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

TELEPHONE NO.:

FL-646

FOR COURT USE ONLY

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER/PLAINTIFF:

RESPONDENT/DEFENDANT:

OTHER PARENT:
RESPONSE OF LOCAL CHILD SUPPORT AGENCY TO
NOTICE OF INTENT TO TAKE
INDEPENDENT ACTION TO ENFORCE SUPPORT ORDER

CASE NUMBER:

1.

The local child support agency consents to the taking of the proposed independent enforcement action as follows (specify):

2.

The local child support agency objects to all or a part of the proposed independent enforcement action for the following 
reasons:

The local child support agency is currently using an administrative or judicial method to enforce the support 
obligation.

The proposed independent enforcement action would interfere with an investigation being conducted by the local 
child support agency.

Other (specify):

a.

b.

c.

Date:

(TYPE OR PRINT NAME)

(SIGNATURE OF ATTORNEY)

3.  DECLARATION OF MAILING
     I served a copy of this document by enclosing it in a sealed envelope and depositing the envelope

directly in the United States mail with postage paid

OR

at my place of business for same day collection

and mailing with the United States mail, following our ordinary business practices with which I am readily familiar.

a. Date of deposit:
b. Addressed as follows:

c.  Place of deposit (city and state):

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-646 [Rev. January 1,  2003]

RESPONSE OF LOCAL CHILD SUPPORT AGENCY TO NOTICE OF INTENT
TO TAKE INDEPENDENT ACTION TO ENFORCE SUPPORT ORDER
(Governmental)

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Family Code, 17404
www.courtinfo.ca.gov.