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Here is the text we could read:

GOVERNMENTAL AGENCY (under Family Code, §§ 17400, 17406):

FOR COURT USE ONLY

FL-530

FAX NO.:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:

TELEPHONE NO.:

E-MAIL ADDRESS:

ATTORNEY FOR (name):

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

OTHER PARENT/PARTY:

1.

a.

b.

2.

3.

4.

5.

6.

JUDGMENT REGARDING PARENTAL OBLIGATIONS (UIFSA)

CASE NUMBER:

 AMENDED

  SUPPLEMENTAL

NOTICE:  THIS IS A PROPOSED JUDGMENT. This Judgment Regarding Parental Obligations (UlFSA) will be 
entered by the court and will become legally binding unless you fill out and file the Response to Uniform Support 
Petition (UlFSA) (form FL-520) with the court clerk within 30 days of the date you were served with the Summons 
(UlFSA) (form FL-510) and Uniform Support Petition (form OMB 0970-0085). If you need a Response form, you 
may get one from the local child support agency, the court clerk, or the family law facilitator. The family law 
facilitator will help you fill out the forms. To file the Response, follow the procedures listed in the information 
sheet attached to that form.

NOTICE: THIS IS A JUDGMENT. It is now legally binding.

THIS MATTER PROCEEDED AS FOLLOWS:
a.
b.

Judgment entered under Family Code section 17404.1.
By court hearing, appearances as follows:

(1) 
(2)
(3)
(4)
(5)
(6)

Date:

Dept:

Judicial Officer:

Petitioner/plaintiff present   
Respondent/defendant present   
Other parent/party present

Attorney present (name):
Attorney present (name):
Attorney present (name):
Local child support agency (Family Code, §§ 17400, 17406) by (name):

Other (specify):

c.

The parent ordered to pay support is the

petitioner/plaintiff

respondent/defendant

other parent/party.

This order is based on presumed income for the parent ordered to pay support under Family Code section 17404.1. 

Attached is a computer printout showing the parents’ income and percentage of time each parent spends with the children.  
The printout, which shows the calculation of child support payable, will become the court’s findings. 
The order is based on the attached documents (specify):

THE COURT ORDERS:
a.

The parent ordered to pay support

b.

The parent ordered to pay support must pay current child support as follows:

Name of child

Date of birth

Monthly support amount

 is the parent of the children named in item 6b.
 has previously been determined to be the parent of the children named in item 6b.

NOTICE: Any party required to pay child support must pay interest on overdue amounts at the legal rate, which is currently 
10 percent per year.

Form Adopted for Mandatory Use
Judicial Council of California  
FL-530 [Rev. January 1, 2020]

JUDGMENT REGARDING PARENTAL OBLIGATIONS 
(UIFSA) 

Page 1 of 3

Family Code, §§ 5700.307, 17404.1 
www.courts.ca.gov

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

OTHER PARENT/PARTY:

6. 

b.

(1)

Mandatory additional child support.

CASE NUMBER:

FL-530

(a)

The parent ordered to pay support must pay additional monthly support for reasonable child-care costs, as follows: 

One-half or

% or 

(specify amount): $

per month of the costs

Payments must be made to the 
The parent ordered to pay support must pay reasonable uninsured health-care costs for the children, as follows: 

State Disbursement Unit

child-care provider.

other parent

(b)

One-half or

Payments must be made to the 

State Disbursement Unit

% or 
other parent

(specify amount): $

per month of the costs
health-care provider.

(2)

Other (specify):

For a total of: $
beginning (date):

(3)

(4)

The low-income adjustment applies.

payable on the:

day of each month

The low-income adjustment does not apply because (specify reasons):

(5)

Any support ordered will continue until further order of court, unless terminated by operation of law.

c.

The parent receiving support must    (1) provide and maintain health insurance

The parent ordered to pay support
coverage for the children, if available at no or reasonable cost, and keep the local child support agency informed of the 
availability of the coverage (the cost is presumed to be reasonable if it does not exceed 5 percent of gross income to add 
a child); (2) if health insurance is not available, provide coverage when it becomes available; (3) within 20 days of the 
local child  support agency’s request, complete and return a health insurance form; (4) provide to the local child support 
agency all information and forms necessary to obtain health-care services for the children; (5) present any claim to secure 
payment or reimbursement to the other parent or caretaker who incurs costs for health-care services for the children; and 
(6) assign  any rights to reimbursement to the other parent or caretaker who incurs costs for health-care services for the 
children. The  parent ordered to provide health insurance must seek continuation of coverage for the child after the child 
attains the age  when the child is no longer considered eligible for coverage as a dependent under the insurance contract, 
if the child is  incapable of self-sustaining employment because of a physically or mentally disabling injury, illness, or 
condition and is  chiefly dependent upon the parent providing health insurance for support and maintenance.

d.

The parent ordered to pay support must pay child support for the past periods and in the amounts set forth below:

Name of child

Date of birth

Period of support

Amount

(1)

Other (specify):

FL-530 [Rev. January 1, 2020]

Page 2 of 3

JUDGMENT REGARDING PARENTAL OBLIGATIONS 
(UIFSA) 

CASE NUMBER:

FL-530

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

OTHER PARENT/PARTY:

6.

d.

(2)

For a total of: $
beginning (date):

   payable: $

   on the:

  day of each month

(3)

Interest accrues on the entire principal balance owing and not on each installment as it becomes due.

e.

f.

No provision of this judgment operates to limit any right to collect the principal (total amount of unpaid support) or to charge and  
collect interest and penalties as allowed by law. All payments ordered are subject to modification.
All payments, unless specified in item 6b(1) above, must be made to the State Disbursement Unit at the address listed below  
(specify address):  

g.
h.

i.
j.

k

l.

An earnings assignment order is issued.
In the event that there is a contract between a party receiving support and a private child support collector, the party ordered to  
pay support must pay the fee charged by the private child support collector. This fee must not exceed 33 1/3 percent of the total  
amount of past due support nor may it exceed 50 percent of any fee charged by the private child support collector. The money  
judgment created by this provision is in favor of the private child support collector and the party receiving support, jointly.

If "The parent ordered to pay support" box is checked in item 6c, a health insurance coverage assignment must issue. 

The parents must notify the local child support agency in writing within 10 days of any change in residence or employment.

The Notice of Rights and Responsibilities and Information Sheet on Changing a Child Support Order (form FL-192) is attached.

The court further orders (specify):

Date:

Number of pages attached:

Approved as conforming to court order.
Date:

(SIGNATURE OF ATTORNEY FOR THE PARENT ORDERED TO PAY SUPPORT)

JUDICIAL OFFICER  

SIGNATURE FOLLOWS LAST ATTACHMENT

FL-530 [Rev. January 1, 2020]

Page 3 of 3

JUDGMENT REGARDING PARENTAL OBLIGATIONS 
(UIFSA)

Judgment Regarding Parental Obligations (UIFSA)

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): 3
Fields(s): 117
Average fields per page: 39
Reading Level: Grade 8
LIST Grouping(s): FA-00-00-00-00.

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_p_party_info was FL-530[0].Page1[0].P1Caption[0].PartyAttyAddInfo_ft[0] (0.54 conf)
f_l_page_p_caption_email_ft was FL-530[0].Page1[0].P1Caption[0].Email_ft[0] (0.42 conf)
f_l_page_p_info_county was FL-530[0].Page1[0].P1Caption[0].CourtInfo[0].CrtCounty[0] (0.39 conf)
f_l_page_p_info_street was FL-530[0].Page1[0].P1Caption[0].CourtInfo[0].CrtStreet[0] (0.39 conf)
f_l_page_p_caption_info was FL-530[0].Page1[0].P1Caption[0].CourtInfo[0].CrtMailingAdd[0] (0.43 conf)
f_l_page_p_caption_court_info_crt_city_zip was FL-530[0].Page1[0].P1Caption[0].CourtInfo[0].CrtCityZip[0] (0.40 conf)
f_l_page_p_court_branch was FL-530[0].Page1[0].P1Caption[0].CourtInfo[0].CrtBranch[0] (0.39 conf)
f_page_p_court_info_respondent was FL-530[0].Page1[0].P1Caption[0].CourtInfo[0].Respondent[0] (0.39 conf)
f_page_p_court_info_parent was FL-530[0].Page1[0].P1Caption[0].CourtInfo[0].OtherParent[0] (0.42 conf)
f_page_p_court_info_petitioner was FL-530[0].Page1[0].P1Caption[0].CourtInfo[0].Petitioner[0] (0.39 conf)
f_page_p_title_name_form was FL-530[0].Page1[0].P1Caption[0].TitlePartyName[0].FormTitle[0].Checkbox[0] (0.35 conf)
f_page_p_title_party_name__1 was FL-530[0].Page1[0].P1Caption[0].TitlePartyName[0].CBChoice1[0] (0.38 conf)
f_page_p_title_party_name__2 was FL-530[0].Page1[0].P1Caption[0].TitlePartyName[0].#field[1] (0.38 conf)
f_page_p_title_party_name__3 was FL-530[0].Page1[0].P1Caption[0].TitlePartyName[0].#field[2] (0.38 conf)
f_l_page_p_caption_fax_ft was FL-530[0].Page1[0].P1Caption[0].Fax_ft[0] (0.44 conf)
f_l_page_p_caption_atty_ft was FL-530[0].Page1[0].P1Caption[0].AttyFor_ft[0] (0.42 conf)
f_l_page_p_caption_phone_ft was FL-530[0].Page1[0].P1Caption[0].Phone_ft[0] (0.43 conf)
f_l_page_case_number_ft was FL-530[0].Page1[0].CaseNumber[0].CaseNumber_ft[0] (0.40 conf)
f_l_page_fill_b_child_name__1 was FL-530[0].Page1[0].FillText06\.b\.child\.name\.1[0] (0.42 conf)
f_l_page_fill_b_child_name__2 was FL-530[0].Page1[0].FillText06\.b\.child\.name\.2[0] (0.42 conf)
f_l_page_fill_b_child_name__3 was FL-530[0].Page1[0].FillText06\.b\.child\.name\.3[0] (0.42 conf)
f_l_page_fill_text_b__1 was FL-530[0].Page1[0].FillText06\.b\.DOB\.1[0] (0.42 conf)
f_l_page_fill_text_b__2 was FL-530[0].Page1[0].FillText06\.b\.DOB\.2[0] (0.42 conf)
f_l_page_fill_text_b__3 was FL-530[0].Page1[0].FillText06\.b\.DOB\.3[0] (0.42 conf)
f_page_fill_b_monthly_amount__1 was FL-530[0].Page1[0].FillText\.06\.b\.monthly\.amount\.1[0] (0.42 conf)
f_page_fill_b_monthly_amount__2 was FL-530[0].Page1[0].FillText\.06\.b\.monthly\.amount\.2[0] (0.42 conf)
f_page_fill_b_monthly_amount__3 was FL-530[0].Page1[0].FillText\.06\.b\.monthly\.amount\.3[0] (0.42 conf)
f_l_page_checkbox__1 was FL-530[0].Page1[0].Checkbox[0] (0.37 conf)
f_l_page_checkbox__2 was FL-530[0].Page1[0].Checkbox[1] (0.37 conf)
f_l_page_checkbox__3 was FL-530[0].Page1[0].Checkbox[2] (0.37 conf)
f_l_page_checkbox__4 was FL-530[0].Page1[0].Checkbox[3] (0.37 conf)
f_l_page_fill_text__1 was FL-530[0].Page1[0].FillText107[0] (0.42 conf)
f_l_page_checkbox__5 was FL-530[0].Page1[0].Checkbox[4] (0.37 conf)
f_l_page_checkbox__6 was FL-530[0].Page1[0].Checkbox[5] (0.37 conf)
f_l_page_checkbox__7 was FL-530[0].Page1[0].Checkbox[6] (0.37 conf)
f_l_page_checkbox__8 was FL-530[0].Page1[0].Checkbox[7] (0.37 conf)
f_l_page_checkbox__9 was FL-530[0].Page1[0].Checkbox[8] (0.37 conf)
f_l_page_checkbox__10 was FL-530[0].Page1[0].Checkbox[9] (0.37 conf)
f_l_page_date_ff__1 was FL-530[0].Page1[0].on_date_ff[0] (0.36 conf)
f_l_page_date_ff__2 was FL-530[0].Page1[0].on_date_ff[1] (0.36 conf)
f_l_page_date_ff__3 was FL-530[0].Page1[0].on_date_ff[2] (0.36 conf)
f_l_page_date_ff__4 was FL-530[0].Page1[0].on_date_ff[3] (0.36 conf)
f_l_page_date_ff__5 was FL-530[0].Page1[0].on_date_ff[4] (0.36 conf)
f_l_page_date_ff__6 was FL-530[0].Page1[0].on_date_ff[5] (0.36 conf)
f_l_page_area_fill_text__1 was FL-530[0].Page1[0].#area[0].FillText90[0] (0.42 conf)
f_l_page_area_checkbox__1 was FL-530[0].Page1[0].#area[0].Checkbox[10] (0.37 conf)
f_l_page_checkbox__11 was FL-530[0].Page1[0].Checkbox[11] (0.37 conf)
f_l_page_checkbox__12 was FL-530[0].Page1[0].Checkbox[12] (0.37 conf)
f_l_page_checkbox__13 was FL-530[0].Page1[0].Checkbox[13] (0.37 conf)
f_l_page_area_fill_text__2 was FL-530[0].Page1[0].#area[1].FillText90[1] (0.42 conf)
f_l_page_area_checkbox__2 was FL-530[0].Page1[0].#area[1].Checkbox[14] (0.37 conf)
f_l_page_fill_text__2 was FL-530[0].Page2[0].FillText\.06\.d\.1\.Other[0] (0.42 conf)
f_l_page_fill_child_name__1 was FL-530[0].Page2[0].FillText\.06\.d\.child\.name\.01[0] (0.42 conf)
f_l_page_fill_child_name__2 was FL-530[0].Page2[0].FillText\.06\.d\.child\.name\.02[0] (0.42 conf)
f_l_page_fill_child_name__3 was FL-530[0].Page2[0].FillText\.06\.d\.child\.name\.03[0] (0.42 conf)
f_l_page_fill_child_name__4 was FL-530[0].Page2[0].FillText\.06\.d\.child\.name\.04[0] (0.42 conf)
f_l_page_fill_child_name__5 was FL-530[0].Page2[0].FillText\.06\.d\.child\.name\.05[0] (0.42 conf)
f_l_page_fill_text_b__4 was FL-530[0].Page2[0].FillText\.06\.d\.DOB\.01[0] (0.42 conf)
f_l_page_fill_text_b__5 was FL-530[0].Page2[0].FillText\.06\.d\.DOB\.02[0] (0.42 conf)
f_l_page_fill_text_b__6 was FL-530[0].Page2[0].FillText\.06\.d\.DOB\.03[0] (0.42 conf)
f_l_page_fill_text_b__7 was FL-530[0].Page2[0].FillText\.06\.d\.DOB\.04[0] (0.42 conf)
f_l_page_fill_text_b__8 was FL-530[0].Page2[0].FillText\.06\.d\.DOB\.05[0] (0.42 conf)
f_page_fill_text_support_period__1 was FL-530[0].Page2[0].FillText\.06\.d\.support\.period\.01[0] (0.42 conf)
f_page_fill_text_support_period__2 was FL-530[0].Page2[0].FillText\.06\.d\.support\.period\.02[0] (0.42 conf)
f_page_fill_text_support_period__3 was FL-530[0].Page2[0].FillText\.06\.d\.support\.period\.03[0] (0.42 conf)
f_page_fill_text_support_period__4 was FL-530[0].Page2[0].FillText\.06\.d\.support\.period\.04[0] (0.42 conf)
f_page_fill_text_support_period__5 was FL-530[0].Page2[0].FillText\.06\.d\.support\.period\.05[0] (0.42 conf)
f_l_page_fill_text_amount__1 was FL-530[0].Page2[0].FillText\.06\.d\.amount\.1[0] (0.42 conf)
f_l_page_fill_text_amount__2 was FL-530[0].Page2[0].FillText\.06\.d\.amount\.2[0] (0.42 conf)
f_l_page_fill_text_amount__3 was FL-530[0].Page2[0].FillText\.06\.d\.amount\.3[0] (0.42 conf)
f_l_page_fill_text_amount__4 was FL-530[0].Page2[0].FillText\.06\.d\.amount\.4[0] (0.42 conf)
f_l_page_fill_text_amount__5 was FL-530[0].Page2[0].FillText\.06\.d\.amount\.5[0] (0.42 conf)
f_l_page_fill_text_b_amount was FL-530[0].Page2[0].FillText\.06\.b\.3\.amount[0] (0.42 conf)
f_page_fill_text_b_day_month was FL-530[0].Page2[0].FillText\.06\.b\.3\.day\.of\.month[0] (0.42 conf)
f_page_fill_text_b_date was FL-530[0].Page2[0].FillText\.06\.b\.3\.beginning\.date[0] (0.42 conf)
f_l_page_fill_text_e_percent__1 was FL-530[0].Page2[0].FillText\.03\.e\.1\.a\.percent[0] (0.42 conf)
f_l_page_fill_text_e_percent__2 was FL-530[0].Page2[0].FillText\.03\.e\.1\.a\.percent[1] (0.42 conf)
page_caption_title_party_name__1 was FL-530[0].Page2[0].PxCaption[0].TitlePartyName[0].Respondent[0] (0.36 conf)
f_page_caption_title_party_name was FL-530[0].Page2[0].PxCaption[0].TitlePartyName[0].OtherParent[0] (0.35 conf)
page_caption_title_party_name__2 was FL-530[0].Page2[0].PxCaption[0].TitlePartyName[0].Petitioner[0] (0.36 conf)
f_l_page_px_case_number was FL-530[0].Page2[0].PxCaption[0].CaseNumber[0].CaseNumber_ft[0] (0.37 conf)
f_l_page_fill_text__3 was FL-530[0].Page2[0].FillText90[0] (0.42 conf)
f_l_page_fill_text__4 was FL-530[0].Page2[0].FillText90[1] (0.42 conf)
f_l_page_checkbox__14 was FL-530[0].Page2[0].Checkbox[0] (0.37 conf)
f_area_check_box_c_paying was FL-530[0].Page2[0].#area[0].CheckBox\.06\.c\.parent\.paying[0] (0.41 conf)
f_page_check_box_c_receiving was FL-530[0].Page2[0].CheckBox\.06\.c\.parent\.receiving[0] (0.41 conf)
f_l_page_check_box__1 was FL-530[0].Page2[0].CheckBox\.06\.d\.0[0] (0.41 conf)
f_l_page_check_box__2 was FL-530[0].Page2[0].CheckBox\.06\.d\.1\.other[0] (0.41 conf)
f_l_page_checkbox__15 was FL-530[0].Page2[0].Checkbox[1] (0.37 conf)
f_l_page_checkbox__16 was FL-530[0].Page2[0].Checkbox[2] (0.37 conf)
f_l_page_checkbox__17 was FL-530[0].Page2[0].Checkbox[3] (0.37 conf)
f_l_page_area_petitioner_cb was FL-530[0].Page2[0].#area[1].petitioner_cb[0] (0.36 conf)
f_l_page_checkbox__18 was FL-530[0].Page2[0].Checkbox[4] (0.37 conf)
f_l_page_checkbox__19 was FL-530[0].Page2[0].Checkbox[5] (0.37 conf)
f_l_page_checkbox__20 was FL-530[0].Page2[0].Checkbox[6] (0.37 conf)
f_l_page_checkbox__21 was FL-530[0].Page2[0].Checkbox[7] (0.37 conf)
f_l_page_checkbox__22 was FL-530[0].Page2[0].Checkbox[8] (0.37 conf)
f_l_page_checkbox__23 was FL-530[0].Page2[0].Checkbox[9] (0.37 conf)
f_l_page_date__1 was FL-530[0].Page2[0].on_date[0] (0.36 conf)
f_l_page_date__2 was FL-530[0].Page2[0].on_date[1] (0.36 conf)
f_l_subform_fill_text_b was FL-530[0].#subform[2].FillText\.06\.b\.2\.other[0] (0.40 conf)
f_l_subform_fill_text_address was FL-530[0].#subform[2].FillText\.06\.f\.address[0] (0.40 conf)
f_l_fill_text_total_amount was FL-530[0].#subform[2].FillText\.06\.d\.2\.total\.amount[0] (0.40 conf)
f_l_subform_fill_text_amount was FL-530[0].#subform[2].FillText\.06\.d\.2\.amount[0] (0.40 conf)
f_l_subform_fill_text_date__1 was FL-530[0].#subform[2].FillText\.06\.d\.2\.date[0] (0.40 conf)
f_l_fill_text_day_month was FL-530[0].#subform[2].FillText\.06\.d\.2\.day\.of\.month[0] (0.40 conf)
f_l_subform_fill_text_date__2 was FL-530[0].#subform[2].FillText\.date\.0[0] (0.40 conf)
f_l_fill_text_date_signing was FL-530[0].#subform[2].FillText\.date\.signing[0] (0.40 conf)
l_title_party_name_respondent was FL-530[0].#subform[2].TitlePartyName[0].Respondent[0] (0.30 conf)
f_l_title_party_name_parent was FL-530[0].#subform[2].TitlePartyName[0].OtherParent[0] (0.35 conf)
l_title_party_name_petitioner was FL-530[0].#subform[2].TitlePartyName[0].Petitioner[0] (0.30 conf)
f_l_subform_case_number_ft was FL-530[0].#subform[2].CaseNumber[0].CaseNumber_ft[0] (0.37 conf)
f_l_subform_check_box__1 was FL-530[0].#subform[2].CheckBox\.06\.d\.2[0] (0.34 conf)
f_l_subform_check_box__2 was FL-530[0].#subform[2].CheckBox\.06\.d\.3[0] (0.34 conf)
f_l_subform_check_box__3 was FL-530[0].#subform[2].CheckBox\.06\.d\.2[1] (0.34 conf)
f_l_subform_area_petitioner_cb was FL-530[0].#subform[2].#area[1].petitioner_cb[0] (0.38 conf)
f_l_subform_date_ff was FL-530[0].#subform[2].on_date_ff[0] (0.41 conf)

We've done our best to group similar variables togther to avoid overwhelming the user.

Suggested Screen 0:

f_l_page_p_party_info
f_l_page_p_caption_email_ft
f_l_page_p_info_county
f_l_page_p_info_street
f_l_page_p_caption_info
f_l_page_p_caption_court_info_crt_city_zip
f_l_page_p_court_branch
f_page_p_court_info_respondent
f_page_p_court_info_parent
f_page_p_court_info_petitioner
f_page_p_title_name_form
f_page_p_title_party_name__1
f_page_p_title_party_name__2
f_page_p_title_party_name__3
f_l_page_p_caption_fax_ft
f_l_page_p_caption_atty_ft
f_l_page_p_caption_phone_ft
f_l_page_case_number_ft
f_l_page_fill_b_child_name__1
f_l_page_fill_b_child_name__2
f_l_page_fill_b_child_name__3
f_l_page_fill_text_b__1
f_l_page_fill_text_b__2
f_l_page_fill_text_b__3
f_page_fill_b_monthly_amount__1
f_page_fill_b_monthly_amount__2
f_page_fill_b_monthly_amount__3
f_l_page_checkbox__1
f_l_page_checkbox__2
f_l_page_checkbox__3
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