Navigating family law in California, one might come across various forms, each designed for specific circumstances. Among them, the FL-684 form stands out due to its comprehensive approach in handling several critical issues related to child welfare and parentage. Primarily, it serves as a request from one party (the petitioner or plaintiff) to the court, asking for orders concerning child support, health insurance, and sometimes, issues of parentage and property restraint. Uniquely, this form allows a parent not only to establish parentage if it has not been determined but also to modify child support in accordance with the state's guidelines. It emphasizes ensuring that children's health insurance needs are adequately met by requiring the responsible party to provide coverage. Additionally, the FL-684 form can include requests related to the preservation of property and other miscellaneous matters that need the court's intervention. It's a strategic legal tool that encapsulates vital requests all in one document, simplifying the legal process for families in transition. The document's dual nature of serving both as a request for new orders and modifications to existing ones underscores its importance in California's family law landscape. It requires careful completion and understanding, as it essentially influences the welfare and financial support of the children involved. By offering a clear and structured way to request significant changes, the FL-684 form plays a pivotal role for parents navigating the complexities of family-related legal proceedings.
| Question | Answer |
|---|---|
| Form Name | Form Fl 684 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | order fl declaration form, order insurance declaration, form 684, request order health |
PETITIONER / PLAINTIFF:
RESPONDENT / DEFENDANT:
OTHER PARENT:
CASE NUMBER:
(THIS IS A REQUEST, NOT AN ORDER)
I REQUEST THE FOLLOWING ORDERS FOR:
Name of child |
Date of birth |
Name of child |
Date of birth |
1.
2.
PARENTAGE. If not previously established, a judgment that you are the parent of the children named above.
CHILD SUPPORT. Monthly child support based on the state guideline. (An Income Withholding for Support
a. This is a request for a change to an existing order
(1)filed on (date if known):
(2)ordering (specify):
b.Child support to commence
(1)on the date this request was mailed or given to you.
(2) effective (specify):
c.Other (specify):
3.
HEALTH INSURANCE COVERAGE
4.
5.
If not previously ordered, an order that you provide health insurance for each child named above and an order that you complete the attached health insurance form and immediately return it to the local child support agency.
NOTICE: Your employer or other person providing health insurance will be ordered to enroll the children in an appropriate health insurance plan if you are found to be the parent, and a National Medical Support Notice will be issued.
FEES AND COSTS |
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Fees: $ |
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Costs: $ |
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PROPERTY RESTRAINT |
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Petitioner/plaintiff |
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Respondent/defendant |
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Other parent |
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be restrained from transferring, encumbering, hypothecating, concealing, or in any way disposing of the following property (specify):
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Form Adopted for Mandatory Use |
REQUEST FOR ORDER AND SUPPORTING DECLARATION |
Family Code §§ 215, 3751, 3761, |
Judicial Council of California |
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(Governmental) |
17402,17404, 17406,17422 www.courtinfo.ca.gov
PETITIONER / PLAINTIFF:
RESPONDENT / DEFENDANT:
OTHER PARENT:
6. OTHER (specify):
CASE NUMBER:
7.
FACTS IN SUPPORT of this request are:
contained in an attached declaration.
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 REQUESTING THESE ORDERS) |
REQUEST FOR ORDER AND SUPPORTING DECLARATION
(Governmental)
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