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Here is the text we could read:

PARTY WITHOUT ATTORNEY OR ATTORNEY

STATE BAR NUMBER:

FOR COURT USE ONLY

FL-230

STATE:

FAX NO.:

ZIP CODE:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:

NAME:

FIRM NAME:

STREET ADDRESS:

CITY:

TELEPHONE NO.:

E-MAIL ADDRESS:

ATTORNEY FOR (name):

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER:

RESPONDENT:

DECLARATION FOR DEFAULT OR UNCONTESTED JUDGMENT

CASE NUMBER:

1.
2.
3.

I declare that if I appeared in court and were sworn, I would testify to the truth of the facts in this declaration.
I request that proof will be by this declaration and that I will not appear before the court unless I am ordered by the court to appear.
All the information in the

Response

Petition for Custody and Support of Minor Children

Petition to Determine Parental Relationship
Response

is true and correct.

is/are the parent(s) of the minor children.

has

has not

been signed regarding these children (attach a

4.
5.

Respondent

and/or
A voluntary declaration of parentage or paternity form
copy if available).

Petitioner

DEFAULT OR UNCONTESTED (Check a or b)
a.

The default of the respondent was entered or is being requested, and I am not seeking any relief not requested in the
petition. OR
The parties have stipulated (agreed in writing) that the matter may proceed as an uncontested matter without notice, and
the stipulation is attached.

CHILD SUPPORT should be ordered as set forth in the proposed Judgment (form FL-250).

Petitioner
payable to the local child support agency at (specify address):

Respondent

is presently receiving public assistance (TANF); thus all support should be made

NOTE: If a support order is requested, submit a completed Income and Expense Declaration (form FL-150), or
Financial Statement (Simplified) (form FL-155), unless a current form is on file. Include your best estimate of the other
party's gross monthly income.

ATTORNEY FEES should be ordered as set forth in the proposed Judgment (form FL-250).
CHILD CUSTODY should be ordered as set forth in the proposed Judgment (form FL-250).
CHILD VISITATION (PARENTING TIME) should be ordered as set forth in the proposed Judgment (form FL-250).
REASONABLE EXPENSES OF PREGNANCY AND BIRTH should be ordered as set forth in the proposed Judgment (form
FL-250).
NAMES OF THE CHILDREN should be changed as set forth in the proposed Judgment (form FL-250).

This declaration may be reviewed by a commissioner sitting as a temporary judge who may determine whether to grant this request
or require my appearance.

I have read and understand the Advisement and Waiver of Rights Re: Determination of Parental Relationship (form FL-235), which
is signed and attached to this declaration.

Other (specify):

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)

Form Adopted for Mandatory Use
Judicial Council of California
FL-230 [Rev. January 1, 2020]

DECLARATION FOR DEFAULT OR UNCONTESTED JUDGMENT
(Uniform Parentage, Custody and Support)

Page 1 of 1

Family Code, §§ 7600, 3120,
3900 et seq.
www.courts.ca.gov

8.
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10.
11.

12.

13.

14.

15.

Declaration for Default or Uncontested Judgment (Uniform Parentage—Custody and Support)

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 1
Fields(s): 42
Average fields per page: 42
Reading Level: Grade 8
LIST Grouping(s): CO-00-00-00-00, FA-00-00-00-00, CO-07-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

f_l_page_fill_text__1 was FL-230[0].Page1[0].FillText1[0] (0.57 conf)
f_l_page_check_box__1 was FL-230[0].Page1[0].CheckBox1[0] (0.41 conf)
f_l_page_check_box__2 was FL-230[0].Page1[0].CheckBox1[1] (0.41 conf)
f_l_page_check_box__3 was FL-230[0].Page1[0].CheckBox1[2] (0.41 conf)
f_l_page_check_box__4 was FL-230[0].Page1[0].CheckBox1[3] (0.41 conf)
f_l_page_check_box__5 was FL-230[0].Page1[0].CheckBox1[4] (0.41 conf)
f_l_page_check_box__6 was FL-230[0].Page1[0].CheckBox1[5] (0.41 conf)
f_l_page_check_box__7 was FL-230[0].Page1[0].CheckBox1[6] (0.41 conf)
f_l_page_check_box__8 was FL-230[0].Page1[0].CheckBox1[7] (0.41 conf)
f_l_page_check_box__9 was FL-230[0].Page1[0].CheckBox1[8] (0.41 conf)
f_l_page_check_box__10 was FL-230[0].Page1[0].CheckBox1[9] (0.41 conf)
f_l_page_check_box__11 was FL-230[0].Page1[0].CheckBox1[10] (0.41 conf)
f_l_page_check_box__12 was FL-230[0].Page1[0].CheckBox1[11] (0.41 conf)
f_l_page_check_box__13 was FL-230[0].Page1[0].CheckBox19[0] (0.41 conf)
f_l_page_p_party_info__1 was FL-230[0].Page1[0].p1Caption[0].AttyPartyInfo[0].AttyBarNo[0] (0.40 conf)
f_page_p_party_info_name was FL-230[0].Page1[0].p1Caption[0].AttyPartyInfo[0].Name[0] (0.41 conf)
f_page_p_party_info_firm was FL-230[0].Page1[0].p1Caption[0].AttyPartyInfo[0].AttyFirm[0] (0.45 conf)
f_page_p_party_info_street was FL-230[0].Page1[0].p1Caption[0].AttyPartyInfo[0].Street[0] (0.41 conf)
f_page_p_party_info_city was FL-230[0].Page1[0].p1Caption[0].AttyPartyInfo[0].City[0] (0.41 conf)
f_page_p_party_info_state was FL-230[0].Page1[0].p1Caption[0].AttyPartyInfo[0].State[0] (0.41 conf)
f_l_page_p_party_info__2 was FL-230[0].Page1[0].p1Caption[0].AttyPartyInfo[0].Zip[0] (0.41 conf)
f_page_p_party_info_phone was FL-230[0].Page1[0].p1Caption[0].AttyPartyInfo[0].Phone[0] (0.41 conf)
f_l_page_p_party_info__3 was FL-230[0].Page1[0].p1Caption[0].AttyPartyInfo[0].Fax[0] (0.41 conf)
f_page_p_party_info_email was FL-230[0].Page1[0].p1Caption[0].AttyPartyInfo[0].Email[0] (0.41 conf)
f_l_page_p_party_info__4 was FL-230[0].Page1[0].p1Caption[0].AttyPartyInfo[0].AttyFor[0] (0.45 conf)
f_l_page_p_info_county was FL-230[0].Page1[0].p1Caption[0].CourtInfo[0].CrtCounty[0] (0.37 conf)
f_l_page_p_info_street was FL-230[0].Page1[0].p1Caption[0].CourtInfo[0].CrtStreet[0] (0.37 conf)
f_l_page_p_caption_info was FL-230[0].Page1[0].p1Caption[0].CourtInfo[0].CrtMailingAdd[0] (0.41 conf)
f_l_page_p_caption_court_info_crt_city_zip was FL-230[0].Page1[0].p1Caption[0].CourtInfo[0].CrtCityZip[0] (0.39 conf)
f_l_page_p_court_branch was FL-230[0].Page1[0].p1Caption[0].CourtInfo[0].CrtBranch[0] (0.37 conf)
f_page_p_title_party_name__1 was FL-230[0].Page1[0].p1Caption[0].TitlePartyName[0].Party2_ft[0] (0.35 conf)
f_page_p_title_party_name__2 was FL-230[0].Page1[0].p1Caption[0].TitlePartyName[0].Party1_ft[0] (0.35 conf)
f_l_page_p_case_number was FL-230[0].Page1[0].p1Caption[0].CaseNumber[0].CaseNumber[0] (0.36 conf)
f_l_page_cb_choice__1 was FL-230[0].Page1[0].CBChoice1_cb[0] (0.33 conf)
f_l_page_cb_choice__2 was FL-230[0].Page1[0].CBChoice1_cb[1] (0.33 conf)
f_l_page_fill_text__2 was FL-230[0].Page1[0].FillText1140[0] (0.42 conf)
f_l_page_fill_text__3 was FL-230[0].Page1[0].FillText56[0] (0.42 conf)
f_l_page_check_box__14 was FL-230[0].Page1[0].CheckBox1[12] (0.41 conf)
f_l_page_check_box__15 was FL-230[0].Page1[0].CheckBox1[13] (0.41 conf)
f_l_page_fill_text__4 was FL-230[0].Page1[0].FillText1[1] (0.42 conf)
f_l_page_check_box__16 was FL-230[0].Page1[0].CheckBox1[14] (0.41 conf)
f_l_page_r_b_choices was FL-230[0].Page1[0].RB2Choices[0] (0.33 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Declaration for Default or Uncontested Judgment (Uniform Parentage—Custody and Support)

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02