Form Fl 450 – Fill Out and Use This PDF

Front page, first box, top of form, left side: Print your name, address, and telephone number in this box if they are not already there. (TYPE OR PRINT IN INK)

You must contact the court clerk's office and ask that a hearing date be set for this motion. The court clerk will give you the information you need to complete this section.

Check this box if you want the court to stop the local child support agency or the other parent from collecting any support from your earnings. If you check this box, you must check the box for either a, b, or c beneath it.

Check this box if you are not the person required to pay support in the earnings assignment.

Check this box if you believe that there is "good cause" to recall the earnings assignment. The court must find that all of the conditions listed in item 2b exist in order for good cause to apply.

(1) Recalling the earnings assignment would be in the best interest of the children for whom I am ordered to pay support (state reasons): (2) I have paid court-ordered support fully and on time for the last 12 months without either an earnings assignment or another mandatory collection process. (3) I do not owe any arrearage (back support). (4) Service of the earnings assignment would cause extraordinary hardship for me, as follows (state reasons; you must prove these reasons at any hearing on this application by clear and convincing evidence):

Check this box if you and the other parent have a written agreement that allows you to pay the support another way. You must attach a copy of the agreement, which must be signed by both the other parent and a representative of the local child support agency if payments are made to a county office.

Check this box if you want to change the earnings assignment. You must check the box for either a, b, or c beneath it.

Check this box if the total arrearages listed in item 9 on the earnings assignment order are wrong. If you check this box, you must check one or more of (1), (2), and (3).

You must attach the original of your statement of arrearages. Keep one copy for yourself.

(1) Check this box if you believe the amount of arrearages listed on the earnings assignment order does not give you credit for all the payments you have made. If you check this box, you must check one or both of the boxes beneath it.

(a) Check this box if you are attaching your own statement of arrearages. This statement must include a monthly listing of what you were ordered to pay and what you actually paid.

(b) Check this box if you wish to list any payments that you believe were not included in the arrearages amount. For each payment you must list the date you paid it, the amount paid, and the person or agency (such as the local child support agency) to whom you made the payment. Bring to the hearing proof of any payment that is in dispute.

(2) Check this box if the child support for any of the children in the case has been terminated (ended). If you check this box, you must list the following information for each child: The name and birthdate of each child. The date the child support order was terminated. The reason child support was terminated.

(3) Check this box if there is another reason you believe the amount of arrearages is incorrect. You must explain the reasons in detail.

Check this box if the total monthly payment shown in item 1 of the earnings assignment order is more than half of your monthly net income.

Check this box if the total monthly payment shown in item 1 of the earnings assignment order causes you a serious hardship. You must write the reasons for the hardship in this space.

(NOTE: If you want to change the amount of money being deducted for arrearage because it creates a hardship, please attach a completed Financial Statement (Simplified) (form FL-155) or Income and Expense Declaration (form FL-150).)

When you sign this Request for Hearing form, you are stating that the information you have provided is true and correct.

You must also complete the certificate of mailing at the bottom of page 2 of the form by printing the name and address of the other parties in brackets and providing a stamped envelope addressed to each of the parties.

NOTICE: Use form FL-450 to request a hearing only if you object to the Income Withholding for Support (form FL-195/OMB0970-0154) or Earnings Assignment Order for Spousal or Partner Support (form FL-435). This form may not be used to modify your current child support amount. (See page 2 of form FL-192, Information Sheet on Changing a Child Support Order.) Page 3 of this form is instructional only and does not need to be delivered to the court.

You must file the completed Request for Hearing form and its attachments with the court clerk within 10 days after the date your employer gave you a copy of Earnings Assignment Order for Spousal or Partner Support (form FL-435) or an Income Withholding for Support (form FL-195/OMB0970-0154).

You may file your request in person at the clerk's office or mail it to the clerk. In either event, it must be received by the clerk within the 10-day period.

The address of the court clerk is the same as the one shown for the superior court on the earnings assignment order.

After you file the request, the court clerk will notify you by mail of the date, time, and location of the hearing.

You may have to pay a filing fee. If you cannot afford to pay the filing fee, the court may waive it, but you will have to fill out some forms first. For more information about the filing fee and waiver of the filing fee, contact the court clerk or the family law facilitator in your county.