Fl 420 Form PDF Details

As a cannabis consumer, you may be familiar with the term "fl 420 form." This is simply a misspelling of the official name for Florida's medical marijuana registration form, which is known as "FL-362." If you are interested in obtaining medical marijuana in Florida, it is important to understand how the registration process works and what documentation is required. In this blog post, we will provide an overview of FL-362 and explain how to complete the application.

In the list, there is some information concerning the fl 420 form. It is definitely worth spending some time to learn this before starting filling in your document.

QuestionAnswer
Form NameFl 420 Form
Form Length1 pages
Fillable?Yes
Fillable fields8
Avg. time to fill out1 min 55 sec
Other namesfl420, fl 420 printable, declaration payment, fl declaration payment history

Form Preview 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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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You will need to enter the following data if you need to complete the document:

portion of gaps in california payment history

Put the asked data in the abc, Numberofpagesattached, def, Otherspecify, Date, TYPEORPRINTNAME, SIGNATUREOFDECLARANT, SUPPORTARREARAGESUMMARY, Principal, Interestoptional, and TotalArrearage segment.

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Write the vital information in Date, Submittedby, TYPEORPRINTNAME, SIGNATURE, PageofFamilyCodeac, wwwcourtinfocagov, LauraLynnMorgan, and MorganILoveYou box.

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