CASE NUMBER:

FL-694

8. 

9. 

I agree to the terms of this order or 
judgment freely and voluntarily.

I understand that the local child 
support agency is required by state 
law to enforce the duty of support.

10.  I UNDERSTAND THAT IF I 

11. 

WILLFULLY FAIL TO SUPPORT 
MY CHILDREN, CRIMINAL 
PROCEEDINGS MAY BE 
INITIATED AGAINST ME.

COLLECTION OF SUPPORT. I 
understand that any support I owe 
may be collected from any of my 
property. This collection may be 
made by intercepting money owed to 
me by the state or federal 
government (such as tax refunds, 
unemployment and disability 
benefits, and lottery winnings), by 
taking property I own, by placing a 
lien on my property, or by any other 
lawful means.

12.  IF I AM REPRESENTED BY AN 

ATTORNEY, MY ATTORNEY HAS 
READ AND EXPLAINED TO ME 
THE TERMS OF THE ORDER OR 
JUDGMENT AND THIS 
ADVISEMENT AND WAIVER OF 
RIGHTS, AND I UNDERSTAND 
THESE TERMS.

ADVISEMENT AND WAIVER OF RIGHTS FOR STIPULATION

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

OTHER PARENT:

1. 

RIGHT TO BE REPRESENTED BY A 
LAWYER. I understand that I have the 
right to be represented by a lawyer of 
my choice at my expense. If I cannot 
afford a lawyer to represent me, I can 
ask the court to appoint one to 
represent me free of charge only if I 
dispute that I am the parent of the 
children named in this action and only 
on the issue of parentage. I 
understand that the attorney for the 
local child support agency does not 
represent me.

2. RIGHT TO A TRIAL. I understand that 
I have a right to have a judicial officer: 
(a) determine if I am the parent of the 
children named in the stipulation, (b) 
decide how much child support I must 
pay, and (c) decide how much (unpaid 
support) I owe for arrearage.

3.  RIGHT TO CONFRONT AND 

CROSS-EXAMINE WITNESSES. I 
understand that in a trial any 
allegations made against me must be 
proved. At the trial I may be present 
with a lawyer when witnesses testify, 
and I may ask them questions. I may 
also present evidence.

4.  RIGHT TO HAVE GENETIC TESTING 

WHERE THE LAW PERMITS. I 
understand that, where the law 
permits, I have the right to have the 
court order genetic testing. The court 
will decide on the testing. The court 
could order that I pay none, some, or 
all of the costs of the genetic testing.

5.  ADMISSION AND WAIVER OF 
RIGHTS. I understand that by 
agreeing to the terms of the order or 
judgment, I am admitting that I am the 
parent of the children named in the 
stipulation and I am giving up the 
rights stated above.

6.  WHERE THE STIPULATION 

INCLUDES CHILD SUPPORT. 
a.  I understand that I will have the 

duty to obey the support order for 
the children named in the 
stipulation until the order is 
changed by the court or ended by 
law.
I also understand that the court 
will order any support payments to 
be paid directly from my wages or 
other earnings and sent to the 
local child support agency if they 
are assigned to collect the 
support.
I have been advised of the amount 
of guideline child support and how 
the proposed child support 
amount was determined.

b.

c.

7.  WHERE THE STIPULATION 

INCLUDES A PROVISION FOR 
HEALTH INSURANCE. I understand 
that I must keep health insurance 
coverage for the minor children if 
insurance is available, or becomes 
available, to me at no or reasonable 
cost. A health insurance coverage 
assignment/National Medical Support 
Notice may be ordered to get health 
insurance for my children.

I have read and understand the Advisement and Waiver of Rights for Stipulation, or 
Attached is a translation of this Advisement in (specify language):

I understand the translation.

Date:

Date:

(TYPE OR PRINT NAME)

(SIGNATURE)

INTERPRETER'S DECLARATION:  The above-named party is unable to read or understand this Advisement because

the party's primary language is (specify): 
Other (specify):

I certify under penalty of perjury under the laws of the State of California that I have, to the best of my ability, read or translated for the 
above-named party the Minutes and/or Order or Judgment and Advisement and Waiver of Rights for Stipulation. The above-named-
party said the terms of the order or judgment were understood by that party before signing it.

(TYPE OR PRINT NAME)

Form Adopted for Court Use 
in Lieu of Mandatory Form Form FL-615 
Judicial Council of California 
FL-694 [Rev. January 1, 2020]

ADVISEMENT AND WAIVER OF RIGHTS FOR STIPULATION 
 (Governmental)

(SIGNATURE)

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