Form Fl 191 – Fill Out and Use This PDF

The FL-191 form is a crucial document for anyone involved in a child support case in California. It serves as a Child Support Case Registry Form, which must be completed and submitted to the court alongside a court order for support. This form maintains the confidentiality of the individuals' information and is not placed in the court file but rather is kept in a secure file with the State of California. If you are navigating the process of filing for child support or need to update your information due to changes, it’s important to accurately fill out and submit the FL-191 form promptly.

To ensure that your child support case is processed efficiently and accurately, click the button below to fill out the FL-191 form.

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Form Fl 191 PDF Details

In family law, the management of child support orders requires meticulous attention to detail and adherence to specific procedures, as illustrated by the comprehensive requirements captured in the FL-191 form. The FL-191, known as the Child Support Case Registry Form, serves a critical role in the child support process in California. By mandating both parents and, if applicable, their attorneys to submit detailed personal and financial information, the form facilitates the efficient administration and enforcement of child support orders. This encompasses a range of crucial data, from the identification of the parties involved to the specifics of the child support order, including information on payment amounts, modifications, and any applicable wage withholding orders. Its confidential status ensures that sensitive information is protected, being maintained in a separate file by the State of California rather than the court's public records. The form is designed to be filled out with care, necessitating accurate, up-to-date information to ensure that child support arrangements are effectively managed and enforced. The protective measures integrated into the form, such as the inclusion of restraining order details, further accentuate the legal system's commitment to the safety and welfare of all parties involved. In essence, the FL-191 exemplifies the legal framework's endeavor to uphold both the financial and physical well-being of children through a structured, secure process.

Question	Answer
Form Name	Form Fl 191
Form Length	4 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min
Other names	form 191, fl 191, california form child, fl 191 form

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FL-191

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):			COURT PERSONNEL:
			STAMP DATE RECEIVED HERE
			To keep other people from
			To keep other people from
			seeing what you entered
			on your form, please
			press the Clear This Form
	TELEPHONE NO.:	FAX NO. (Optional):	buttonDOatNOTthe endFILEof the
	TELEPHONE NO.:	FAX NO. (Optional):	form when finished.
E-MAIL ADDRESS (Optional):			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:
CHILD SUPPORT CASE REGISTRY FORM		CASE NUMBER:
Mother	First form completed
Father	Change to previous information

THIS FORM WILL NOT BE PLACED IN THE COURT FILE. IT WILL BE

MAINTAINED IN A CONFIDENTIAL FILE WITH THE STATE OF CALIFORNIA.

Notice: Pages 1 and 2 of this form must be completed and delivered to the court along with the court order for support. Pages 3 and 4 are instructional only and do not need to be delivered to the court. If you did not file the court order, you must complete this form and deliver it to the court within 10 days of the date on which you received a copy of the support order. Any later change to the information on this form must be delivered to the court on another form within 10 days of the change. It is important that you keep the court informed in writing of any changes of your address and telephone number.

1.Support order information (this information is on the court order you are filing or have received).

a.Date order filed:

b. Initial child support or family support order

Modification

c.Total monthly base current child or family support amount ordered for children listed below, plus any monthly amount ordered payable on past-due support:

Child Support:

Family Support:

Spousal Support:

(1) Current $ base child support:

(2)	Additional	$
	monthly
	support:
(3)	Total	$
(3)	Total	$
	past-due
	support:

Reserved order $0 (zero) order

Current	$
base family		Reserved order
base family
support:

		$0 (zero) order
Additional	$


monthly
support:
Total	$
past-due
support:

Current	$
spousal
spousal
support:

Total $ past-due support:

Reserved order $0 (zero) order

(4) Payment $ on past- due support:

(5)Wage withholding was

				Payment $
				on past-
				due support:
ordered				ordered but stayed until (date):
ordered				ordered but stayed until (date):

Payment $ on past- due support:

2.Person required to pay child or family support (name): Relationship to child (specify):

3.Person or agency to receive child or family support payments (name): Relationship to child (if applicable):

TYPE OR PRINT IN INK

		Page 1 of 4
Form Adopted for Mandatory Use	CHILD SUPPORT CASE REGISTRY FORM	Family Code, § 4014
Judicial Council of California	CHILD SUPPORT CASE REGISTRY FORM	www.courtinfo.ca.gov
FL-191 [Rev. July 1, 2005]

Social security number

Date of birth

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

OTHER PARENT:

CASE NUMBER:

4. The child support order is for the following children:

Child’s name

Additional children are listed on a page attached to this document.

You are required to complete the following information about yourself. You are not required to provide information about the other person, but you are encouraged to provide as much as you can. This form is confidential and will not be filed in the court file. It will be maintained in a confidential file with the State of California.

5. Father’s name:	6. Mother’s name:
a. Date of birth:	a. Date of birth:
b. Social security number:	b. Social security number:
c. Street address:	c. Street address:

City, state, zip code:

d.Mailing address:

City, state, zip code:

e.Driver’s license number:

State:

f. Telephone number:

g. Employed Not employed Employer’s name:

City, state, zip code:

d.Mailing address:

City, state, zip code:

e.Driver’s license number: State:

f.Telephone number:

Self-employed	g.		Employed	Not employed

		Employer’s name:

Self-employed

Street address:	Street address:
City, state, zip code:	City, state, zip code:
Telephone number:	Telephone number:

7.	A restraining order, protective order, or nondisclosure order due to domestic violence is in effect.

	a. The order protects:	Father	Mother	Children

	b. From:	Father	Mother

c. The restraining order expires on (date):

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 PERSON COMPLETING THIS FORM)

FL-191 [Rev. July 1, 2005]	CHILD SUPPORT CASE REGISTRY FORM

Page 2 of 4

INFORMATION SHEET FOR CHILD SUPPORT CASE REGISTRY FORM

(Do NOT deliver this Information Sheet to the court clerk.)

Please follow these instructions to complete the Child Support Case Registry Form (form FL-191) if you do not have an attorney to represent you. Your attorney, if you have one, should complete this form.

Both parents must complete a Child Support Case Registry Form. The information on this form will be included in a national database that, among other things, is used to locate absent parents. When you file a court order, you must deliver a completed form to the court clerk along with your court order. If you did not file a court order, you must deliver a completed form to the court clerk WITHIN 10 DAYS of the date you received a copy of your court order. If any of the information you provide on this form changes, you must complete a new form and deliver it to the court clerk within 10 days of the change. The address of the court clerk is the same as the one shown for the superior court on your order. This form is confidential and will not be filed in the court file. It will be maintained in a confidential file with the State of California.

INSTRUCTIONS FOR COMPLETING THE CHILD SUPPORT CASE REGISTRY FORM (TYPE OR PRINT IN INK):

If the top section of the form has already been filled out, skip down to number 1 below. If the top section of the form is blank, you must provide this information.

Page 1, first box, top of form, left side: Print your name, address, telephone number, fax number, and e-mail address, if any, in this box. Attorneys must include their State Bar identification numbers.

Page 1, second box, top of form, left side: Print the name of the county and the court’s address in this box. Use the same address for the court that is on the court order you are filing or have received.

Page 1, third box, top of form, left side: Print the names of the petitioner/plaintiff, respondent/defendant, and other parent in this box. Use the same names listed on the court order you are filing or have received.

Page 1, fourth box, top of form, left side: Check the box indicating whether you are the mother or the father. If you are the attorney for the mother, check the box for mother. If you are the attorney for the father, check the box for father. Also, if this is the first time you have filled out this form, check the box by "First form completed.” If you have filled out form FL-191 before, and you are changing any of the information, check the box by “Change to previous information.”

Page 1, first box, right side: Leave this box blank for the court’s use in stamping the date of receipt.

Page 1, second box, right side: Print the court case number in this box. This number is also shown on the court papers.

Instructions for numbered paragraphs:

1.a. Enter the date the court order was filed. This date is shown in the “COURT PERSONNEL: STAMP DATE RECEIVED HERE" box on page 1 at the top of the order on the right side. If the order has not been filed, leave this item blank for the court clerk to fill in.

b.If the court order you filed or received is the first child or family support order for this case, check the box by “Initial child support or family support order." If this is a change to your order, check the box by “Modification.”

c.Information regarding the amount and type of support ordered and wage withholding is on the court order you are filing or have received.

(1)If your order provides for any type of current support, check all boxes that describe that support. For example, if your order provides for both child and spousal support, check both of those boxes. If there is an amount, put it in the blank provided. If the order says the amount is reserved, check the “Reserved order” box. If the order says the amount is zero, check the “$0 (zero) order" box. Do not include child care, special needs, uninsured medical expenses, or travel for visitation here These amounts will go in (2). Do NOT complete the Child Support Case Registry form if you receive spousal support only.

(2)If your order provides for a set monthly amount to be paid as additional support for such needs as child care, special needs, uninsured medical expenses or travel for visitation check the box in Item 2 and enter the monthly amount. For example, if your order provides for base child support and in addition the paying parent is required to pay $300 per month, check the box in item 2 underneath the "Child Support" column and enter $300. Do NOT check this box if your order provides only for a payment of a percentage, such as 50% of the childcare.

FL-191 [Rev. July 1, 2005]

CHILD SUPPORT CASE REGISTRY FORM

Page 3 of 4

(3)If your order determined the amount of past due support, check the box in Item 3 that states the type of past due support and enter the amount. For example, if the court determined that there was $5000 in past due child support and $1000 in past due spousal support, you would check the box in item 3 in the "Child Support" column and enter $5000 and you would also check the box in item 3 in the "Spousal Support" column and enter $1000.

(4)If your order provides for a specific dollar amount to be paid towards any past due support, check the box in Item 4 that states the type of past due support and enter the amount. For example, the court ordered $350 per month to be paid on the past due child support, you would check the box in Item 4 in the "Child Support" column and enter $350.

(5)Check the "ordered" box if wage withholding was ordered with no conditions. Check the box "ordered but stayed until" if wage withholding was ordered but is not to be deducted until a later date. If the court delayed the effective date of the wage withholding, enter the specific date. Check only one box in this item.

2.a. Write the name of the person who is supposed to pay child or family support. b. Write the relationship of that person to the child.

3.a. Write the name of the person or agency supposed to receive child or family support payments. b. Write the relationship of that person to the child.

4.List the full name, date of birth, and social security number for each child included in the support order. If there are more than five children included in the support order, check the box below item 4e and list the remaining children with dates of birth and social security numbers on another sheet of paper. Attach the other sheet to this form.

The local child support agency is required, under section 466(a)(13) of the Social Security Act, to place in the records pertaining to child support the social security number of any individual who is subject to a divorce decree, support order, or paternity determination or acknowledgment. This information is mandatory and will be kept on file at the local child support agency.

Top of page 2, box on left side: Print the names of the petitioner/plaintiff, respondent/defendant, and other parent in this box. Use the same names listed on page 1.

Top of page 2, box on right side: Print your court case number in this box. Use the same case number as on page 1, second box, right side.

You are required to complete information about yourself. If you know information about the other person, you may also fill in what you know about him or her.

5.If you are the father in this case, list your full name in this space. See instructions for a–g under item 6 below.

6.If you are the mother in this case, list your full name in this space.

a.List your date of birth.

b.Write your social security number.

c.List the street address, city, state, and zip code where you live.

d.List the street address, city, state, and zip code where you want your mail sent, if different from the address where you live.

e.Write your driver's license number and the state where it was issued.

f.List the telephone number where you live.

g.Indicate whether you are employed, not employed, self-employed, or by checking the appropriate box. If you are employed, write the name, street address, city, state, zip code, and telephone number where you work.

7.If there is a restraining order, protective order, or nondisclosure order, check this box.

a.Check the box beside each person who is protected by the restraining order.

b.Check the box beside the parent who is restrained.

c.Write the date the restraining order expires. See the restraining order, protective order, or nondisclosure order for this date.

If you are in fear of domestic violence, you may want to ask the court for a restraining order, protective order, or nondisclosure order.

You must type or print your name, fill in the date, and sign the Child Support Case Registry Form under penalty of perjury. When you sign under penalty of perjury, you are stating that the information you have provided is true and correct.

FL-191 [Rev. July 1, 2005]	CHILD SUPPORT CASE REGISTRY FORM
FL-191 [Rev. July 1, 2005]

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How to Edit Form Fl 191 Online for Free

You can complete the fl191 document using our PDF editor. The next steps will enable you to easily prepare your document.

Step 1: On the following website page, select the orange "Get form now" button.

Step 2: Now you can manage the fl191. You should use the multifunctional toolbar to include, delete, and modify the text of the file.

These particular segments will help make up your PDF form:

Type in the details in the Support order information this, Date order filed, a b, Initial child support or family, Modification, Total monthly base current child, Spousal Support, Family Support, Current base child support, Additional monthly support, Total pastdue support, Payment on past due support Wage, Reserved order zero order, Current base family support, and Additional monthly support field.

step 2 to finishing child support forms ca

You will be demanded specific essential information so you can fill in the PETITIONERPLAINTIFF, RESPONDENTDEFENDANT, OTHER PARENT, CASE NUMBER, The child support order is for the, Childs name, Date of birth, Social security number, Additional children are listed on, You are required to complete the, Fathers name, Date of birth, Social security number, Street address, and City state zip code field.

PETITIONERPLAINTIFF, RESPONDENTDEFENDANT, OTHER PARENT, CASE NUMBER, The child support order is for the, Childs name, Date of birth, Social security number, Additional children are listed on, You are required to complete the, Fathers name, Date of birth, Social security number, Street address, and City state zip code in child support forms ca

The space City state zip code, City state zip code, Drivers license number, Drivers license number, State, Telephone number, State, Telephone number, Employed, Not employed, Selfemployed, Employed, Not employed, Selfemployed, and Employers name is where you can put all parties' rights and responsibilities.

Completing child support forms ca part 4

Review the fields I declare under penalty of perjury, Date, TYPE OR PRINT NAME, SIGNATURE OF PERSON COMPLETING, FL Rev July, CHILD SUPPORT CASE REGISTRY FORM, and Page of and next complete them.

child support forms ca I declare under penalty of perjury, Date, TYPE OR PRINT NAME, SIGNATURE OF PERSON COMPLETING, FL Rev July, CHILD SUPPORT CASE REGISTRY FORM, and Page of fields to fill

Step 3: Choose the Done button to make certain that your finished document may be exported to any electronic device you pick out or sent to an email you indicate.

Step 4: Generate copies of the document - it can help you refrain from upcoming concerns. And don't be concerned - we do not share or check the information you have.

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