GOVERNMENTAL AGENCY (under Family Code, §§ 17400, 17406) OR                               
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

FOR COURT USE ONLY

FL-640

TELEPHONE NO.:

E-MAIL ADDRESS (Optional):

FAX NO. (Optional):

ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

OTHER PARENT:

NOTICE AND MOTION TO CANCEL (SET ASIDE) SUPPORT ORDER
BASED ON PRESUMED INCOME

CASE NUMBER:

If the support order is based on presumed income, you may file this motion and ask the court to cancel (set aside) the 
support order. If the court agrees with you, the court will issue another order based on the actual income, earning capacity, 
or income allowable by law. You must file the original of this motion and the attachments with the court clerk within one year 
from the date the first collection of support was made and serve a copy on all other parties in this case. Keep a copy of this 
motion for your records.

1.  

To:

Petitioner/Plaintiff 

Respondent/Defendant

Local child support agency

Other (specify):

A hearing on this motion will be held as follows (see instructions on how to get a hearing date):

a.  Date:

Time:

 Dept.:

  Div.:

  Room:

b.  Address of court:

same as noted above

 other (specify):

I am asking the court to cancel (set aside) the child support order in this case.
I am asking the court to issue another order because the current order is based on a presumed income that is different from the 
actual income. 

  Attached is an Income and Expense Declaration (form FL-150) or a Financial Statement (Simplified) (form FL-155), or other 
  information concerning income for any relevant years.      
  Attached is my proposed Answer to Complaint or Supplemental Complaint Regarding Parental Obligations (Governmental) 
  (form FL-610).
  My address and telephone number for receipt of all notices and court dates are as follows:

2.
3.

4.

5.

6.

Date:

Address:
City, state, and zip code: 
Home telephone:
Work telephone:

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

(TYPE OR PRINT NAME)

(SIGNATURE)

This case may be referred to a court commissioner for hearing. By law, court commissioners do not have the authority to 
issue final orders and judgments in contested cases unless they are acting as temporary judges. The court commissioner in 
your case will act as a temporary judge unless, before the hearing, you or any other party objects to the commissioner acting 
as a temporary judge. The court commissioner may still hear your case to make findings and recommendations to a judge. 
However, if you object to the commissioner acting as a temporary judge, an order will not be made until a judge reviews your 
case.

Form Adopted for Mandatory Use 
Judicial Council of California 
FL-640 [Rev. January 1, 2012]

NOTICE AND MOTION TO CANCEL (SET ASIDE) SUPPORT 
ORDER BASED ON PRESUMED INCOME 
(Governmental)

Page 1 of  2

Family Code, §§ 2330.1, 17400, 
17428, 17430, 17432
www.courts.ca.gov

CASE NUMBER:

FL-640

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

OTHER PARENT:

1.

2.

3.

 At the time of service I was at least 18 years of age and not a party to the legal action.

 My residence or business address is (specify):

PROOF OF SERVICE

I served a copy of the foregoing Notice and Motion to Cancel (Set Aside) Support Order Based on Presumed Income   
(Governmental) and all attachments as follows (check either a, b, or c for each person served):

a.    

 Personal delivery. I personally delivered a copy and all attachments as follows:

(1)   

Name of party or attorney served:

(2)  

 Name of local child support agency served:

(a)  Address where delivered:

(a)  Address where delivered:

(b)  Date delivered:
(c)  Time delivered:

(b)  Date delivered:
(c)  Time delivered:

b.  

 Mail. I am a resident of or employed in the county where the mailing occurred. 

(1)    I enclosed a copy in an envelope and

(a)  

(b)  

 deposited the sealed envelope with the U.S. Postal Service with the postage fully prepaid. 

placed the envelope for collection and mailing on the date and at the place shown below, following  our  
ordinary business practices. I am readily familiar with this business’s practice for collecting and processing 
correspondence for mailing. On the same day that correspondence is placed for collection and mailing, it is 
deposited in the ordinary course of business with the U.S. Postal Service in a sealed envelope with 
postage fully prepaid.

(2)   

 Name of party or attorney served:

(3)  

 Name of local child support agency served:

(a)  Address:

(a)  Address:

(b)  Date mailed:

(b)  Date mailed:

(c)  Place of mailing (city and state):

(c)  Place of mailing (city and state):

(3)

Address Verification (please specify):

(a)   

(b)   

(i)

(ii)

I served a request to modify a child custody, visitation, or child support judgment or permanent order, 
which included an address verification declaration (Declaration Regarding Address Verification— 
Postjudgment Request to Modify a Child Custody, Visitation, or Child Support Order (form FL-334) may 
be used for this purpose).   

The address for each individual identified in items 3a and 3b was 

verified by the California Child Support Enforcement System (CSE) as the current primary mailing 
address on file. 

other (specify):

c.

Other (specify code section):

 Additional page is attached.

Date:

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

(TYPE OR PRINT NAME)

(SIGNATURE OF PERSON WHO SERVED MOTION)

FL-640 [Rev. January 1, 2012] 

Page 2 of 2

NOTICE AND MOTION TO CANCEL (SET ASIDE) SUPPORT 
ORDER BASED ON PRESUMED INCOME
(Governmental)