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The Double Elimination 20 form, officially known as the Declaration of Support Payment History, is a crucial document in the realm of child and spousal support cases in California. This form enables individuals to systematically record and report the amounts of support ordered by the court alongside actual payments made over time. The information gathered serves as a foundation for determining any past due support owed. The form meticulously guides users on how to fill in monthly support amounts, detailing changes in court orders and payments made. In addition, it requests information about any periods of incarceration for either parent, which may impact support obligations. Understanding the nuances of this form is essential, as it is not confidential; both parties in the case may review it, and discrepancies may require substantiation through documents like cancelled checks. For those who might feel overwhelmed, assistance is readily available through local court Family Law Facilitator Offices, ensuring that everyone can accurately navigate their obligations and rights surrounding support payments.

Form Sample

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

DEPARTMENT OF CHILD SUPPORT SERVICES

DECLARATION OF SUPPORT PAYMENT HISTORY

DCSS 0569 (06/17/2018)

INSTRUCTIONS FOR COMPLETING THE DECLARATION

OF SUPPORT PAYMENT HISTORY

On the back of this page is the Declaration of the Support Payment History for your case. Please provide the amount of support that was ordered by the court and the amount that was paid for each month. These figures will help determine the amount of the past due support owed, if any.

Within the boxes on the bottom half of the page, please complete the:

"Amount Ordered" column for each year

Fill in the amount of support that was ordered by the court each month since your order began. If there has been a change in your order, make sure each month reflects the correct amount of support due.

"Amount Paid" column for each year

Fill in the dollar amount of support paid in that month. If more than one payment was made in a given month, put the total dollar amount of support paid. Put the dollar amount next to the month in which the payment was actually paid, and not the month the payments were intended to cover. If needed, you may attach more sheets.

Within the boxes on the bottom half on the page, only if it applies to your case, please complete the:

“Incarceration/Institutionalization History"

Fill in the details of any time periods during which the other parent of your child was involuntarily confined in a state prison, county jail, juvenile facility, mental health facility, or other facility. If needed, you may attach additional sheets.

Please complete a separate page(s) for child support, spousal support, family support, medical support, unreimbursed medical expenses, and other types of support not listed. DO NOT combine child support and spousal support unless your court order combines the two support payments into a "family" support order.

Be aware that this Declaration is not confidential and may be given to the other parent or party in your case for review. If there is a disagreement regarding the payment history, the parties may be required to present proof of payments, for example, cancelled checks, or receipts.

If you have questions and/or need assistance with child support forms, you can get free help from your local court's Family Law Facilitator Office. Information for the Family Law Facilitator can be found at the California Courts website at http://www.courts.ca.gov/selfhelp-facilitators.htm.

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

DEPARTMENT OF CHILD SUPPORT SERVICES

DECLARATION OF SUPPORT PAYMENT HISTORY

DCSS 0569 (06/17/2018)

Person completing this form (name):

 

 

 

I am the:

 

 

 

 

 

Support Payment History for (check one):

Child

Spousal

Family

Unreimbursed medical expenses

Medical

Other (specify):

 

 

Custodial Party Noncustodial Parent

 

YEAR

 

 

YEAR

 

 

YEAR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AMOUNT

 

AMOUNT

AMOUNT

AMOUNT

AMOUNT

AMOUNT

 

ORDERED

 

PAID

ORDERED

 

PAID

ORDERED

 

PAID

January

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

February

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

March

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

April

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

May

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

June

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

July

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

August

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

September

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

October

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

November

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

December

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Incarceration/Institutionalization History

BEGIN DATE

(MM/DD/YYYY)

RELEASE DATE (MM/DD/YYYY)

FACILITY/INSTITUTION NAME AND LOCATION

OTHER DETAILS, SUCH AS CHARGING

OFFENSE(S), CONVICTION(S),

VICTIM NAME(S), COURT WHERE

SENTENCED, ETC.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. I am aware that this may be provided to the other parent for their verification and that either party may be required to provide documentation.

Signature:

 

Date:

 

CSE Case Number:

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Document Specifications

Fact Name Details
Form Title Declaration of Support Payment History
Governing Law California Family Code
Purpose This form helps determine past due support by detailing the amounts that were ordered and paid.
Confidentiality Notice This declaration is not confidential and may be shared with the other parent for verification.

Steps to Filling Out Double Elimination 20

Filling out the Double Elimination 20 form is an essential step to ensure that your child support payment history is accurately documented. Once completed, this form helps clarify any past due support owed. You will be required to fill in details regarding the ordered support amounts and the payments made each month. Follow these steps carefully to complete the form.

  1. Begin by writing your name in the designated space at the top of the form.
  2. Indicate your role by checking the appropriate box for either Custodial Party or Noncustodial Parent.
  3. Select the type of support payment history you are providing by checking one box: Child, Spousal, Family, Unreimbursed Medical Expenses, Medical, or Other (if applicable).
  4. For each year, fill out the “Amount Ordered” and “Amount Paid” columns. Start with January and continue through December.
  5. For the “Amount Ordered” column, enter the dollar amount that was ordered by the court for each month. If the order changed, ensure you enter the correct amount for each month.
  6. For the “Amount Paid” column, record the total dollar amount paid in that month. If there were multiple payments, combine them and enter the total next to the respective month.
  7. If there were periods of incarceration or institutionalization that apply to your case, complete the section titled “Incarceration/Institutionalization History.” Provide the begin and release dates, facility or institution name and location, and any other relevant details.
  8. If you need more space, feel free to attach additional sheets of paper as necessary.
  9. At the bottom of the form, sign and date it. Your signature indicates your declaration under penalty of perjury that the information provided is true and correct.
  10. Lastly, include your Child Support Enforcement (CSE) Case Number, if applicable.

More About Double Elimination 20

What is the purpose of the Double Elimination 20 form?

The Double Elimination 20 form, officially known as the Declaration of Support Payment History, is designed to document the payment history of support obligations. This helps determine any past due support owed, ensuring that both parties have a clear record of what was ordered and what has been paid over time.

Who needs to fill out this form?

The form should be completed by either the custodial party or the noncustodial parent involved in a support case. This is to track the payments made and received for child support, spousal support, or other related obligations.

What information do I need to provide for each month?

You will need to list the amount of support ordered by the court for each month, as well as the total amount paid during that month. It's important to accurately record the payments based on when they were actually made, not when they were intended to cover.

What if I have multiple payments in one month?

In cases where more than one payment is made throughout a month, you should add them together and enter the total amount next to the respective month. This provides a clear picture of the total support provided for that specific month.

What do I do if there is a change in the support amount?

If there has been a modification to the support amount ordered, ensure that each month reflects the correct amount due since the modification took place. This will prevent any discrepancies in the record of payments.

How should I document incarceration or institutionalization of the other parent?

If the other parent has been involuntarily confined, you should provide details of the time periods, including the facility name, dates of confinement, and any other relevant information. Attach additional sheets if necessary to include all pertinent details.

Can I combine different types of support on this form?

Is this declaration confidential?

No, the Declaration of Support Payment History is not confidential. It may be shared with the other parent or party in your case for their review, making transparency essential in order to avoid potential disagreements.

Where can I get assistance if I have questions about the form?

If you have any questions or need help while completing the Double Elimination 20 form, you can reach out to your local court's Family Law Facilitator Office. They provide free assistance and can guide you through the process. More information can be found on the California Courts website.

Common mistakes

  1. Not affirming the support amounts. One common mistake is failing to accurately report the amount of support that was ordered by the court for each month. Ensure you include the correct figures to avoid complications down the line.

  2. Confusing payment months. It’s crucial to record the payments in the right month. If payments are mistakenly recorded for a month in which they weren’t made, it can create unnecessary disputes. Remember to document payments according to when they were actually paid, rather than when they were intended to cover.

  3. Combining different types of support. Another frequent error involves merging child support with spousal support. Only combine these if your court order explicitly lists them as a "family" support order. Otherwise, maintain separate entries.

  4. Neglecting to provide incarceration details. If the other parent has been incarcerated or institutionalized, it’s important to detail those periods accurately. Missing out on this information can affect calculations of support and payment history.

  5. Overlooking documentation. When discrepancies arise, failing to keep proof of payments can be detrimental. It’s advisable to have records like canceled checks or receipts ready in case proof is needed.

Documents used along the form

The Double Elimination 20 form is important for documenting support payment history in California. However, you may need to use other forms and documents alongside it to support your case. Here’s a list of commonly used forms that can help you navigate the legal landscape surrounding child support.

  • Child Support Order (CSO): This is a court document that specifies the amount of child support that must be paid. It's essential for setting the baseline payment obligations for both parents.
  • Income Verification Form: This form helps establish the income levels of both parents. Accurate income information is critical for determining fair child support amounts.
  • Modification Request Form: If there’s a need to change the child support agreement, this form initiates the process. It includes reasons for modification and supporting evidence.
  • Proof of Payment Receipts: These documents serve as evidence of payments made towards child support. Always keep detailed records of payments, as they may be needed to resolve disputes.
  • Declaration of Disclosure: This document requires both parties to disclose important financial information. Transparency is crucial in child support cases to avoid misunderstandings.
  • Health Insurance Verification Form: This form shows whether medical insurance is provided for the child. It helps keep track of health-related financial responsibilities.
  • Income Withholding Order: This order allows for the automatic deduction of child support payments from the paying parent's paycheck. It streamlines the payment process and ensures timely support.
  • Request for Hearing: If disputes arise regarding child support matters, this form can be submitted to the court to request a hearing. It ensures your concerns are addressed formally.
  • Exhibit A: This is optional but can include additional supporting documents related to income or expenses that affect child support. It provides detailed context to the court.

Having the right forms at your disposal can significantly ease the process of managing child support. Each document serves a purpose in helping to clarify responsibilities and rights. Make sure to fill out all forms accurately and promptly to avoid complications.

Similar forms

The Income Withholding for Support (IWO) form is often utilized in conjunction with support payment histories. Similar to the Double Elimination 20 form, the IWO outlines specific details regarding the amount of child support that should be withheld from an employee's paycheck. It ensures that the obligated parent meets their financial responsibilities consistently. The IWO requires the employer to deduct a specified amount and remit it directly to the designated child support agency. Both documents seek to assure that support payments are tracked and managed effectively, promoting accountability in family financial obligations.

The Child Support Guidelines Worksheet is another document that bears similarities to the Double Elimination 20 form. This worksheet is employed by the court to calculate the appropriate amount of child support based on a variety of factors, such as income and expenses of both parents. Just as the Double Elimination 20 form helps track payments, the guidelines worksheet assists in establishing payment amounts. By formalizing income and support obligations, both forms aim to ensure that children's needs are met across changing circumstances.

The Support Order form outlines the specific obligations of each parent, dictating the amount and type of support payable. Like the Double Elimination 20 form, the Support Order provides a clear framework for financial accountability. It details what was agreed upon by the court, including both child and spousal support. Both forms require accurate reporting and reinforce the importance of documenting financial activities related to family support.

The Declaration of Financial Information (DFI) form is another essential document related to support payment histories. The DFI captures a parent’s financial situation, including income, expenses, assets, and debts. This information can influence the determination of support payments, similar to the way the Double Elimination 20 form provides historical payment data to evaluate support obligations. Both forms play vital roles in providing transparency in the financial dynamics of a family unit.

The Child Support Enforcement (CSE) Registration provides a broader context for understanding support payments. This document may include information about multiple support orders and the corresponding payment history for all involved parties. Like the Double Elimination 20 form, it conveys essential details necessary for ensuring compliance with support obligations. Both documents work in tandem to facilitate the tracking and enforcement of child support across different jurisdictions.

Lastly, the Financial Affidavit form also serves a purpose akin to that of the Double Elimination 20 form. The Financial Affidavit presents a comprehensive view of an individual's financial status, which is crucial when establishing or modifying support obligations. By detailing income and expenditures, it helps in the assessment of fairness and necessity regarding support amounts. Both forms are integral in providing a structured approach to family finances and support responsibilities.

Dos and Don'ts

When filling out the Double Elimination 20 form, it is critical to pay attention to detail. Here are some guidelines to help you navigate this process effectively.

  • Do fill in the amount of support ordered by the court for each month accurately.
  • Do ensure the "Amount Paid" column reflects the total support paid in the month it was actually received.
  • Do keep your calculations organized and clear. Use neat handwriting or type the information if possible.
  • Do attach additional sheets if you need more space for entries.
  • Do double-check each figure before submitting the form to avoid errors.
  • Don't combine child support and spousal support unless specifically instructed by the court order.
  • Don't forget to include any details related to incarceration or institutionalization if applicable.
  • Don't include personal information that is not required by the form, as confidentiality concerns may arise.
  • Don't submit the form without signing and dating it, as this could render your submission invalid.

By following these points, you will increase the accuracy and effectiveness of your submission. Remember, clarity is key when it comes to legal documents.

Misconceptions

Understanding the Double Elimination 20 form can be crucial for individuals navigating support payment history in California. However, there are several misconceptions that might lead to confusion. Below is a list highlighting those misconceptions and clarifying the facts.

  • Misconception 1: The form is confidential.
  • This form is not confidential and can be shared with the other parent or party involved in the case.

  • Misconception 2: You only need to fill out the form if you have missed payments.
  • All parties may need to complete the form regardless of payment history to provide a comprehensive report.

  • Misconception 3: Payments can be reported for months not included in the court order.
  • You should only report payments that align with the timeframes specified in the legal order.

  • Misconception 4: You can combine different types of support payments on one form.
  • Each type of support, such as child support and spousal support, must be documented separately unless they are part of a combined "family" support order.

  • Misconception 5: The "Amount Ordered" section can be left blank if there are no changes.
  • You must complete this section with the amounts ordered by the court for each month, regardless of whether they have changed.

  • Misconception 6: You can use estimates for the amounts paid each month.
  • The form requires exact amounts. If multiple payments are made in a month, total those payments accurately.

  • Misconception 7: The form doesn’t need to be signed.
  • The declaration must be signed, affirming the truthfulness of the information provided under penalty of perjury.

  • Misconception 8: You do not need to keep proof of payments.
  • Both parties may be asked to provide proof of payments, such as canceled checks or receipts, particularly in cases of dispute.

Being aware of these misconceptions can simplify the process and ensure that the information reported is accurate and complete.

Key takeaways

When filling out the Double Elimination 20 form, it is essential to adhere to the specified guidelines to ensure accuracy and completeness. Here are key takeaways regarding the form's use:

  • Accurate Information Required: Provide the ordered support amount alongside the actual amounts paid for clarity.
  • Monthly Breakdown: Clearly indicate both the "Amount Ordered" and "Amount Paid" for each month since the support order began.
  • Changes in Support: If there have been changes in the court’s support order, reflect those adjustments in the relevant months.
  • Incarceration Details: If applicable, fill in the incarceration history of the other parent, noting details such as facility names and other pertinent information.
  • Separate Types of Support: Do not combine different support categories unless specified by your court order; keep child support distinct from spousal support unless required.
  • Public Document: Be aware that this Declaration is not confidential and may be shared with the other party in your case, so maintain thoroughness and accuracy.

Completing this form correctly is crucial for determining any past due support obligations. Prepare documentation such as receipts and cancelled checks as proof of payments when necessary.