR field.

stage 2 to completing double elimination bracket template

You will be asked for some crucial data if you need to prepare the November, December, IncarcerationInstitutionalization, BEGIN DATE MMDDYYYY, RELEASE DATE MMDDYYYY, FACILITYINSTITUTION NAME AND, OTHER DETAILS SUCH AS CHARGING, and I declare under penalty of perjury area.

Entering details in double elimination bracket template step 3

In paragraph Signature, Date, CSE Case Number, and Page of, identify the rights and responsibilities.

Filling in double elimination bracket template part 4

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Step 4: Generate copies of the file - it will help you stay clear of potential future challenges. And don't get worried - we do not share or check your details.

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