ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number,  and address):

FOR COURT USE ONLY

FL-685

TELEPHONE NO.:

FAX NO. (Optional):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

E-MAIL ADDRESS (Optional):

ATTORNEY FOR (Name):

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER/PLAINTIFF:

RESPONDENT/IDEFENDANT:

OTHER PARENT:

RESPONSE TO GOVERNMENTAL NOTICE OF MOTION 
OR ORDER TO SHOW CAUSE

HEARING DATE:

TIME:

DEPT., ROOM, OR DIVISION:

CASE NUMBER:

1.

I

PARENTAGE

do

do not

admit that I am the parent of all of the children.

I admit that I am the parent of all of the children except (specify):

2.

CHILD SUPPORT

I consent to the order requested. 

I request the following child support order:

HEALTH INSURANCE COVERAGE
I consent to the order requested. 

I request the following health insurance coverage order:

FEES AND COSTS

do not

consent to the order requested.

PROPERTY RESTRAINT

do not

consent to the order requested.

do

do

OTHER

do

do not

consent to the other orders requested.

a.

b.

a.

b.

I

I

I

3.

4.

5.

6.

Form Adopted for Mandatory Use 
Judicial Council of California 
FL-685 [Rev. January 1, 2012]

RESPONSE TO GOVERNMENTAL NOTICE OF MOTION

OR ORDER TO SHOW CAUSE

(Governmental)

Page 1 of 2

Family Code, § 213;
Code of Civil Procedure, § 1005
www.courts.ca.gov

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

OTHER PARENT:

7.

FACTS IN SUPPORT of this response are:

CASE NUMBER:

FL-685

contained in an attached declaration.

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

(TYPE OR PRINT NAME)

(SIGNATURE OF DECLARANT)

PROOF OF SERVICE BY MAIL
I am at least 18 years of age, not a party to this cause, and a resident of or employed in the county where the mailing took place.
My residence or business address is (specify):

I served a copy of this response by enclosing it in a sealed envelope with postage fully prepaid and depositing it in the U.S. mail as 
 follows:
(a) Date of deposit:

(b) Place of deposit (city and state):

(c) Addressed as follows:

4.

I served this Response, 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.)   

5.

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 RESPONSE)

FL-685 [Rev. January 1, 2012]

Page 2 of 2

RESPONSE TO GOVERNMENTAL NOTICE OF MOTION 
OR ORDER TO SHOW CAUSE 
(Governmental)

Date:

1.
2.

3.

Date: